Objective To investigate the correlation between voice fatigue index(VFI)and the subjective and objective assessment results of voice impairment.Methods Fifty-one patients with voice disorders and 48 normal subjects were selected for VFI assessment and comparison of the differences in scores between the two groups.Sub-jective voice handicap index(VHI)and objective acoustic assessment were performed on the patients with voice dis-orders to analyze the correlation between VFI scores and the results of subjective and objective assessment of voice disorders.Results There was significant difference of the VFI scores between the voice disorder patients and the control group,with the total VFI score,part Ⅰ and part Ⅱ scores higher than those of control group,and the partⅢ score lower than those of the control group(P＜0.05),and there was a strong correlation between the total and part VFI scores and the total and part VHI scores(P＜0.05 or P＜0.01).The VFI part Ⅰ and part Ⅱ scores were regatively correlated with the I-low(P＜0.05),but there was not a significant correlation with the other acoustics parameters and the dysphonia severity index(DSI)(P＞0.05).Conclusion Voice fatigue symptoms were more prominent in the voice-impaired population,and the VFI score was significantly correlated with the subjective voice disorder severity,but the correlation with the objective acoustic parameters was not significant.

Objective To investigate the correlation between voice fatigue index(VFI)and the subjective and objective assessment results of voice impairment.Methods Fifty-one patients with voice disorders and 48 normal subjects were selected for VFI assessment and comparison of the differences in scores between the two groups.Sub-jective voice handicap index(VHI)and objective acoustic assessment were performed on the patients with voice dis-orders to analyze the correlation between VFI scores and the results of subjective and objective assessment of voice disorders.Results There was significant difference of the VFI scores between the voice disorder patients and the control group,with the total VFI score,part Ⅰ and part Ⅱ scores higher than those of control group,and the partⅢ score lower than those of the control group(P＜0.05),and there was a strong correlation between the total and part VFI scores and the total and part VHI scores(P＜0.05 or P＜0.01).The VFI part Ⅰ and part Ⅱ scores were regatively correlated with the I-low(P＜0.05),but there was not a significant correlation with the other acoustics parameters and the dysphonia severity index(DSI)(P＞0.05).Conclusion Voice fatigue symptoms were more prominent in the voice-impaired population,and the VFI score was significantly correlated with the subjective voice disorder severity,but the correlation with the objective acoustic parameters was not significant.

Objective To compare the effect of routine speech training and computer-assisted training on post-stroke dysarthria. Methods From March,2021 to April,2023,72 patients with post-stroke dysarthria in Beijing Bo'ai Hospital were ran-domly divided into control group(n=36)and experimental group(n=36).Both groups received routine rehabili-tation,while the control group received routine speech training,and the experimental group received computer-assisted training,for four weeks.They were assessed with modified Frenchay Dysarthria Assessment(m-FDA)and Speech Intelligibility(SI)before and after intervention. Results Eight cases in the control group and one case in the experimental group dropped down.The scores of m-FDA and SI improved in both groups after treatment(|Z|＞4.183,P＜0.001),and there was no significant difference between two groups(|Z|＜1.598,P＞0.05).Noninferiority of m-FDA was found between two groups(|t|＞3.656,P＜0.001). Conclusion Computer-assisted training could improve the speech function of patients with post-stroke dysarthria,simi-lar to routine speech training.

Objective To investigate the relationship between motor function of articulation organs and speech intelligibility(SI)in patients with dysarthria after stroke. Methods A total of 67 patients with dysarthria after stroke in Beijing Bo'ai Hospital from November,2020 to October,2023 were collected.They were assessed with SI test and Frenchay Dysarthria Assessment(FDA).The patients were divided into low SI group(SI≤65%)and high SI group(SI>65%). Results All the sub-scores of FDA were lower in the high SI group than in the low SI group(Z>1.543,P<0.05),except that of the jaw;and the SI was negatively pairwise correlated with FDA sub-scores(r<-0.343,P<0.001),espe-cially with the lip,tongue and laryngeal(r<-0.6). Conclusion The motor function of articulation organs may be related to SI in patients with dysarthria after stroke,espe-cially the lip,tongue and laryngeal.

Objective:To observe the clinical effect when Lee Silverman voice therapy (LSVT) is used to treat stroke survivors with dysarthria.Methods:Forty-nine stroke survivors with dysarthria were randomly divided into a control group ( n=25) and a treatment group ( n=24). The control group received conventional treatment, while the treatment group received daily one-hour sessions of LSVT, 4 times per week for 4 weeks. Before and after the treatment, both groups were given a speech intelligibility (SI) test, a Frenchay dysarthria assessment (FDA), and acoustic analysis including intensity, pitch, triangular vowel space area (tVSA), vowel articulation index (VAI), and formant centralization ratio (FCR). Their maximum phonation time (MPT) was measured and a voice handicap index (VHI) was assigned. Results:Before and after treatment, there were significant differences in VHI observed in the observation group, as well as significant differences in their average SI, FDA, MPT, tVSA, VAI and FCR values. In the control group the significant changes were limited to the VAI, FDA, MPT and FCR measurements. However, after the intervention, no significant differences were found between the two groups in VAI, nor in their SI, FDA, VHI, MPT, intensity, pitch, tVSA and FCR scores.Conclusions:LSVT has similar therapeutic effects to conventional treatment in relieving voice impairment, improving speech intelligibility, improving the motor functioning of articulation organs and improving the articulation accuracy of stroke survivors with dysarthria. Therefore, it is worthy of clinical application.

Objective:To observe the clinical effect when Lee Silverman voice therapy (LSVT) is used to treat stroke survivors with dysarthria.Methods:Forty-nine stroke survivors with dysarthria were randomly divided into a control group ( n=25) and a treatment group ( n=24). The control group received conventional treatment, while the treatment group received daily one-hour sessions of LSVT, 4 times per week for 4 weeks. Before and after the treatment, both groups were given a speech intelligibility (SI) test, a Frenchay dysarthria assessment (FDA), and acoustic analysis including intensity, pitch, triangular vowel space area (tVSA), vowel articulation index (VAI), and formant centralization ratio (FCR). Their maximum phonation time (MPT) was measured and a voice handicap index (VHI) was assigned. Results:Before and after treatment, there were significant differences in VHI observed in the observation group, as well as significant differences in their average SI, FDA, MPT, tVSA, VAI and FCR values. In the control group the significant changes were limited to the VAI, FDA, MPT and FCR measurements. However, after the intervention, no significant differences were found between the two groups in VAI, nor in their SI, FDA, VHI, MPT, intensity, pitch, tVSA and FCR scores.Conclusions:LSVT has similar therapeutic effects to conventional treatment in relieving voice impairment, improving speech intelligibility, improving the motor functioning of articulation organs and improving the articulation accuracy of stroke survivors with dysarthria. Therefore, it is worthy of clinical application.

Objective:To analyze the factors influencing dysphagia after an injury to the cervical spinal cord (CPCI) to provide a basis for clinical screening and intervention.Methods:A total of 110 CPCI patients with dysphagia were divided into a severe dysphagia group ( n=19), a mild dysphagia group ( n=35), and a control group ( n=56) according to their functional oral intake scale scores. Data on gender, age, level of injury, degree of damage, duration of injury, causes of injury, surgical mode, tracheotomy status, occurrence of pneumonia and pharynx swelling were collected. Univariate and multivariate logistic regressions were evaluated to identify factors affecting swallowing. Results:The regressions highlighted age, the severity of the spinal cord injury, tracheotomy status, and the occurrence of pneumonia and pharyngeal swelling during hospitalization as the best predictors of swallowing difficulties. Multifactoral logistic regression analysis revealed that undergoing tracheotomy and catching pneumonia during hospitalization were major risk factors for severe dysphagia.Conclusions:Tracheotomy and pneumonia during hospitalization are useful predictors of severe dysphagia after a cervical spinal cord injury.

Objective To explore the factors related to the recovery of nil per os (NPO) patients after stroke by retrospective data analysis, and to establish a predictive model.Methods The information of demographics, evaluation and treatment of 141 stroke patients admitted to the Hearing and Language Department in Beijing Bo'ai Hospital from April, 2017 to November, 2020 were selected. The predictive model was established by univariate analysis and Logistic regression. The fitting degree and discriminant validity of the model were evaluated by Hosmer-Lemeshow (H-L) test and receiver operating characteristic (ROC) curve. Other 121 patients with post-stroke dysphagia from December, 2020 to November, 2021 were used as the validation set to verify the model.Results For univariate analysis, National Institute of Health Stroke Scale (NIHSS) score, drinking water test results, autonomous cough ability, cough after swallowing, movement ability of tongue and jaw, and electrical stimulation treatment were significantly associated with the outcome (H=65.803, χ2 > 4.623, P<0.05). Multivariate Logistic regression analysis showed that NIHSS score (X1, OR=0.772, 95%CI 0.64 to 0.82, P<0.001), spontaneous cough ability (X2, OR=5.116, 95%CI 1.28 to 20.41, P=0.021), and electrical stimulation during treatment (X3, OR=94.718, 95%CI 5.65 to 1589.26, P=0.002) were independent factors for the outcome of swallowing function. Thus, the predictive model was P=11+e−(2.368−0.325X1+1.632X2+4.551X3) P = 1 1 + e - ( 2.368 - 0.325 X 1 + 1.632 X 2 + 4.551 X 3 ) , which was well fitting (P=0.845), with the largest area under curve (0.884). The overall accuracy of the model in the validation set was 91.7%.Conclusion The patients with dysphagia would like to recover well if he/she was with lower NIHSS scores and normal autonomous cough ability; meanwhile, the addition of electrical stimulation therapy in comprehensive rehabilitation may be helpful. A predictive model has been established, which needs a further research.

ObjectiveTo investigate the abnormal changes of gray matter structure covariant network in post-stroke aphasia (PSA) patients. MethodsFrom June, 2019 to March, 2022, 15 PSA patients (patient group) from Dongzhimen Hospital, Beijing University of Chinese Medicine and Beijing Bo'ai Hospital were recruited, as well as 15 healthy subjects (control group). Their brain structure magnetic resonance imaging data were collected. The brain covariant network was constructed based on gray matter volume correlation, and graph theory analysis method was used to evaluate the global and node network level topology properties of structural covariant network. The differences of gray matter covariant network properties between patients and controls were compared. ResultsThere was no significant difference in the global network level topology properties between two groups (P > 0.05). At the nodal level, compared with the control group, the betweenness decreased in the right middle frontal gyrus, right posterior cingulate gyrus, right amygdala, left middle occipital gyrus, and increased in the right inferior frontal gyrus and the right suboccipital gyrus of the insula operculum (P < 0.05); the node degree decreased in the left superior frontal gyrus, left anterior cingulate and paracingulate gyrus, left hippocampus and left amygdala, while it increased in the right inferior frontal gyrus, left supplementary motor area, right superior occipital gyrus, right inferior occipital gyrus, and right lentiform pallidus (P < 0.05); the node efficiency decreased in the left anterior cingulate and paracingulate gyrus, left hippocampus, left amygdala, left temporal pole: superior temporal gyrus, and increased in the inferior frontal gyrus of right insula, left supplementary motor area and right suboccipital gyrus (P < 0.05). ConclusionThe abnormal reduction of node network properties in some brain regions in the left hemisphere of PSA patients may be a characteristic structural covariation pattern, and there may be some compensation in the right hemisphere of the structural network in some brain regions.

Objective To explore the rehabilitation for chorea after bilateral thalamus hemorrhage. Methods A case was reviewed. Re-sults The score of Fugl-Meyer Assessment of balance increased from 0 to 7, the modified Barthel Index increased from 25 to 50, and the co-ordination of movement improved significantly after rehabilitation treatment. Conclusion Early comprehensive rehabilitation may reduce the chorea movement, improve the activities of daily living and balance for chorea after bilateral thalamus hemorrhage.