The Application Of The Voice Realtime Accent Method Treatment On Speech Dysfunction In Patients With Parkinson’s Disease

Among neurological disorders examined in the Global Burden of Disease,Injuries,and Risk Factors Study(GBD)2015,Parkinson’s disease was the fastest growing in prevalence,disability,and deaths.Nearly 90% of Parkinson’s disease patients have varying degrees of speech disorder,in which low loudness is a typical symptom,and abnormal loudness perception is an important cause of low loudness in Parkinson’s disease patients,which will lead to low speech intelligibility and affect the quality of daily communication.The Accent Method(AM)is a commonly used intervention method for voice and speech disorders in clinic.it takes rhythm as the core element to build the framework of voice and articulation training to help patients obtain breathing,phonation,articulation and coordination between body movement and speech,to alleviate the pathological symptoms of speech function.Based on the analysis of the characteristics of speech function in patients with Parkinson’s disease,the purpose of this study is to put forward a voice real-time Accent Method which combines stress therapy with loudness perception calibration,and to explore the feasibility of this therapy in the intervention of speech disorder in this kind of patients.the specific contents of the study are as follows:1.Study Ⅰ: to explore the characteristics of speech function in patients with Parkinson’s disease.The functional characteristics of each speech subsystem of patients with Parkinson’s disease were analyzed by subjective and objective assessment tools.The results showed that compared with normal adults,Parkinson’s disease patients had poor speech function and significantly decreased speech prosodic function.in the objective speech acoustic evaluation,the respiratory and vocal function parameters(MPT,MCA,average intensity,etc.)of Parkinson’s disease patients were lower than those of normal adults,and the phonation quality(Jitter,Shimmer,NNE)parameters of Parkinson’s disease patients were higher than those of normal adults,showing rough sound quality,hoarseness or accompanied by breath sounds.There was no significant difference in resonance function between normal adults and normal adults.The space area of vowels decreased in the evaluation of articulation,which showed the trend of centralization of articulation and insufficient movement of articulation.2.Study Ⅱ,develop the Voice Real-time Accent Method(v RAM)strategy.Based on previous studies,combined AM and loudness perception calibration,the real-time audio-visual feedback technology was used to calibrate the loudness perception of patients with Parkinson’s disease,and the v RAM is initially constructed.In this study,we compared the effects of v RAM,which emphasizes the development of respiration,vocalization,and arousal,and LSVT LOUD,which only emphasizes a single dimension(vocalization intensity),on speech disorders in patients with Parkinson’s disease.The results showed that compared with LSVT LOUD,v RAM could not only improve respiratory coordination and speech loudness,but also be more beneficial to the improvement of phonation quality and articulation ability.On this basis,the v RAM strategy is further adjusted.3.Study Ⅲ,a single group of pre-and post-test experiments were used to verify the efficacy of the v RAM on speech function in patients with Parkinson’s disease.The results showed that after two weeks of the v RAM treatment,the respiratory function,loudness,voice quality and articulation function of the patients were significantly improved.The innovation of this study and its theoretical and practical significance:On the basis of absorbing the respective advantages of the Accent Method and LSVT LOUD therapy,the intervention effect of the v RAM on speech disorder in patients with Parkinson’s disease was proposed and verified.The characteristics of the therapy are as follows:(1)emphasizing the auditory calibration training of loudness;(2)emphasizing the real-time speech feedback during training and reflecting the therapeutic effect through objective indicators;(3)based on Mandarin,it provides a wealth of words and sentences for training,which provides a set of feasible intervention measures for clinical speech rehabilitation training for patients with Parkinson’s disease.