| 제목 |
Association between Phonation and the Vowel Quadrilateral in Patients with Stroke |
| 소속 |
Kyung Hee University Hospital at Gangdong, Department of Rehabilitation Medicine1, Kyung Hee University Medical Center, Department of Rehabilitation Medicine2 |
| 저자 |
Eo Jin Park1*, Seung Don Yoo1†, Hee-Sang Kim2, Jong Ha Lee 2, Dong Hwan Yun2, Dong Hwan Kim1, Jinmann Chon 2, Seung Ah Lee1, Yun Soo Soh 2, Yong Kim2, Young Rok Han 1, Myung Chul Yoo2, Young Hwa Choi1 |
Objective: Dysarthria is associated with impaired control of respiration and speech organ movement. There are many cases of dysarthria and dysphonia in patients with stroke. Dysphonia adversely affects communication and social activities, and it can interfere with everyday life. The purpose of this study is to assess the association between phonation abilities and the vowel quadrilateral in patients with stroke.
Method: The subjects were the patients with articulation and phonation disorders of stroke. Formant parameters were measured for the four corner vowels (/a/, /u/, /i/ and /ae/) and was expressed in two-dimensional coordinates, reflecting the resonance frequency of the vocal cords. Vowel space area (VSA) and formant centralization ratio (FCR) were mesured for the four corner vowels. Phonation ability was evaluated by the Dysphonia Severity Index (DSI) and maximal phonation time (MPT) through acoustic evaluation for each vowel. Pearson's correlation analysis was performed to confirm the association, and multiple linear regression analysis was performed between variables.
Results: The mean age of the subjects was 66.33 ± 13.26 years, consisting of 17 men (56.67%) and 13 women (43.33%). The type of stroke was 18 ischemic stroke (60%), 12 hemorrahgic stroke (40%), and 17 brain stem lesions (56.67%) and 13 non-brain stem lesions(43.33%). The average Mini-Mental State Examination was 24.50 ± 3.21 and the modified Barthel index was 48.96 ± 20.96. The correlation coefficients of VSA and MPT/u/ were 0.420, VSA and MPT/i/ were 0.536, VSA and DSI/u/ were 0.392, VSA and DSI/i/ were 0.364, and FCR and DSI/i/ were -0.448. Multiple linear regression analysis showed that VSA was a factor significantly influencing MPT/u/ (β=0.420, p=0.021, R2=0.147), MPT/i/ (β=0.536, p=0.002, R2=0.262), DSI/u/ (β=0.564, p=0.045, R2=0.256), and DSI/i/ (β=0.6, p=0.03, R2=0.302).
Conclusion: This study showed that MPT/u/ and MPT/i/ were positive correlated with VSA. DSI/u/ and DSI/i/ were positive correlated with VSA. The vowel quadrilateral can be a useful tool for evaluating the phonation function of stroke patients. |
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Fig 1. Mean area of quadrilateral vowel space in the brain stem and non-brain stem subgroups
Table 1. Multiple linear regression of vowel quadrilateral parameters as a predictor of dysphonia
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