万萍医生的科普号

bstractA 35-year-old female patient with spasmodic dysphonia underwent massage and vocal training. Chinese manipulation was administered toTiantu(CV 22) andLianquan(CV 23), the convergent acupoints of the conception meridian andYinlink vessel,Yamen(GV 15) andFengfu(GV 16), the convergent acupoints ofDumeridian andYanglink vessel, as well as large intestine channel of handYangmingHegu(LI 4), by gently pressing and rubbing for stimulation. In addition, throat muscle massage therapy and vocal training were performed. Results were evaluated using acoustic measurements in combination with a single statistical method. A comprehensive treatment combining vocal training and face-neck massage was shown to relieve dystonia of facial-cervical muscles in patients, as well as improve voice quality while providing a safe treatment method.Key Words:spasmodic dysphonia; massage; vocal training; acoustic measurement; case report

AbstractObjectives:Liuzijue Qigong (LQG), a kind of traditional Chinese health exercise (TCHE), is not only widely used to strengthen physical fitness and maintain psychological well-being in the elderly but has also been utilized to help improve respiratory function. As respiratory support is an important driving force for speech production, it is logical to postulate that the LQG training method with 6 monosyllabic speech sounds,xū, hē, hū, sī, chuī, andxī, can help individuals (1) experience a relaxing and natural state of speech production, (2) eliminate voice symptoms, and (3) improve their overall body function and mood. In the current study, we hypothesized that the LQG method with these 6 sounds can be effective in improving vocal function in subjects with unilateral vocal fold paralysis (UVFP) in comparison with a conventional voice therapy method.Methods:A total of 48 patients with UVFP who met the inclusion criteria were randomly divided into 2 groups. Twenty-four subjects in the experimental group were trained with LQG, and those in the control group received conventional voice training (abdominal breathing and yawn-sign exercises) for a total of 4 sessions, twice a week. Patients in both groups were assessed with acoustic tests, the GRBAS scale, the Voice Handicap Index (VHI-10), and the Hospital Anxiety and Depression Scale (HADS) pre- and posttreatment. Statistical analysis was conducted using nonparametric tests andttests.Results:There existed significant changes in maximum phonation time (MPT), jitter, shimmer, normalized noise energy (NNE), GRBAS scores, VHI-10 scores, and grade of A in HADS scores pre- and posttreatment in both the experimental group and the control group (P<.004). However, no significant changes were seen posttreatment between the 2 groups (P>.05).Conclusions:LQG could help improve vocal function in UVFP patients as our preliminary data showed no significant differences between LQG and conventional voice therapy methods.

Abstract:Background:Studies have recognized that the damage in the subcortical and su- pratentorial regions may affect voluntary and involuntary aspects of the swallowing function. The current study attempted to explore the dysphagia characteristics in patients with subcortical and supratentorial stroke.Methods:Twelve post first or second subcortical and supratentorial stroke patients were included in the study. The location of the stroke was ascertained by computed tomography and mag- netic resonance imaging. The characteristics of swallowing disorder were assessed by video fluoroscopic swallowing assessment/fiberoptic endoscopic evaluation of swallowing. The following main parameters were analyzed: oral transit time, pha- ryngeal delay time, presence of cricopharyngeal muscle achalasia (CMA), distance of laryngeal elevation, the amounts of vallecular residue and pyriform sinus residue (PSR), and the extent of pharyngeal contraction.Results:Eighty-three percent of the 12 patients were found suffering from pharyngeal dysphagia, with 50% having 50%-100% PSRs, 50% having pharyngeal delay, and 41.6% cases demonstrating CMA. Simple regression analysis showed PSRs were most strongly associated with CMA. Pharyngeal delay in the study can be caused by infarcts of basal ganglia/ thalamus, infarcts of sensory tract, infarcts of swallowing motor pathways in the centrum semiovale, or a combination of the three.Conclusion:Subcortical and su- pratentorial stroke may result in pharyngeal dysphagia such as PSR and pharyngeal delay. PSR was mainly caused by CMA.Key Words:Subcortical and supratentorial stroke—dysphagia—cricopharyngeal muscle achalasia—pharyngeal delay. 2015 National Stroke Association. Published by Elsevier Inc. All rights reserved.