CN106530852B - Breathe structure sound training device and its training method - Google Patents
Breathe structure sound training device and its training method Download PDFInfo
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Abstract
A kind of breathing structure sound training device and its training method, the patient for being appropriate for breathing structure sound training is filtered out using patient's selecting module, preceding pronunciation evaluation is instructed to selected patient using therapeutic evaluation module, " word rhymed formula " is carried out to patient using breathing pronunciation training module and breathes pronunciation training, basic structure sound training is carried out to patient using basic structure sound training module, breathing pronunciation training and basic structure sound are carried out after training, therapeutic evaluation after being instructed using therapeutic evaluation module to patient, according to therapeutic evaluation after pronunciation evaluation before instructing and instruction, determine training front and back difference and training effect.The present invention combines basic structure sound training with word rhymed formula, breach the difficulties of the adnormal respiration in speech training, control of breathing ability when to patient's speech has clear improvement, Articulation ability can be improved comprehensively, provide effective, easy, inexpensive speech rehabilitation method for dysarthria-control of breathing exception patient.
Description
Technical field
The present invention relates to a kind of breathing structure sound training device and its training methods.
Background technique
The structure system for electrical teaching of human body includes respiratory system, sonification system, sympathetic response, structure sound, voice system.Wherein respiratory system packet
Include larynx trachea-bronchial epithelial cell below, lung, thorax and related respiratory muscle.Respiratory system is the power source of speech, is only passed through
Breathing generates air-flow, impacts vocal cord vibration, the activity of other structure sound organs in addition could sounding.Speech is formed when exhaling
, such as say one section of word, it is necessary to extend the process of expiration, and breathing process will shorten as far as possible.
Dysarthria, abbreviation dysarthrosis are since neuropathy and speech generate the fiber crops in relation to muscle
Numbness, convergent force weaken or move uncoordinated caused disfluency, and the lesion from brain to muscle in itself all can cause speech different
Often.The cause of disease is often brain trauma, cerebral apoplexy, brain tumor, brain paralysis, amyotrophic lateral sclerosis, myasthenia gravis, cerebellar lesion, pa
Golden Sen Shi disease, multiple sclerosis etc..It shows as not assisting because of muscle inability, paralysis or the dystonia of vocal organs and movement
Adjust etc. and occur sounding, pronunciation, sympathetic response, the rhythm, pronounce indistinctly etc. abnormal, volume, tone, speed, the rhythm and pace of moving things, the rhythm are abnormal,
Hypernasality, wherein speech process control of breathing is the basic reason for causing structure mail to be inscribed extremely, as breathing pattern is abnormal, breathing
Miopragia, air-breathing and expiration inaccurate coordination play the problems such as sound is abnormal.
For these diseases, breathing Muscle tensility is high, Muscle tensility is low or Muscle tensility is uncoordinated, causes respiratory muscle strength
Weak, expiratory duration is short or air-flow is uncoordinated, is the major reason of dysarthrosis.
Trainer often lays particular emphasis on the training of mouth face structure sound organ as emphasis, ignores edge in breathing problem, or training
With traditional breathing pronunciation training scheme, ignore the synchronous training of pronunciation with breathing, strengthen muscular strength simply, deliberately changes breathing mould
Formula, patient compliance is poor, is unfavorable for restoring instead.
Summary of the invention
The present invention provides a kind of breathing structure sound training device and its training method, combines basic structure sound training with word rhymed formula, dashes forward
The difficulties for having broken the adnormal respiration in speech training, control of breathing ability when to patient's speech have clear improvement, can
Articulation ability is improved comprehensively, provides effective, easy, inexpensive speech for dysarthria-control of breathing exception patient
Language method of rehabilitation.
In order to achieve the above object, the present invention provides a kind of breathing structure sound training device, includes:
Patient's selecting module, for classifying and filtering out the patient for being appropriate for breathing structure sound and training to patient；
Pronunciation training module is breathed, synchronizes training for carrying out breathing pronunciation to patient；
Basic structure sound training module, for carrying out basic structure sound training to patient；
Therapeutic evaluation module, for determining the training effect of patient.
The breathing pronunciation training module includes:
Media playing apparatus, for playing breathing pronunciation training " word rhymed formula " pronunciation mouth shape and the demonstration of limbs guiding action；
Air-flow reception device, for receiving and measuring respiratory air flow；
Decibel tester, for acquiring intensity of sound data；
Sound frequency tester, for acquiring sound frequency data；
Air-flow harmony cent shellfish monitors feedback apparatus, connection air-flow reception device, decibel tester and sound frequency test
Instrument, for showing the acquisition data of air-flow and sound, Real-time Feedback is to patient, and adjust automatically breathes and the target value of pronunciation；
Limbs guide auxiliary apparatus completes breathing pronunciation training for assisting patient to adjust limbs state.
The limbs guide auxiliary apparatus includes: electronic standing bed, standing-rack, seat.
The basic structure sound training module includes:
Media playing apparatus, for playing the training action demonstration and voice training demonstration of lip, tongue, lower jaw；
Decibel tester, for acquiring intensity of sound data；
Sound frequency tester, for acquiring sound frequency data.
The present invention also provides a kind of breathing structure sound training methods comprising the steps of:
Step S1, the patient for being appropriate for breathing structure sound training is filtered out using patient's selecting module；
Step S2, preceding pronunciation evaluation is instructed to selected patient using therapeutic evaluation module, to determine the serious of dysarthrosis
Degree；
Step S3, " word rhymed formula " is carried out to patient using breathing pronunciation training module and breathes pronunciation training；
Step S4, basic structure sound training is carried out to patient using basic structure sound training module；
Step S5, breathing pronunciation training and basic structure sound are being carried out after training, using therapeutic evaluation module to patient
Therapeutic evaluation after instructing；
Step S6, therapeutic evaluation module according to instruct before pronunciation evaluation and instruction after therapeutic evaluation, determine training front and back difference and
Training effect.
In the step S1, the patient for being appropriate for breathing structure sound training need to meet into a group condition, and described enters a group item
Part includes:
Through the evaluation of Frenchay dysarthrosis evaluation charter, there are dysarthrosis, and respiratory function severity is commented when speech
Deciding grade and level not >=b grades；
It is tolerable to complete 40 minutes speech training persons；
Seat balance reaches 3 grades；
At least unilateral upper extremity exercise function is normal or at least unilateral upper limb Brunnstrom >=4 grade.
In the step S3, carry out breathing pronunciation training method comprising the following steps:
Step S3.1, breathing pronunciation training " word rhymed formula " pronunciation mouth shape, respiratory air flow method are played using media playing apparatus
It is demonstrated with limbs guiding action；
Step S3.2, limbs state is adjusted using limbs guide auxiliary apparatus auxiliary patient；
Step S3.3, patient follows multimedia presentation to carry out " word rhymed formula " pronunciation breathing pronunciation training, until pronunciation breathing
Air-flow and sound reach target value.
" the word rhymed formula " includes according to pronunciation sequence: it hisses, breathe out, exhaling, Xi, blow, play, specific pronunciation requires as follows:
Hiss: the corners of the mouth draws after tightening, flat pair up and down of molar, in stay gap, molar interspaces with tongue side, breath main points for from
Pass through between molar, in the gap on tongue both sides, slowly goes out；
Breathe out: molar is gently sticked on the micro- arch of tongue body, tongue side, and breath main points are slowly to go out between maxilla from tongue；
Exhale: tongue body sinking, lip pinch circle, face throat, breath main points are direct oral cavity middle part and a pinch mouth for circle after going out from larynx
Lip slowly goes out；
Xi: upper and lower front tooth alignment is loosened, in stay slit, after the lower tooth of tongue top, breath main points are from the flat submitting of between cog；
It blows: drawing after tongue body and the corners of the mouth, molar is opposite, and two lips pull open tightening to two sides, forms narrow gap, breath main points in front
To go out from larynx, under saying more than is proper through tongue both sides, slowly go out through narrow gap between lip；
Play: the corners of the mouth draws after loosening, and molar is flat up and down, and to being gently engaged, whole oral cavity breath is flattened, and breath main points are from slot
By slowly going out in the gap of tooth.
The method for adjusting limbs state using limbs guide auxiliary apparatus auxiliary patient includes:
Patient normal for motor function, without adjusting limbs state；
For there is standing, seat balance difficulties person, limbs guiding is completed using electronic standing bed, standing-rack, seat etc..
Breathing pronunciation training is carried out using abdominal respiration.
In patient's training process, respiratory air flow is received and measured using air-flow reception device, is adopted using decibel tester
Collect intensity of sound data, sound frequency data are acquired using sound frequency tester, is monitored and is fed back using air-flow harmony cent shellfish
The acquisition data Real-time Feedback of instrument display air-flow and sound is to patient, and adjust automatically breathes and the target value of pronunciation.
In the step S4, carry out the method for basic structure sound training comprising the following steps:
Step S4.1, lip, tongue, the training action demonstration of lower jaw and voice training is played using media playing apparatus to demonstrate；
Step S4.2, patient follows multimedia presentation to carry out lip, tongue, the training of lower jaw and voice training, until patient
Intensity of sound and sound frequency reach target value.
The training of the lip includes: the expansion of tongue, closure, preceding prominent, the extension of rear shrink movement, tongue, retraction, upper act；
The training of the tongue includes: extension, retraction, upper act and the lateral movement of tongue；
The training of the lower jaw includes: patting the skin near lower jaw central part and temporomandibular joint with hand；
The voice training includes: first sending out vowel, then sends out bilabial sound consonant, then by the consonant learned in conjunction with vowel
It trains, takes vowel+consonant+vowel form to continue to train after people, be finally transitioned into trained word and sentence.
In patient's training process, intensity of sound data are acquired using decibel tester, are adopted using sound frequency tester
Collect sound frequency data, the data Real-time Feedback of acquisition is to patient.
In the step S2 and step S5, therapeutic evaluation module instructs preceding hair to selected patient using primary evaluation index
Therapeutic evaluation after sound assessment and instruction, obtains patient's rating.
The primary evaluation index includes: the respiration in speech special project evaluation in Frenchary dysarthrosis evaluation table refers to
Mark and/or longest sound Shi Zhibiao.
The respiration in speech special project deliberated index is divided into five ranks of a, b, c, d, e by degree of injury:
A grades refer to the exception that breathes no more；
B grades refer to that, since control of breathing is poor, fluency pole is destroyed by accident, and patient may state that he feels to stop
Get off and deeply breathe, that is, an additional breathing is needed to complete this requirement；
C grades refer to that patient must say fastly, because control of breathing is poor, sound may disappear, and patient may need to exhale for 4 times
Suction could complete this requirement；
D grades refer to that patient's air-breathing or expiration are spoken, or breathing very table is shallow, can only use several words, uncoordinated, and have
Apparent changeability, patient may need 7 breathings that could complete this requirement；
E grades refer to that speech is seriously hampered due to entirely breathing shortage control, and possible 1 breathing can only say 1 word.
Index refers to when the described longest sound: patient continues the maximum duration of bill simple or compound vowel of a Chinese syllable/a/ after deep air-breathing.
When primary evaluation index can not carry out completely, preceding pronunciation evaluation is instructed to selected patient using secondary evaluation index
With therapeutic evaluation after instruction.
The secondary evaluation index includes: the respiration in speech special project evaluation in Frenchary dysarthrosis evaluation table refers to
The combination of one or more of mark, maximum number number ability, S/Z ratio, response grading index index.
The maximum number number ability refers to that a people after deep air-breathing, continuously says 1 maximum duration without a break, it is desirable that hair
The tone and loudness of sound are controlled in comfort level；
The S/Z ratio refer to patient after deep air-breathing, respectively hair/s/ sound and/z/ sound, calculate both longest sounding when
Between ratio；
The response grading index includes five loudness scales: whispered sound is 0-20 decibels；It is softly 20-40 decibels；
Talk sound is 40-60 decibels；Loud is 60-70 decibels；Shouting sound is 70 or more decibels.
In the step S6, determine training front and back difference and training effect method comprising the following steps:
It is evaluated according to the respiration in speech special project deliberated index in Frenchary dysarthrosis evaluation table: to hair before instruction
Patient's rating that therapeutic evaluation obtains after patient's rating and instruction that sound assessment obtains is compared, if grade reduces
More than or equal to 2 grades or be reduced to a grades, then evaluate training it is effective, if grade is reduced more than equal to 1 grade, less than 2
Grade then evaluates training effectively, if grade is unchanged or grade increases, evaluates training in vain, carries out refreshment；
It is evaluated according to index MPT when longest sound: MPT training front and back rate of change is judged, if rate of change is less than or equal to
5%, then it evaluates training in vain, carries out refreshment；
Wherein, after MPT training front and back rate of change (%)=MPT training before-MPT training before/MPT training × 100%；
Alternatively, being evaluated according to maximum number number ability: rate of change before and after maximum number number ability training is judged, if changed
Rate is less than or equal to 5%, then evaluates training in vain, carry out refreshment；
Before and after maximum number number ability training after rate of change (%)=maximum number number ability training-maximum number number ability training before/
Before maximum number number ability training × 100%；
Alternatively, being evaluated according to S/Z ratio: judge S/Z training front and back rate of change, if rate of change is less than or equal to 5%,
It is invalid then to evaluate training, carries out refreshment；
After S/Z training front and back rate of change (%)=S/Z training before-S/Z training/S/Z training before × 100%；
Alternatively, grading index is evaluated according to response: it is more than or equal to 2 grades if grade increases or is reduced to a grades,
It is effective then to evaluate training, if grade, which increases, is more than or equal to 1 grade, less than 2 grades then evaluate training effectively, if waited
Grade is unchanged or grade declines, then evaluates training in vain, carry out refreshment.
The present invention combines basic structure sound training with word rhymed formula, breaches the difficulties of the adnormal respiration in speech training, right
Control of breathing ability when patient's speech has clear improvement, and can improve Articulation ability comprehensively, is dysarthria-breathing
The abnormal patient of control provides effective, easy, inexpensive speech rehabilitation method.
Detailed description of the invention
Fig. 1 is a kind of structural schematic diagram for breathing structure sound training device provided by the invention.
Fig. 2 is a kind of flow chart for breathing structure sound training method provided by the invention.
Specific embodiment
Below according to FIG. 1 to FIG. 2, presently preferred embodiments of the present invention is illustrated.
As shown in Figure 1, the present invention provides a kind of breathing structure sound training device, include:
Patient's selecting module 1, for classifying and filtering out the patient for being appropriate for breathing structure sound and training to patient；
Pronunciation training module 2 is breathed, synchronizes training for carrying out breathing pronunciation to patient；
Basic structure sound training module 3, for carrying out basic structure sound training to patient；
Therapeutic evaluation module 4, for determining the training effect of patient.
The breathing pronunciation training module 2 includes:
Media playing apparatus, for playing breathing pronunciation training " word rhymed formula " pronunciation mouth shape and the demonstration of limbs guiding action, with
Just patient is trained according to demonstration；
Air-flow reception device, for receiving and measuring respiratory air flow；The air-flow reception device includes air-flow receiver
And such as air blowing cylinder device can be used in flow sensor, air-flow receiver, air-flow receiver collects respiratory air flow, will pass through flow
Sensor can obtain flow and total flow in the unit time for generating air-flow in patient expiration and breathing process, and being converted into can
Display signal is simultaneously shown in air-flow harmony cent shellfish monitoring feedback apparatus；Decibel tester, for acquiring intensity of sound number
According to；
Sound frequency tester, for acquiring sound frequency data；
Air-flow harmony cent shellfish monitors feedback apparatus, connection air-flow reception device, decibel tester and sound frequency test
Instrument, for showing the acquisition data of air-flow and sound；
Limbs guide auxiliary apparatus completes breathing pronunciation training for assisting patient to adjust limbs state.
The limbs guide auxiliary apparatus includes: electronic standing bed, standing-rack, seat etc..
The basic structure sound training module 3 includes:
Media playing apparatus, for playing the training action demonstration and voice training demonstration of lip, tongue, lower jaw, so as to patient
It is trained according to demonstration；
Decibel tester, for acquiring intensity of sound data；
Sound frequency tester, for acquiring sound frequency data.
As shown in Fig. 2, the present invention also provides a kind of breathing structure sound training methods comprising the steps of:
Step S1, the patient for being appropriate for breathing structure sound training is filtered out using patient's selecting module；
Step S2, preceding pronunciation evaluation is instructed to selected patient using therapeutic evaluation module, to determine the serious of dysarthrosis
Degree；
Step S3, breathing pronunciation training is carried out to patient using breathing pronunciation training module；
Step S4, basic structure sound training is carried out to patient using basic structure sound training module；
Step S5, breathing pronunciation training and basic structure sound are being carried out after training, using therapeutic evaluation module to patient
Therapeutic evaluation after instructing；
Step S6, therapeutic evaluation module according to instruct before pronunciation evaluation and instruction after therapeutic evaluation, determine training front and back difference and
Training effect.
In the step S1, the patient for being appropriate for breathing structure sound training need to meet into a group condition, and described enters a group item
Part includes:
Through Frenchay dysarthrosis evaluation charter (recovery centre, the people's hospital of Heibei revises) evaluation, there are structure sound barriers
Hinder, and respiratory function severity evaluates rank >=b grades when speech；
Physical strength is preferable, can tolerate and completes 40 minutes speech training persons；
Seat balance reaches 3 grades and (applies thrust from each different directions all around to patient i.e. under static balancing, beat
Broken static balancing, adjusts patient as early as possible and reaches equilibrium state)；
At least unilateral upper extremity exercise function is normal or at least unilateral upper limb Brunnstrom >=4 grade (Brunnstrom technology
Be by the 1970s Sweden physics trainer Signe Brunnstrom found a set of central lesion after
For the training method of dyskinesia, main each different phase according to patient motion functional rehabilitation, proposition " restores six ranks
Section " is theoretical: i.e. Muscle tensility is gradually increased by low, and association response, associated movement, spasticity are gradually significant, with associated movement
Completion, there is disengaging movement, fine movement etc., until restoring completely normal).
In the step S3, carry out breathing pronunciation training method comprising the following steps:
Step S3.1, breathing pronunciation training " word rhymed formula " pronunciation mouth shape, respiratory air flow method are played using media playing apparatus
It is demonstrated with limbs guiding action；
Step S3.2, limbs state is adjusted using limbs guide auxiliary apparatus auxiliary patient；
Step S3.3, patient follows multimedia presentation to carry out " word rhymed formula " pronunciation breathing pronunciation training, until pronunciation breathing
Air-flow and sound reach target value.
In patient's training process, respiratory air flow is received and measured using air-flow reception device, is adopted using decibel tester
Collect intensity of sound data, sound frequency data are acquired using sound frequency tester, is monitored and is fed back using air-flow harmony cent shellfish
Instrument shows the acquisition data of air-flow and sound.It is set objectives in real time value according to the measurement situation of air-flow and sound, if not up to
Target value, then the prompt of air-flow harmony cent shellfish monitoring feedback apparatus and guidance patient are toward target value effort, for example, can set target value
Being set to intensity of sound is 30-70 decibels, sound frequency 20HZ-20000HZ.
" the word rhymed formula " includes according to pronunciation sequence: it hisses, breathe out, exhaling, Xi, blow, play, specific pronunciation requires as follows:
Hiss: the corners of the mouth draws after tightening, flat pair up and down of molar, in stay gap, molar interspaces with tongue side, breath main points for from
Pass through between molar, in the gap on tongue both sides, slowly goes out；
Breathe out: molar is gently sticked on the micro- arch of tongue body, tongue side, and breath main points are slowly to go out between maxilla from tongue；
Exhale: tongue body sinking, lip pinch circle, face throat, breath main points are direct oral cavity middle part and a pinch mouth for circle after going out from larynx
Lip slowly goes out；
Xi: upper and lower front tooth alignment is loosened, in stay slit, after the lower tooth of tongue top, breath main points are from the flat submitting of between cog；
It blows: drawing after tongue body and the corners of the mouth, molar is opposite, and two lips pull open tightening to two sides, forms narrow gap, breath main points in front
To go out from larynx, under saying more than is proper through tongue both sides, slowly go out through narrow gap between lip；
Play: the corners of the mouth draws after loosening, and molar is flat up and down, and to being gently engaged, whole oral cavity breath is flattened, and breath main points are from slot
By slowly going out in the gap of tooth.
The method for adjusting limbs state using limbs guide auxiliary apparatus auxiliary patient includes:
Patient normal for motor function, without adjusting limbs state；
For there is standing, seat balance difficulties person, limbs guiding is completed using electronic standing bed, standing-rack, seat etc..
Breathing pronunciation training is carried out using abdominal respiration.
In the step S4, carry out the method for basic structure sound training comprising the following steps:
Step S4.1, lip, tongue, the training action demonstration of lower jaw and voice training is played using media playing apparatus to demonstrate；
Step S4.2, patient follows multimedia presentation to carry out lip, tongue, the training of lower jaw and voice training；
Step S4.3, in patient's training process, intensity of sound data are acquired using decibel tester, using sound frequency
Tester acquires sound frequency data, it is desirable that the intensity of sound and sound frequency of patient reaches target value, for example, target value can be set
Be set to: intensity of sound control is being 30-70 decibels, and sound frequency control is in 20HZ-20000HZ.
The training of the lip includes: the expansion of tongue, closure, preceding prominent, the extension of rear shrink movement, tongue, retraction, the upper fortune such as lift
It is dynamic.
The training of the tongue includes: extension, retraction, upper act and lateral movement of tongue etc..
The training of the lower jaw includes: patting the skin near lower jaw central part and temporomandibular joint with hand.
The voice training includes: first sending out vowel, such as " a " " u ", then consonant is sent out, such as " b " " p " by bilabial sound
" m " after capable of sending out these sounds, then by the consonant learned in conjunction with vowel, after skilled, just takes vowel+consonant+vowel shape
Formula continues to train, and is finally transitioned into trained word and sentence.
In the step S2 and step S5, therapeutic evaluation module instructs preceding hair to selected patient using primary evaluation index
Therapeutic evaluation after sound assessment and instruction, obtains patient's rating；When primary evaluation index can not carry out completely, commented using secondary
Pronunciation evaluation and therapeutic evaluation after instruction before valence index instructs selected patient.
The primary evaluation index includes: the respiration in speech special project evaluation in Frenchary dysarthrosis evaluation table refers to
Mark and/or longest sound Shi Zhibiao.
In the present embodiment, the Frenchary dysarthrosis evaluation table uses the people's hospital of Heibei's rehabilitation in 1998
The improvement Frenchary dysarthrosis evaluation table that center is revised, improvement version Frenchary dysarthrosis overall merit can be more complete
Disclose all functions and the speech characteristics of dysarthria face as evaluation total evaluation structure sound situation.The Frenchary structure
Sound barrier hinders in evaluation table comprising reflection, breathing, lip, tongue, jaw, soft palate, larynx, the correlation evaluation projects of speech 8 and 28 sub-projects,
The present invention selects respiration in speech special project deliberated index therein as the primary evaluation index of respiration in speech obstacle severity.
The respiration in speech special project deliberated index is divided into five ranks of a, b, c, d, e by degree of injury:
A grades refer to the exception that breathes no more；
B grades refer to that, since control of breathing is poor, fluency pole is destroyed by accident, and patient may state that he feels to stop
Get off and deeply breathe, that is, an additional breathing is needed to complete this requirement；
C grades refer to that patient must say fastly, because control of breathing is poor, sound may disappear, and patient may need to exhale for 4 times
Suction could complete this requirement；
D grades refer to that patient's air-breathing or expiration are spoken, or breathing very table is shallow, can only use several words, uncoordinated, and have
Apparent changeability, patient may need 7 breathings that could complete this requirement；
E grades refer to that speech is seriously hampered due to entirely breathing shortage control, and possible 1 breathing can only say 1 word.
(Maximum Phonation Time, MPT) index refers to when the described longest sound: patient holds after deep air-breathing
Supervention single vowel/a/ maximum duration.It is required that patient's sound strength control is being 30-70 decibels, and sound frequency control exists
20HZ-20000HZ, selection one meets intensity of sound and sound frequency condition simultaneously from record twice, and numerical value is biggish
Final measurement when measurement result is as longest sound.
When the index of maximum duration is evaluated for training effect, refers to after training after a period of time, monitor patient most
Whether significantly improved when long sound.Index and respiration in speech special project deliberated index are combined when longest sound evaluates for training effect
When, refer to after training after a period of time, it is desirable that at least a kind of in respiration in speech special project deliberated index or maximum duration index
Index improves significantly.
The secondary evaluation index includes: the respiration in speech special project evaluation in Frenchary dysarthrosis evaluation table refers to
The combination of one or more of mark, maximum number number ability (MCA), S/Z ratio, response grading index index.
The maximum number number ability refers to that a people after deep air-breathing, continuously says 1 maximum duration without a break, it is desirable that hair
The tone and loudness of sound are controlled in comfort level.When maximum number number capacity index is evaluated for training effect, when referring to by one section
Between training after, whether the maximum number number ability for monitoring patient significantly improves.
The S/Z ratio refer to patient after deep air-breathing, respectively hair/s/ sound and/z/ sound, calculate both longest sounding when
Between ratio.When S/Z ratio index is evaluated for training effect, refers to after training after a period of time, monitor the S/Z ratio of patient
Whether value significantly improves.
The response grading index includes five loudness scales: whispered sound is 0-20 decibels；It is softly 20-40 decibels；
Talk sound is 40-60 decibels；Loud is 60-70 decibels；Shouting sound is 70 or more decibels.Response grading index index is for training
When effect assessment, refer to after training after a period of time, whether the responsiveness for low decibel for monitoring patient has significantly
It improves.Special deliberated index and maximum number number ability (MCA), S/Z ratio, response grading index are combined and are evaluated for training effect
When, refer to after training after a period of time, it is desirable that special deliberated index, maximum number number ability (MCA), S/Z ratio, response grade
At least a kind of index of index, improves significantly.
In the step S6, determine training front and back difference and training effect method comprising the following steps:
It is evaluated according to the respiration in speech special project deliberated index in Frenchary dysarthrosis evaluation table: to hair before instruction
Patient's rating that therapeutic evaluation obtains after patient's rating and instruction that sound assessment obtains is compared, if grade reduces
More than or equal to 2 grades or be reduced to a grades, then evaluate training it is effective, if grade is reduced more than equal to 1 grade, less than 2
Grade then evaluates training effectively, if grade is unchanged or grade increases, evaluates training in vain, carries out refreshment.If evaluation
Training is effective or effective, can carry out refreshment, can also be without refreshment.
Evaluated according to index MPT when longest sound: judge MPT training front and back rate of change, change rate be at least up to 5% with
On, illustrate there is training effect.
Wherein, before MPT training front and back rate of change (%)=(after MPT training before-MPT training)/MPT is trained × 100%；
Alternatively, being evaluated according to maximum number number ability: rate of change before and after maximum number number ability training is judged, if changed
Rate is less than or equal to 5%, then evaluates training in vain, carry out refreshment；
Before and after maximum number number ability training after rate of change (%)=maximum number number ability training-maximum number number ability training before/
Before maximum number number ability training × 100%；
Alternatively, being evaluated according to S/Z ratio: judge S/Z training front and back rate of change, if rate of change is less than or equal to 5%,
It is invalid then to evaluate training, carries out refreshment；
After S/Z training front and back rate of change (%)=S/Z training before-S/Z training/S/Z training before × 100%；Alternatively, according to sound
Answer grading index to be evaluated: being more than or equal to 2 grades if grade increases or be reduced to a grade, evaluate train it is effective, if
Grade, which increases, is more than or equal to 1 grade, and less than 2 grades then evaluate training effectively, if grade is unchanged or grade declines,
It is invalid then to evaluate training, carries out refreshment.
In one embodiment of the invention, after carrying out single breath pronunciation training and the training of single basis structure sound
Therapeutic evaluation after being instructed.The time of single training is no more than 20 minutes, and single training weekly is no more than 5 times, each course for the treatment of
It is 3 weeks.Therapeutic evaluation is in ambient noise less than 30 after breathing pronunciation training, basic structure sound training, instructing preceding pronunciation evaluation and instruction
It is carried out in the soundproof room of dBA.
The invention has the following advantages that
1, basic structure sound training is combined using " word rhymed formula " guiding art, control of breathing ability when to patient's speech, which has, obviously to be changed
It is kind, Articulation ability can be improved comprehensively；
2, in conjunction with real-time respiratory air flow and pronunciation feedback, curative effect is improved；
3, in conjunction with multimedia presentation, training effectiveness is improved, saves manpower；
4, simple and easy, it is easy to promote in community hospital and family, training does not account for place, and training compliance is good, is maincenter
Dysarthria-control of breathing exception patient provides effective, easy, inexpensive speech rehabilitation side after neural disease damage
Method；
5, using the kinesiatrics of Chinese tradition " word rhymed formula ", based on the independent exercising of patient, with modern rehabilitation theory
There are many inherent meeting points, effective combination of sound gas coaching method and structure the sound training of " word rhymed formula " breaches exhaling in speech training
Abnormal difficulties are inhaled, advantages of TCM is carried forward, open brand-new chapter in neural rehabilitation training field for art is guided for Chinese medicine.
It is discussed in detail although the contents of the present invention have passed through above preferred embodiment, but it should be appreciated that above-mentioned
Description is not considered as limitation of the present invention.After those skilled in the art have read above content, for of the invention
A variety of modifications and substitutions all will be apparent.Therefore, protection scope of the present invention should be limited to the appended claims.
Claims (22)
1. a kind of breathing structure sound training device, characterized by comprising:
Patient's selecting module, for classifying and filtering out the patient for being appropriate for breathing structure sound and training to patient；
Pronunciation training module is breathed, synchronizes training for carrying out breathing pronunciation to patient；
Basic structure sound training module, for carrying out basic structure sound training to patient；
Therapeutic evaluation module, for determining the training effect of patient；
The breathing pronunciation training module includes:
Media playing apparatus, for playing breathing pronunciation training " word rhymed formula " pronunciation mouth shape and the demonstration of limbs guiding action；Described
" word rhymed formula " includes according to pronunciation sequence: hissing, breathes out, exhaling, Xi, blows, plays；
Air-flow reception device, for receiving and measuring respiratory air flow；
Decibel tester, for acquiring intensity of sound data；
Sound frequency tester, for acquiring sound frequency data；
Air-flow harmony cent shellfish monitors feedback apparatus, and connection air-flow reception device, decibel tester and sound frequency tester are used
In the acquisition data of display air-flow and sound, Real-time Feedback is to patient, and adjust automatically breathes and the target value of pronunciation；
Limbs guide auxiliary apparatus completes breathing pronunciation training for assisting patient to adjust limbs state.
2. breathing structure sound training device as described in claim 1, which is characterized in that the limbs guide auxiliary apparatus packet
Contain: electronic standing bed, standing-rack, seat.
3. breathing structure sound training device as described in claim 1, which is characterized in that the basic structure sound training module packet
Contain:
Media playing apparatus, for playing the training action demonstration and voice training demonstration of lip, tongue, lower jaw；
Decibel tester, for acquiring intensity of sound data；
Sound frequency tester, for acquiring sound frequency data.
4. a kind of breathing structure sound training that the breathing structure sound training device using as described in any one of claim 1-3 carries out
Method, which is characterized in that comprise the steps of:
Step S1, the patient for being appropriate for breathing structure sound training is filtered out using patient's selecting module；
Step S2, preceding pronunciation evaluation is instructed to selected patient using therapeutic evaluation module, to determine the severity of dysarthrosis；
Step S3, " word rhymed formula " is carried out to patient using breathing pronunciation training module and breathes pronunciation training；" the word rhymed formula " according to
Pronunciation sequence includes: hissing, breathes out, exhaling, Xi, blows, plays；
Step S4, basic structure sound training is carried out to patient using basic structure sound training module；
Step S5, breathing pronunciation training and basic structure sound are being carried out after training, patient is being instructed using therapeutic evaluation module
Therapeutic evaluation afterwards；
Step S6, therapeutic evaluation module determines training front and back difference and training according to therapeutic evaluation after pronunciation evaluation before instructing and instruction
Effect.
5. breathing structure sound training method as claimed in claim 4, which is characterized in that in the step S1, be appropriate for exhaling
The patient for inhaling the training of structure sound need to meet into a group condition, and group condition that enters includes:
Through the evaluation of Frenchay dysarthrosis evaluation charter, there are dysarthrosis, and respiratory function severity evaluates grade when speech
Not >=b grades；
It is tolerable to complete 40 minutes speech training persons；
Seat balance reaches 3 grades；
At least unilateral upper extremity exercise function is normal or at least unilateral upper limb Brunnstrom >=4 grade.
6. breathing structure sound training method as claimed in claim 4, which is characterized in that in the step S3, carry out breathing hair
Sound training method comprising the following steps:
Step S3.1, breathing pronunciation training " word rhymed formula " pronunciation mouth shape, respiratory air flow method and limb are played using media playing apparatus
The demonstration of body guiding action；
Step S3.2, selection adjusts limbs state using limbs guide auxiliary apparatus auxiliary patient；
Step S3.3, patient follows multimedia presentation to carry out " word rhymed formula " pronunciation breathing pronunciation training, until the air-flow of pronunciation breathing
Reach target value with sound.
7. breathing structure sound training method as claimed in claim 6, which is characterized in that the specific pronunciation requirement of " the word rhymed formula "
It is as follows:
Hiss: the corners of the mouth draws after tightening, flat pair up and down of molar, in stay gap, molar interspaces with tongue side, and breath main points is from molars
Between, pass through in the gap on tongue both sides, slowly go out；
Breathe out: molar is gently sticked on the micro- arch of tongue body, tongue side, and breath main points are slowly to go out between maxilla from tongue；
Exhale: tongue body sinks, lip pinch circle, face throat, slow with a pinch round lip in the middle part of direct oral cavity after breath main points is go out from larynx
Delay and goes out；
Xi: upper and lower front tooth alignment is loosened, in stay slit, after the lower tooth of tongue top, breath main points are from the flat submitting of between cog；
Blow: drawing after tongue body and the corners of the mouth, molar is opposite, and two lips pull open tightening to two sides, form narrow gap in front, breath main points be from
Larynx goes out, and under saying more than is proper through tongue both sides, slowly goes out through narrow gap between lip；
Play: the corners of the mouth draws after loosening, and molar is flat up and down, and to being gently engaged, whole oral cavity breath is flattened, and breath main points are from molar
By slowly going out in gap.
8. breathing structure sound training method as claimed in claim 6, which is characterized in that described uses limbs guide auxiliary apparatus
The method that auxiliary patient adjusts limbs state includes:
Patient normal for motor function, without adjusting limbs state；
For there is standing, seat balance difficulties person, limbs guiding is completed using electronic standing bed, standing-rack, seat etc..
9. breathing structure sound training method as claimed in claim 6, which is characterized in that carry out breathing pronunciation instruction using abdominal respiration
Practice.
10. breathing structure sound training method as claimed in claim 6, which is characterized in that in patient's training process, using air-flow
Reception device receives and measures respiratory air flow, intensity of sound data is acquired using decibel tester, using sound frequency tester
Sound frequency data are acquired, the acquisition data Real-time Feedback of air-flow and sound is shown using air-flow harmony cent shellfish monitoring feedback apparatus
To patient, and adjust automatically breathes and the target value of pronunciation.
11. breathing structure sound training method as claimed in claim 4, which is characterized in that in the step S4, carry out basic structure
Sound training method comprising the following steps:
Step S4.1, lip, tongue, the training action demonstration of lower jaw and voice training is played using media playing apparatus to demonstrate；
Step S4.2, patient follows multimedia presentation to carry out lip, tongue, the training of lower jaw and voice training, until the sound of patient
Intensity and sound frequency reach target value.
12. breathing structure sound training method as claimed in claim 11, which is characterized in that the training of the lip includes: tongue
Expansion, closure, preceding prominent, the extension of rear shrink movement, tongue, retraction, upper act；
The training of the tongue includes: extension, retraction, upper act and the lateral movement of tongue；
The training of the lower jaw includes: patting the skin near lower jaw central part and temporomandibular joint with hand；
The voice training includes: first sending out vowel, then sends out bilabial sound consonant, then the consonant learned is instructed in conjunction with vowel
Practice, takes vowel+consonant+vowel form to continue to train after people, be finally transitioned into trained word and sentence.
13. as claimed in claim 11 breathing structure sound training method, which is characterized in that in patient's training process, using point
Shellfish tester acquires intensity of sound data, acquires sound frequency data using sound frequency tester, the data of acquisition are anti-in real time
Feed patient.
14. breathing structure sound training method as claimed in claim 4, which is characterized in that in the step S2 and step S5, treat
Pronunciation evaluation and therapeutic evaluation after instruction, obtain patient's evaluation before effect evaluation module instructs selected patient using primary evaluation index
Grade.
15. breathing structure sound training method as claimed in claim 14, which is characterized in that the primary evaluation index includes:
Respiration in speech special project deliberated index and/or longest sound Shi Zhibiao in Frenchary dysarthrosis evaluation table.
16. breathing structure sound training method as claimed in claim 15, which is characterized in that the respiration in speech special project evaluation refers to
Mark is divided into five ranks of a, b, c, d, e by degree of injury:
A grades refer to the exception that breathes no more；
B grades refer to that, since control of breathing is poor, fluency pole is destroyed by accident, and patient may state that he feels to stop
It once deeply breathes, that is, an additional breathing is needed to complete this requirement；
C grades refer to that patient must say fastly, because control of breathing is poor, sound may disappear, and patient may need 4 breathings
It can complete this requirement；
D grades refer to that patient's air-breathing or expiration are spoken, or breathing very table is shallow, can only use several words, uncoordinated, and have obvious
Changeability, patient may need 7 times breathing could complete this require；
E grades refer to that speech is seriously hampered due to entirely breathing shortage control, and possible 1 breathing can only say 1 word.
17. breathing structure sound training method as claimed in claim 15, which is characterized in that index refers to when the described longest sound:
Patient continues the maximum duration of bill simple or compound vowel of a Chinese syllable/a/ after deep air-breathing.
18. breathing structure sound training method as claimed in claim 14, which is characterized in that when primary evaluation index can not be opened completely
Zhan Shi, pronunciation evaluation and therapeutic evaluation after instruction before being instructed using secondary evaluation index to selected patient.
19. breathing structure sound training method as claimed in claim 18, which is characterized in that the secondary evaluation index includes:
Respiration in speech special project deliberated index, maximum number number ability, S/Z ratio, response grade in Frenchary dysarthrosis evaluation table
The combination of one or more of index index.
20. breathing structure sound training method as claimed in claim 19, which is characterized in that the maximum number number ability refers to one
Individual continuously says 1 maximum duration after deep air-breathing without a break, it is desirable that the tone and loudness of sounding are controlled in comfort level；
The S/Z ratio refers to patient after deep air-breathing, and hair/s/ sound and/z/ sound, calculate the two longest phonation time respectively
Ratio；
The response grading index includes five loudness scales: whispered sound is 0-20 decibels；It is softly 20-40 decibels；Talk
Sound is 40-60 decibels；Loud is 60-70 decibels；Shouting sound is 70 or more decibels.
21. breathing structure sound training method as claimed in claim 20, which is characterized in that in the step S6, determine training
Front and back difference and the method for training effect comprising the following steps:
It is evaluated according to the respiration in speech special project deliberated index in Frenchary dysarthrosis evaluation table: pronunciation before instruction is commented
Patient's rating that therapeutic evaluation obtains after estimating patient's rating of acquisition and instructing is compared, if grade is reduced more than
Equal to 2 grades or be reduced to a grades, then evaluate training it is effective, if grade is reduced more than equal to 1 grade, less than 2 etc.
Grade is then evaluated and is trained effectively, if grade is unchanged or grade increases, is evaluated and is trained invalid, progress refreshment.
22. breathing structure sound training method as claimed in claim 21, which is characterized in that in the step S6, determine training
Front and back difference and the method for training effect also comprise the steps of:
It is evaluated according to index MPT when longest sound: judging MPT training front and back rate of change, if rate of change is less than or equal to 5%,
Evaluation training is invalid, carries out refreshment；
Wherein, after MPT training front and back rate of change (%)=MPT training before-MPT training before/MPT training × 100%；
Alternatively, being evaluated according to maximum number number ability: rate of change before and after maximum number number ability training is judged, if rate of change is small
In being equal to 5%, then evaluates training in vain, carry out refreshment；
Before and after maximum number number ability training after rate of change (%)=maximum number number ability training-maximum number number ability training before/it is maximum
Before number number ability training × 100%；
Alternatively, being evaluated according to S/Z ratio: judging that S/Z training front and back rate of change is commented if rate of change is less than or equal to 5%
Fixed training is invalid, carries out refreshment；
After S/Z training front and back rate of change (%)=S/Z training before-S/Z training/S/Z training before × 100%；Alternatively, according to response etc.
Grade index is evaluated: be more than or equal to 2 grades if grade increases or be reduced to a grade, evaluate train it is effective, if grade
Increase and be more than or equal to 1 grade, less than 2 grades then evaluate training effectively, if grade is unchanged or grade declines, comment
Fixed training is invalid, carries out refreshment.
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| CN111028863B (en) * | 2019-12-20 | 2023-12-26 | 广州科慧健远医疗科技有限公司 | Method for diagnosing post-stroke dysarthria tone errors based on neural network and diagnostic device thereof |
| CN112843630B (en) * | 2021-04-14 | 2021-11-12 | 戴华丽 | Training device for respiratory rehabilitation therapy |
| CN114566256B (en) * | 2022-01-18 | 2024-06-25 | 华东师范大学 | Correction scheme generation system for d-structure dystonia of initial consonant |
| CN114566257B (en) * | 2022-01-18 | 2024-06-25 | 华东师范大学 | Correction scheme generation system for b-structure dystonia of initial consonant |
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