PNF 구강안면 운동 프로그램이 마비말장애가 있는 아급성 뇌졸중 환자의 교대운동속도와 연속운동속도에 미치는 효과

원영식,이순현,김계호,문종훈 대한고유수용성신경근촉진법학회 2018 PNF and Movement Vol.16 No.3

Purpose: The aim of the present study was to investigate the effect of a PNF orofacial exercise program on diadochokinesis in subacute stroke patients with dysarthria. Methods: Thirteen subacute stroke inpatients with dysarthria were recruited for the study. All participants were randomly assigned to two groups: an experimental group (n=7) and a control group (n=6). The experimental group performed a PNF orofacial exercise program, and the control group carried out an orofacial self-exercise. Both groups received the treatments 30 minutes per day, 5 days per week, for 4 weeks. The outcome measures were assessed before and after the intervention, including an alternating motion rate (AMR) and sequential motion rate for diadochokinesis. Results: After the intervention, both groups showed significant improvement in diadochokinesis (p<0.05). In the change values for both groups, the experimental group showed a more significant improvement than the control group did in /pə/ of AMR (p<0.05). Conclusion: These findings suggest that PNF orofacial exercise programs may have positive effects on the improvement of diadochokinesis in subacute stroke patients with dysarthria.

정상성인의 조음기관 구조 및 기능선별검사 제작을 위한 예비연구

신문자(Moonja Shin),김재옥(Jaeock Kim),이수복(Soobok Lee),이소연(Soyeon Lee) 한국음성학회 2008 음성과학 Vol.15 No.4

This study was purposed to introduce Korean Oro-motor Mechanism Screening Examination (KOMSE) and to provide the standardized scores taken from 120 normal adults aged 18~59. KOMSE was composed of 13 items of structure, 17 items of function, 3 items of voice, and 14 items of regularity and accuracy of articulation during diadochokinesis. Additionally, maximum phonation time and diadochokinetic rates were measured. Total score of KOMSE is ranged from 0 to 200. It was significantly higher in the 50~59 age group than in the 20~29 age group, but was not significantly different in sex. MPT had a significant difference in sex, but no significant difference among different age groups. The rate of DDK was also had no significant difference among different age groups. However, some reducing trend in the rate of DDK was observed as age increased. KOMSE would be very helpful for SLPs to screen the abnormality of oro-motor mechanism.

정상압 수두증 환자와 정상 노인의 조음교대운동 수행력 비교

윤성희,박기수,강경훈,윤장혁,하지완 한국음성학회 2024 말소리와 음성과학 Vol.16 No.1

Normal pressure hydrocephalus (NPH) is a condition wherein the cerebrospinal pressure in the brain is within the normal range, but the cerebrospinal fluid increases above the normal level, causing ventriculomegaly. In patients with NPH, the articulatory system exhibits reduced mobility and range, which may affect diadochokinesis (DDK) and speech intelligibility. In this study, we investigated the characteristics of DDK, including accurate-token DDK and all-token DDK including inaccurate tokens, in patients with NPH and healthy elderly adults (HE). We also examined the classification accuracy of DDK between the two groups. Finally, we investigated whether there was a correlation between speech intelligibility and DDKs in the NPH group. The results showed that NPH and HE groups differed significantly in both accurate-token DDK and all-token DDK, and their classification accuracy was relatively high. However, there was no correlation between speech intelligibility and DDK. The findings suggest that the DDK is a useful method for sensitively assessing speech motor performance in patients with NPH.

소프트웨어를 이용한 마비말장애 화자의 일련운동속도 분석

박희준,안신욱,신범주 한국음성학회 2018 말소리와 음성과학 Vol.10 No.4

Purpose: The primary goal of this study was to discover whether the articulatory diadochokinesis (sequential motionrate, SMR) collected using the Motor Speech Disorder Assessment (MSDA) software module can diagnose dysarthria and determine its severity. Methods: Two subject groups, one with spastic dysarthria (n=26) and a control group of speakers (n=30) without neurological disease, were set up. From both groups, the SMR was collected by MSDA at a time, and then analyzed using descriptive statistics. Results: For the parameters of syllable rate, jitter, and the mean syllable length (MSL) at the front and back, the control group displayed better results than the dysarthria patients. Conclusions: At the level of articulatory diadochokinesis, the results showed that the use of MSDA software in clinical practice was generally suitable for quickly recording the parameters of syllable rate, jitter, and mean syllable length.

아동의 조음교대운동 특성: 광주광역시 초등학교 1, 2학년을 대상으로

최아림,유재연 한국장애인재활협회 부설 재활연구소 2018 재활복지 Vol.22 No.2

Diadochokinesis (DDK) aims to identify the evaluating the oral mitor ability and the moter coordination ability. There are few DDK normative data on elementary school students in Korea, The purpose of this study was to investigate the characteristics of the speed and regularity of DDK in first- and second-grade students in elementary school. The subjects were a total of 194 students in first- (45 males, 50 females) and second-grade (47 males, 52 females) in elementary schools in Gwangju Metropolitan City. As evaluation tasks, AMR task ‘pʌ’, ‘tʌ’, and ‘kʌ’ and SMR task ‘pʌtʌkʌ’ were performed. The speed and regularity of DDK was measured using Motor speech profile (Model 5141, KayPENTAX) and Praat (v6.0.3.6). The results of this study, First, there was a statistically significant difference by grade in AMR speed for ‘pʌ’, ‘tʌ’, and ‘kʌ’ and the AMR speed was faster in second grade group. And, there was no statistically significant. Second, AMR regularity showed a statistically significant difference in ‘pʌ’, ‘tʌ’, and ‘kʌ’ according to sex and was found to be more regular in female student group. There was no significant difference in regularity by grade. Third, the SMR speed showed statistically significant difference in ‘pʌtʌkʌ’ by grade and was faster in second grade group. And there was no statistically significant difference by sex. The results of this study showed that the DDK performance ability in first- and second-grade students in elementary school was slightly different according to grade and sex. In future research, it is necessary to investigate the correlation between the articulation accuracy and linguistic intelligibility, and to find out the usefulness of DDK in articulation evaluation. 조음교대운동(DDK)은 구강운동능력과 운동 협응 능력을 평가하여 조음기관의 기능을 알아본다. 현재 국내에는 초등학생을 대상으로 한 DDK 규준데이터가 부족하여 초등학교 1, 2학년 아동을 대상으로 학년 및 성별에 따른 DDK 속도와 규칙성의 특성을 알아보고 규준데이터를 제공하기 위해 실시하였다. 연구대상은 광주광역시 초등학교에 재학 중인 1학년(남자 45명, 여자 50명)과 2학년(남자: 47명, 여자: 52명), 총 194명이며 수행과제는 AMR ‘퍼’, ‘터’, ‘커’와 SMR ‘퍼터커’를 사용하였고 Motor Speech Profile advanced (Model 5141)와 Window용 Praat을 사용하여 분석하였다. 연구결과 첫째, AMR 속도는 ‘퍼’, ‘터’, ‘커’ 모두 학년에 따라 통계적으로 유의한 차가 있었으며 2학년의 AMR 속도가 더 빨랐고 성별에 따라 통계적으로 유의한 차이는 없었다. 둘째, AMR 규칙성은 ‘퍼’, ‘터’, ‘커’ 모두 성별에 따라 통계적으로 유의한 차이가 있었으며 여학생의 AMR이 더 규칙적인 것으로 나타났고 학년에 따른 규칙성에서는 차이가 없었다. 셋째, SMR 속도는 ‘퍼터커’ 모두 학년에 따라 통계적으로 유의한 차이가 있었으며 2학년 집단에서 SMR 속도가 더 빨랐고 성별에 따라 통계적으로 유의한 차이가 없었다. 학년과 성별에 따른 상호작용 효과는 AMR과 SMR 속도와 규칙성에서는 모두 나타나지 않았다. 본 연구를 통해 초등학교 1, 2학년 아동의 DDK 수행력이 학년과 성별에 따라 다소 차이가 있는 것으로 나타났다. 차후 연구에서는 속도와 규칙성 외에 조음정확도, 말 명료도 등과의 상관을 알아봄으로써 조음평가에서 DDK 수행력의 활용성을 알아볼 필요가 있다.

파킨슨병 환자 대상 조음교대운동의 음향적 분석

강영애(Kang, Young Ae),박현영(Park, Hyun Young),구본석(Koo, Bon Seok) 한국음성학회 2013 말소리와 음성과학 Vol.5 No.4

The acoustic analysis of diadochokinesis(DDK) has been used to evaluate dysarthria. However, there has not been an automatic method to evaluate dysarthria. The aim of this study was to introduce a new automated program to measure DDK tasks and to apply this to clinical patients with idiopathic Parkinson"s disease(IPD). Fourty-seven patients with IPD and a healthy control group of twenty participants were selected with every DDK task recorded three times. Twenty-five acoustic parameters in the program were developed. The relevant parameters were times of DDK, pitch related parameters, intensity parameters which were analyzed by 2-way ANOVA. Significant differences between the groups were found in the times of DDK, pitch related parameters, and intensity parameters. The findings indicated that the pitch of control group was more stable than that of the IPD. Even though the patients with IPD had a higher intensity value, this phenomenon was caused by the weakness of the IPD group who could not control their speech with a breath.

음향학적 분석을 통한 노년층 연령에 따른 조음교대운동의 속도 및 규칙성

조윤희(Cho, YoonHee),김향희(Kim, HyangHee) 한국음성학회 2013 말소리와 음성과학 Vol.5 No.3

Aging is related to anatomical and physiological changes in respiratory and phonation organs. These changes influence articulation which leads to inaccurate speech and slow articulatory diadochokinesis(DDK). DDK indicates the range, rate, regularity, accuracy, and agility of articulation that reflect motor speech function. The purpose of this study is to investigate the rates and regularities of DDK in healthy Korean elderly through passive acoustic analysis (Praat). Thirty subjects between the ages of 65 and 94 participated in this study. Rate was observed for 5 seconds, while regularity was calculated based on the standard deviation on the following: 1) syllable duration of each task; 2) gap duration between syllables. Then, simple regression analysis was conducted in order to examine the effect of age on performance. The result showed that the slow rate was not a significant factor in terms of advancing age. Furthermore, regularity indicated a significant difference in the following: 1) /p?/, /k?/ and /p?t?k?/ in syllable duration; 2) /k?/ duration in the gap between syllables. In conclusion, articulatory coordination is reduced with the onset of aging. In particular, /k?/ would be a sensitive task for articulatory coordination.

Characteristics of Diadochokinesis in Typically Developing Children and Adults

Jisu Jang,Yu Gyeong Choe,하승희 한국청각언어재활학회 2021 Audiology and Speech Research Vol.17 No.1

Purpose: The purpose of this study was to examine the characteristics of the rate and perceptual judgment of diadochokinesis (DDK) in typically developing children and adults. Methods: Participants were typically developing children aged 2;6 to 9;11 and normal adults. For DDK tasks, they were asked to repeat [p*a], [t*a], [k*a], [p*at*a], and [p*at*ak*a] accurately and quickly with one breath. The number of repetitions per second was measured as DDK rate for each stimuli. The perceptual judgment of DDK were also performed in terms of regularity, rate, and accuracy using a three-point scale. Results: Children showed increases in the number of repetitions per second for all the DDK tasks with age. However, all the children groups between ages 2;6 and 9:11 exhibited significantly slower DDK rates than adults. In the perceptual judgment of DDK tasks, accuracy, rate, and consistency of sequential motion rates using [p*at*a] and [p*at*ak*a] showed statistically significant differences across age groups. Children demonstrated similar accuracy of SMR tasks with adults after age 6;0. Conclusion: This study showed developmental patterns of speech motor skills based on rate, accuracy, and consistency of DDK tasks. This study provides references for assessing speech motor skills related to children with speech difficulties.

운동감소형 마비말장애의 조음교대운동 특성

정은영(EunYoung Jung),조성래(Sung-Rae Cho),김윤정(YunJung Kim),김향희(HyangHee Kim) 한국언어청각임상학회 2011 Communication Sciences and Disorders Vol.16 No.1

배경 및 목적: 객관적 측정을 통한 운동감소형 마비말장애 환자의 조음교대운동 수행력의 차이와 중증도에 따른 조음교대운동 수행력의 차이에 대한 연구는 부족한 실정이다. 이에 본 연구에서는 첫째, 운동감소형 마비말장애군이 정상군에 비해 조음교대운동의 속도 및 규칙성에서 차이를 보이는지 알아보았고, 둘째, 말명료도의 중증도에 따라 같은 변인에서 차이를 보이는지 살펴보았다. 방법: 경도의 운동감소형 마비말장애 환자 11명, 중등도의 운동감소형 마비말장애 환자 7명, 정상인 26명을 대상으로 '퍼', '터', '커', '퍼터커' 과제를 실시한 후, Motor Speech Profile Model 4500와 Window용 Praatⓡ 으로 분석하였다. 결과: 첫째, 운동감소형 마비말장애군이 정상군에 비해 AMR 과제에서 느린 속도를 보였으나, SMR 과제에서는 정상 속도를 보였다. 규칙성에 있어서 조음교대운동 과제 모두에서 운동감소형 마비말장애군이 정상군에 비해 불규칙적이었다. 둘째, 조음교대운동 과제에서 모두에서 중증도에 따른 속도의 차이를 보이지 않았다. 그런데 규칙성에 있어서 '퍼', '터', '퍼터커' 과제에서 경도의 환자군이 정상군에 비해 불규칙적이었고, '커' 과제에서 중등도의 환자군이 경도의 환자군에 비해 불규칙적이었다. 논의 및 결론: 본 연구의 결과는 객관적인 측정을 통하여 운동감소형 마비말장애 환자의 조음교대운동 과제에 대한 속도 및 규칙성의 특징을 살펴볼 수 있었다. 특히 중증도에 따른 운동감소형 마비말장애 환자의 조음교대운동 수행력을 제시하였다는 점에서 의의가 있다고 할 수 있다. Background & Objectives: There have been few studies on diadochokinetic performance in patients with hypokinetic dysarthria. In this study, differences in the rates and regularities of DDK tasks were compared between hypokinetic dysarthria patients and normal subjects. In addition, the differences between a mild and moderate form of the disorder were compared based on speech intelligibility. Methods: Eleven patients with mild hypokinetic dysarthria, seven with moderate hypokinetic dysarthria, and 26 normal controls were asked to perform DDK tasks. The subjects were asked to perform both AMR and SMR tasks which were acoustically analyzed using the Motor Speech Profile™(Model 4500) and the Praat computer program. Results: The hypokinetic dysarthria group demonstrated relatively slower rates of AMR compared to those of the normal group, while the rates of the SMR group were within the normal range. The hypokinetic group demonstrated irregular patterns in both AMR and SMR tasks compared to those of the normal group. In addition, hypokinetic dysarthria patients with different severities did not exhibit any differences in the rates of completion for the AMR and SMR tasks. However, the repetition of /p˄/ and /t˄/ in the AMR and the SMR tasks were more irregular in mild hypokinetic patients than they were in normal subjects, whereas the repetition of /k˄/ was more irregular in moderate hypokinetic patients than it was in the mild group. Discussion & Conclusion: The results of this study show the objective measurement of diadochokinetic performance in patients with hypokinetic dysarthria. Furthermore, these results made a significant contribution by analyzing the differences in diadochokinetic performance according to the severity of dysarthria.

Comparison of Speech Motor Function, Articulation, and Phonological Characteristics of Children with and without Palatine Tonsil Hypertrophy: A Follow-Up 7 Months after Tonsillectomy

Yunkyung Song(송윤경) 한국언어청각임상학회 2016 Communication Sciences and Disorders Vol.21 No.4

배경 및 목적: 1차 연구에서 구개편도비대 아동은 일반 아동에 비하여 길항반복운동 소요시간이 더 길고, 자음정확도가 더 낮으며, 음운변동을 더 다양하게 보이는 것으로 나타났다. 편도절제술 6주 후 결과에서도 자음정확도와 음운변동은 같은 경향을 보였다. 이에 술 후 7개월이 흐른 후 이 변인들에 변화가 있는지 알아보기 위하여 일반 아동과 비교하여 보았다. 방법: 초기 평가 7개월 후, 선행연구에 참여하였던 구개편도비대 아동 27명과 일반 아동 29명을 대상으로 길항반복운동과 아동용 발음평가를 시행하여 비교하였다. 또한 평가 결과, 여전히 지체된 자음정확도를 보인 아동 세 명을 대상으로 조음 치료를 시행하였다. 결과: 편도절제술 7개월 후 아동들은 길항반복운동 소요시간, 자음정확도, 음운변동에서 일반 아동들과 유의한 차이를 보이지 않았다. 조음 치료 후 두 명의 아동은 개선을 보였으나, 한 명의 아동은 개선을 보이지 않았다. 논의 및 결론: 편도절제술 후 7개월이면 구개편도비대 아동은 일반 아동의 수준을 따라잡는 것을 알 수 있었다. 그러나 개별적인 특성상 이 시기에도 지체된 아동이 있으며, 치료 후 특성도 개인차가 있음을 알 수 있었다. 이는 구개편도비대가 말소리에 미치는 부정적 영향이 편도절제술 후에도 일부 지속될 수 있음을 알려준다. 편도절제술 시기 및 조음 치료의 필요성에 관한 추후 연구가 요구된다. Objectives: In a previous study, the diadochokinesis (DDK) and the percentage of consonants correct (PCC) of children with palatine tonsil hypertrophy (TH) were significantly lower than those of typically developing children (TD), and the number of children who produced phonological processes (PP) was significantly higher in TH than in TD. And there were no significant changes in PCC and PP at 6 weeks after tonsillectomy. So, the purpose of this study was to compare the values (DDK, PCC, PP) in children 7 months after tonsillectomy (AT) and TD. Methods: Twenty-seven AT and 29 TD were measured for DDK and the Assessment of Phonology and Articulation for Children (APAC). An independent t-test and χ2-test were conducted to determine whether there were significant differences between the groups. Three children who had lower PCC than their peer group were given individual speech therapy. Results: There were no significant differences in DDK, PCC, and PP between AT and TD. Except for one child, the children improved in PCC and PP after speech therapy. Conclusion: The results suggested that AT can catch up with TD. But there were individual differences in improvement of PCC and PP at 7 months after tonsillectomy and after speech therapy. It is necessary for a follow-up study to examine the timing of tonsillectomy and necessity of speech therapy after tonsillectomy.