5-6岁构音障碍儿童联合使用语言治疗和骨科矫正的长期效果

E. Bychkova, A. V. Sandakov, Y. Kuzmina
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The question of preservation of the achieved osteopathic correction results is practically not covered.Aim is to study the long-term results of osteopathic correction of somatic dysfunctions in children aged 5–6 years with dysarthria.Materials and methods. The study involved children with an established diagnosis of dysarthria at the age of 5–6 years. The study participants were divided into the control (15 people) and the main (26 people) groups. The participants in the control group received speech therapy, the participants in the main group received speech therapy and osteopathic correction. The logopaedic, osteopathic and neurological examinations were performed at the start of the study. The logopaedic examination was repeated 12 months after the completion of the correction. The osteopathic examination was repeated immediately after the completion of the correction, after 6 and 12 months. 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引用次数: 0

摘要

介绍。构音障碍是一种运动动力学障碍,其表现形式为口齿不清和发音不清。此外,运动实现受损,语言器官(软腭、舌头、嘴唇)的活动受限,因此发音困难。仅仅借助语言治疗师的练习来矫正构音障碍并不总是足够有效;因此,人们一直在寻找能够在更短的时间内更有效地解决语言治疗问题的方法。在这方面,人们对整骨矫正有很大的兴趣。在现有文献中,对构音障碍儿童的躯体功能障碍和整骨矫正的结果进行了足够详细的描述,但仅限于治疗结束时。保存已取得的整骨矫正结果的问题实际上并未涉及。目的是研究5-6岁构音障碍儿童躯体功能障碍的骨科矫正的长期效果。材料和方法。该研究涉及5-6岁确诊为构音障碍的儿童。研究参与者被分为对照组(15人)和主要组(26人)。对照组接受言语治疗,主组接受言语治疗和整骨矫正。在研究开始时进行语音学、骨科和神经学检查。矫治完成后12个月复查。矫治完成后,6个月和12个月后立即进行骨科检查。矫正完成后6个月和12个月复查神经学检查。在对两组进行矫正的长期结果的研究中,在表征语言障碍严重程度的几个指标上都有积极的趋势,包括语音障碍和构音障碍。主治疗组与对照组相比,差异有统计学意义(p< 0.05)。主组整体及局部躯体功能障碍严重程度降低,颅骶系统局部病变及内脏功能障碍检出率降低,差异均有统计学意义(p< 0.05)。主组神经系统状态指标的检出率显著(p< 0.05)降低,包括收敛性、面部对称性、咽反射、颈部肌肉张力、Romberg姿势、局部疼痛、掩饰、舌在中心位置、口底肌肉状况、颈部肌肉张力、指鼻试验等指标。本研究不仅证明了骨科矫正与言语治疗联合应用的临床疗效,而且根据随访评价数据,对取得的结果进行了保存。所获得的结果使得推荐在学龄前儿童构音障碍的复杂矫正中纳入整骨矫正成为可能。
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Long-term results of combined use of speech therapy and osteopathic correction in 5–6 year old children with dysarthria
Introduction. Dysarthria is a disorder of motor dynamics, which manifests itself in oral speech in the form of illegibility and indistinctness. Also motor realization is impaired, the mobility of the organs of speech (soft palate, tongue, lips) is limited, and so articulation is difficult. Correction of dysarthria only with the help of exercises with a speech therapist is not always effective enough; therefore, there is a constant search for methods that would make it possible to solve speech therapy problems more efficiently and in a shorter time. In this regard, there is great interest in osteopathic correction. The somatic dysfunctions and the results of osteopathic correction of children with dysarthria are described in sufficient detail in the available literary, but only for the end of treatment. The question of preservation of the achieved osteopathic correction results is practically not covered.Aim is to study the long-term results of osteopathic correction of somatic dysfunctions in children aged 5–6 years with dysarthria.Materials and methods. The study involved children with an established diagnosis of dysarthria at the age of 5–6 years. The study participants were divided into the control (15 people) and the main (26 people) groups. The participants in the control group received speech therapy, the participants in the main group received speech therapy and osteopathic correction. The logopaedic, osteopathic and neurological examinations were performed at the start of the study. The logopaedic examination was repeated 12 months after the completion of the correction. The osteopathic examination was repeated immediately after the completion of the correction, after 6 and 12 months. The neurological examination was repeated 6 and 12 months after the completion of the correction.Results. During the study of the long-term results of the correction performed in the both groups, there was a positive trend in several indicators characterizing the severity of speech impairment, including impaired speech pronunciation and dysarthria. In the main group, the dynamics was statistically significantly (p<0,05) more pronounced than in the control group. In the main group, there was a statistically significant (p<0,05) decrease in the severity of global and regional somatic dysfunctions, as well as a decrease in the detection frequency of local disorders of the craniosacral system and local visceral dysfunctions. Also in the main group there was a significant (p<0,05) decrease in the detection frequency of disorders of several indicators characterizing neurological status, including such indicators as convergence, facial symmetry, pharyngeal reflex, neck muscle tension, Romberg posture, local soreness, maskiness, the location of the tongue in the center, the condition of the muscles of the floor of the mouth, the tension of the muscles of the neck, fi nger-nose test.Conclusion. The study demonstrated not only the clinical efficacy of the combined use of osteopathic correction and speech therapy, but also the preservation of the achieved results according to the follow-up evaluation data. The obtained results make it possible to recommend the inclusion of osteopathic correction in the complex correction of dysarthria in preschool children.
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