麻痺性構音障害に関する追跡調査

抄録

The objects of this study were to follow-up dysarthric patients who had been discharged from our hospital, and to observe the long-range change in dysarthric speech.
The subjects were 46 dysarthric patients who had initial evaluation and speech therapy at Izu Nirayama Rehabilitation Hospital in an 8-year period (from Oct. 1967 to Sept. 1975). All patients had neither aphasia nor severe intellectual disturbances. Thirty-six of the 46 patients were dysarthric as the result of CVA, and none of them had had more than one attack. Six patients had suffered traumatic accidents. The mean age of the CVA group and traumatic accident group were 55 and 25 years old respectively. The mean length of time from the onset of dysarthria to the initial evaluation (at admission) was 1 year and 2 months. The mean length of time from the onset to the present time was 6 years. The mean duration of admission was 6 months.
To evaluate the conditions of dysarthria, we made “The Scale of the Intelligibility of the Dysarthric Speech”. Speech samples of the patients were recorded by tape-recorder at admission, at discharge and at the present time, and were evaluated by two speech therapists. This scale includes 7 stages. Stage VII is the highest and stage I is the lowest. The results were as follows:
1) The conditions of dysarthria did not change in 63% of the 46 patients; they improved in 20%, and worsened in 17%. In the CVA group, 67% of the patients remained unchanged; 11% improved, and 22% worsened. In the traumatic accident group, 50% of the patients remained unchanged, and 50% improved.
2) Of 9 improved patients, 7 went up 1 stage; of 8 worsened patients, 6 went down by 1 stage. Of 17 patients whose stages changed, the changes in 14 patients were seen after discharge. The fact that dysarthric speech changed only slightly and that this change tended to be seen after discharge are very important for those of us who have to consider the process of the rehabilitation of these patients.
3) Seven patients, whose speech intelligibility stages were distributed from III to VII, got jobs again after discharge.