As seqüelas envolvidas nos acidentes vasculares encefálicos podem comprometer o funcionamento de diversos mecanismos, inclusive os responsáveis pela fala e voz. Desse modo, torna-se importante compreender a interface entre as manifestações vocais e o controle motor laríngeo em indivíduos idosos acometidos por acidente vascular encefálico (AVE). O objetivo deste estudo é correlacionar os resultados da diadococinesia laríngea com os aspectos perceptivo-auditivos das vozes idosos pós-acidente vascular encefálico. Participaram do estudo 29 idosos (15 homens e 14 mulheres) acometidos por AVE. Foi realizada a análise da Diadococinesia (DDC) laríngea, utilizando o programa Motor Speech Profile Advanced, da KayPentax. Também foi realizada a análise perceptivo-auditiva da voz, com base no Protocolo CAPE-V. Os resultados da DDC laríngea foram correlacionados com os resultados da análise perceptivo-auditiva da voz por meio dos Testes de Correlação de Pearson e de Spearman (p<0,05). Os resultados demonstraram haver correlação entre DDC laríngea e análise perceptivo-auditiva da voz quanto aos parâmetros de velocidade, instabilidade da duração da DDC, bem como instabilidade de intensidade. Desse modo, houve correlações entre: Grau Geral e velocidade da DDC (mP e mT) no grupo total e no grupo feminino; instabilidade da duração da DDC (dpP, cvP e jitP) no grupo total e feminino e instabilidade de intensidade (cvI) no grupo masculino. A rugosidade se correlacionou com: a velocidade (mP/a/) no grupo feminino; instabilidade do período da DDC no grupo total e feminino (dpP, cvP e jitP do /i/), bem como masculino (cvP do /i/); instabilidade de intensidade no grupo masculino (cvI /i/). A soprosidade se correlacionou com a velocidade da DDC no grupo total (mT /a/) e masculino (mP e mT /a/). Houve correlação entre tensão e: velocidade da DDC no grupo feminino (mP/a/) e masculino (mP/i/), instabilidade do período da DDC no grupo total (dpP e cvP do /a/) e instabilidade da intensidade da DDC para os homens (cvI /i/), sendo que no grupo total quanto maior a tensão, menos instável a DDC do /a/. A instabilidade do Cape-V da vogal /a/ se correlacionou com a instabilidade de duração do período (cvP/a/) para os homens e instabilidade da intensidade (cvI /a/) da DDC no grupo total e feminino. A pastosidade foi correlacionada com: velocidade da DDC (mP e mTdo /i/), instabilidade da duração (dpP e jitP do /i/) e instabilidade da intensidade da DDC (cvI /a/), no grupo total e masculino. Os resultados indicam que, quanto maior o grau de desvio vocal, mais lenta e/ou instável é a DDC para 96% das correlações significativas encontradas. Os resultados demonstraram haver correlação entre qualidade vocal e diadococinesia laríngea em homens e mulheres idosas pós Acidente Vascular Encefálico, sendo que o padrão de instabilidade da DDC demonstrou ser distinto de acordo com cada gênero. / The implications involved in stroke may compromise the function of several mechanisms, including those responsible for speech and voice. Thus, it is important to understand the interface between the vocal and laryngeal motor control in elderly subjects affected by stroke (CVA). This study aimed at correlating the vocal fold diadochokinesiss results with perceptual evaluation of elderly post stroke voices. The study included 29 elderly (15 men and 14 women) affected by stroke. The vocal fold diadochokinesis (DDK), was performed using the Motor Speech Profile Advanced software (KayPentax). Perceptual voice analysis was performed based on the CAPE-V protocol. The results of vocal fold DDK were correlated with those of perceptual voice analysis through Pearson´s and Spearman´s correlation tests (p <0.05). The results showed correlations between vocal fold DDK and the perceptual voice analysis in terms of speed, duration and intensity instability parameters of DDK. Thus, there were correlations between dysphonia degree and speed of the DDK (mP and mT) in the total group and female group, duration instability of DDK (dpP, jitP and cvP) in the total and female group, and intensity instability (cvI) in the male group. The hoarseness was correlated with: the speed (mP /a/) in the female group; instability of DDK period in the total and female group (dpP, cvP, jitP /i/) and male group (cvP/i/); intensity instability in the male group (cvI/i/). The breathiness was correlated with the speed of DDK in the total (mT /a/) and male group (mP and mT /a/). There was a correlation between strain and the speed of DDK in the female (mP /a/) and male group (mP /i/), instability of DDK period in the total group (dpP, cvP /a/) and intensity instability of DDK for men (cvI /i/); thus, in the total group, the higher the strain, the lower the instability of DDK /a/. The instability of vowel / a / in Cape-V was correlated with duration instability (cvP / a /) for men and intensity instability (cvI / in total and female group. The articulation and resonance was correlated with the speed of DDK (mP, mT /i/), duration instability (jitP, dpP /i/) and intensity instability (cvI / a /), in the total and male group. The results indicate that the higher the degree of dysphonia, the slower and/or unstable the DDK for 96% of the significant correlations found. The results showed a correlation between voice quality andvocal fold diadochokinesis in older men and women, following stroke, being the DDK instability pattern distinct, according to gender.

The diploma thesis deals with the speech therapy of people after stroke. The aim of this diploma thesis is the analysis of the communication abilities of people after stroke. On the basis of this analysis was created for two person therapeutic material, which was verified during speech therapy. The diploma thesis is devided into two parts. The theoretical part of the thesis analyses the issue of stroke and neurogenic communication disorders on the basis of the current state of knowledge. The practical part of the thesis is performed with qualitatively focused research with the use of case studies, observation and creating own therapeutic material. Case studies describe speech therapy and work with material. The research shows that the therapeutic material is usable in practice. KEYWORDS stroke, aphasia, dysarthria, therapeutic material, case studies

The thesis titled Evaluation design therapy of neurogenic disorders of language in clinical speech therapy aims to find out what effect the speech reeducation to improve communication skills in people with acquired neurogenic communication disorders speech. Next, determine whether therapy plays a role during client environment, if the success rate of therapy affected patient's condition and the extent to which the clients are motivated to therapy. The theoretical part summarizes the findings from the literature on neurogenic communication disorders, aphasia and dysarthria. Each chapter is devoted to the terminological definition and definition, etiology, symptoms (for aphasia), classification, diagnostics and therapy. The practical part deals with the research survey. There are set targets mentioned methodology, research sample characteristics and place of the investigation. Following processing of four case studies. Which describes the therapy sessions and individual work with clients. KEYWORDS Neurogenic speech disorders, aphasia, dysarthria, logopedic therapy

Parkinson's disease is a degenerative neurological condition which affects motor control, in almost all cases involving speech, and is frequently of many years duration. Much is known about speech production but less of the psychosocial consequences of the speech impairment (dysarthria). Accounts of people with dysarthria have shown that its impact on quality of social participation can be varied and profound. However, level of participation has not been investigated. Reduction in social activity and social networks has been found following onset of other neurogenic communication disorders. In Parkinson's disease there is some evidence of social activity reduction but this has not been studied in relation to severity of dysarthria. Social anxiety has been found to be raised in speakers with other speech production impairments and this may be a contributor to reduction in social engagement. Investigation of social variables is of importance in understanding relationships within a biopsychosocial model of health which underpins intervention for therapies for communication disorders. Aims The study aimed to investigate the impact of dysarthria on social participation and whether presence of dysarthria in Parkinson's disease (PD) resulted in changes to social anxiety, social networks and social activity. It further sought to investigate whether severity of dysarthria resulted in changes to the same variables. Method A group of 43 mild-moderately dysarthric speakers with PD were recruited. Exclusion criteria were applied to control for cognitive impairment, depression, apathy, movement disability and co-occurring neurological and communication impairment. A group of 30 non-neurologically impaired participants were recruited matched for age, sex, socioeconomic status and educational attainment. Participants with PD were further grouped using measures of sentence intelligibility and motor speech impairment into higher and lower functioning groups. All participants completed a social anxiety questionnaire, a social activity checklist and detailed their social network. Group data were compared to address the research questions. Semi-structured interviews were carried out with all participants to explore change to social life and perceptions of causes of change. Results Participants reported a range of changes to interaction and social engagement arising from speech and other impairments and also from intra and interpersonal contextual factors. Quantitative data showed that presence of dysarthria was associated with social anxiety and avoidance but not changes to social activity level or social network size. Greater severity of dysarthria was associated with deterioration in social activities and social network. There was wide individual variation on these variables. Outcomes Impact of dysarthria may be significant and unrelated to severity of impairment and satisfaction with level of activity is low in dysarthric speakers. Mild - moderately dysarthric speakers with PD may experience social anxiety in particular types of social situation. Moderately dysarthric speakers may experience loss of social capital in terms of quantitative changes in social networks and social activities. Motor speech impairment was a better predictor of social functioning than intelligibility in this sample. It is possible that a threshold for change lies at a more severe level of speech involvement. How speakers with PD perceive and experience their social interactions is discussed and limitations to the research are considered. The implications of the findings are discussed in relation to the ICF framework and the concept of social capital.

Submitted by Fabio Sobreira Campos da Costa (fabio.sobreira@ufpe.br) on 2016-04-12T11:30:48Z No. of bitstreams: 2 license_rdf: 1232 bytes, checksum: 66e71c371cc565284e70f40736c94386 (MD5) Disserta_Mest.DianaPrietoVega.pdf: 7775175 bytes, checksum: d13a57b88d99a46a1d7f3434f703422f (MD5) / Made available in DSpace on 2016-04-12T11:30:48Z (GMT). No. of bitstreams: 2 license_rdf: 1232 bytes, checksum: 66e71c371cc565284e70f40736c94386 (MD5) Disserta_Mest.DianaPrietoVega.pdf: 7775175 bytes, checksum: d13a57b88d99a46a1d7f3434f703422f (MD5) Previous issue date: 2015-09-14 / FACEPE / Os principais sintomas da disartria hipocinética na doença de Parkinson (DP) são: redução da intensidade, tom e volume monótono, falhas na qualidade da voz, inadequada coordenação fonorespiratória, dificuldades na precisão articulatória, mudanças na velocidade da voz e dificuldades para iniciar e manter a fala. A estimulação transcraniana por corrente contínua (ETCC), é um método não invasivo e uma alternativa segura para modificações na excitabilidade cortical sendo uma ferramenta alternativa para o manejo de diferentes desordens psiquiátricas e neurológicas, entre elas o Parkinson. O objetivo da presente pesquisa é analisar a eficácia da aplicação da ETCC na área de Broca e aumentar os efeitos terapêuticos do tratamento fonoaudiológico convencional em pacientes com diagnostico neurológico de doença de Parkinson. Um total de 18 pacientes participaram deste estudo, (idade média de 61,1 ± 3,6 anos; 14 homens) com diagnóstico neurológico de doença de Parkinson nos estágios Hoehn & Yarh I, II e III. Para este estudo, a metodologia foi desenvolvida em três fases. Fase 1 (Avaliação): os pacientes foram avaliados em dois momentos, em estado Off e On, e para o processo avaliativo foi utilizado o Protocolo de Avaliação da Disartria de Origem Central em Pacientes com doença de Parkinson. Fase 2 (Intervenção): consistiu em 10 sessões de intervenção, estas eram distribuídas três vezes por semana com um intervalo de 48 horas entre cada uma. Cada sessão durava 60 minutos; os primeiros 20 minutos corresponderam à aplicação da ETCC (real ou falsa) e os próximos 40 minutos à terapia em fonoaudiologia. Ao finalizar cada sessão era feita o registro vocal. Fase 3 (Encerramento terapêutico): correspondeu ao processo de reavaliação sendo feito o mesmo processo da fase 1. Os sujeitos do estudo foram randomizados em dois grupos (experimental e controle). Para usar a ETCC real (grupo experimental), era colocado o eletrodo ânodo sobre a área de Broca e o cátodo na região supraorbital direita, com intensidade de 2mA durante 20 minutos. Para a ETCC falsa (grupo controle) era feito o mesmo posicionamento dos eletrodos mas após 30 segundos o equipamento que gera corrente continua era automaticamente desligado. Os resultados deste estudo são apresentados no artigo original intitulado: “Transcranial Direct Current Stimulation in Broca’s Area at Parkinson’s Disease Patients”. Os resultados de nosso estudo indicaram que houve efeito positivo da ETCC e a terapia fonoaudiológica sob a articulação no grupo experimental. Assim mesmo foi observado que a terapia melhora os resultados totais do protocolo de avaliação da disartria tanto no grupo experimental quanto no grupo controle. Em conclusão nosso estudo sugere que a terapia fonoaudiológica traz benefícios na comunicação oral dos pacientes com doença de Parkinson nos estágios iniciais. Além disso, foram observados os efeitos positivos da ETCC anódica e o trabalho terapêutico sobre a articulação da fala. Portanto, pode-se considerar a intervenção fonoaudiológica como o método efetivo para tratar a disartria hipocinética, porém ainda assim faltam determinar os efeitos da ETCC sobre as outras áreas de comunicação oral, como também definir parâmetros de estimulação, identificar outras áreas do córtex cerebral a estimular e conhecer os efeitos a longo prazo. / The main symptoms of hypokinetic dysarthria in Parkinson's disease (PD) are: intensity reduction, monotonous tone and volume, voice quality failures, inadequate phono-respiratory coordination, difficulty in articulatory precision, changes in voice speed and difficulty in starting and maintaining the speech. The Transcranial Direct Current Stimulation (tDCS) is a non-invasive method and a safe alternative for changes in cortical excitability, being an alternative tool for different psychiatric and neurological disorders management, among them Parkinson’s disease. The objective of this study is to analyze the effectiveness of tDCS application in Broca’s area and increase the therapeutic effects of conventional speech therapy in patients with neurological diagnosis of Parkinson's disease. A total of 18 patients participated in this study (mean age 61.1 ± 3.6 years old; 14 men) with neurological diagnosis of Parkinson's disease in Hoehn & Yarh stages I, II and III. For this study, the methodology was developed in three phases. Phase 1 (Baseline): The patients were evaluated at two moments, in Off and On state, and for the evaluation process was used a Dysarthria Assessment Protocol of Center Origin in Parkinson's disease patients. Phase 2 (Intervention): Consisted of 10 intervention sessions, these were distributed three times a week with a 48 hours interval between each one. Each session lasted 60 minutes; the first 20 minutes corresponded to tDCS application (real or fake) and the next 40 minutes on speech therapy. At the end of each session was made the vocal register. Phase 3 (Post-intervention): Corresponded to review process; is made the same process of phase 1. The subjects were randomized into two groups (experimental and control). To use real tDCS (experimental group), was placed the anode electrode on Broca's area and the cathode on the right supraorbital region with 2 mA intensity for 20 minutes. For false tDCS (control group) was done the same electrodes positioning but after 30 seconds the machine that generates direct current was turned off automatically. The results of this study are presented in the original article entitled: “Transcranial Direct Current Stimulation in Broca’s Area at Parkinson’s Disease Patients”. In conclusion our study suggests that speech therapy is beneficial in the oral communication of Parkinson's patients at early stages. Furthermore, positive effects of anodic tDCS and therapeutic work were observed in speech articulation. The results of our study indicate that there was a positive effect of tDCS and speech therapy on articulation in experimental group. Likewise it was observed that speech therapy improved overall results of dysarthria protocol both experimental group and control group. In conclusion our study suggests that speech therapy is beneficial in the oral communication of Parkinson's disease patients at early stages. Furthermore, positive effects of anodic ETCC and therapeutic work were observed on speech articulation. Therefore, it can be considered the speech therapy as the effective method to treat the hypokinetic dysarthria but still lacking for determining the tDCS effects on other oral communication areas, as well as define the stimulation parameters, identify other areas of brain cortex to stimulate and to know the long-term effects.

abstract: Speech is known to serve as an early indicator of neurological decline, particularly in motor diseases. There is significant interest in developing automated, objective signal analytics that detect clinically-relevant changes and in evaluating these algorithms against the existing gold-standard: perceptual evaluation by trained speech and language pathologists. Hypernasality, the result of poor control of the velopharyngeal flap---the soft palate regulating airflow between the oral and nasal cavities---is one such speech symptom of interest, as precise velopharyngeal control is difficult to achieve under neuromuscular disorders. However, a host of co-modulating variables give hypernasal speech a complex and highly variable acoustic signature, making it difficult for skilled clinicians to assess and for automated systems to evaluate. Previous work in rating hypernasality from speech relies on either engineered features based on statistical signal processing or machine learning models trained end-to-end on clinical ratings of disordered speech examples. Engineered features often fail to capture the complex acoustic patterns associated with hypernasality, while end-to-end methods tend to overfit to the small datasets on which they are trained. In this thesis, I present a set of acoustic features, models, and strategies for characterizing hypernasality in dysarthric speech that split the difference between these two approaches, with the aim of capturing the complex perceptual character of hypernasality without overfitting to the small datasets available. The features are based on acoustic models trained on a large corpus of healthy speech, integrating expert knowledge to capture known perceptual characteristics of hypernasal speech. They are then used in relatively simple linear models to predict clinician hypernasality scores. These simple models are robust, generalizing across diseases and outperforming comprehensive set of baselines in accuracy and correlation. This novel approach represents a new state-of-the-art in objective hypernasality assessment. / Dissertation/Thesis / Masters Thesis Electrical Engineering 2020

Bakgrund: Kommunikation handlar om att förmedla information mellan individer. Det kan uppstå talsvårigheter till följd av afasi eller dysartri. Dysartri innebär att artikulationen påverkas på grund av förlamning i talmuskulatur medan afasi beror på en skada i hjärnans talcentrum. För att uppnå en god omvårdnad av personer med talsvårigheter var det viktigt att individen fick känna sig sedd och hörd. Stor vikt lades på sjuksköterskan och hens förmåga att uppfatta vad personen med talsvårigheter ville förmedla både verbalt och icke-verbalt. Det var därför viktigt att uppmärksamma personers erfarenheter av att leva med talsvårigheter. Syfte: Syftet med litteraturstudien var att beskriva personers erfarenheter av att leva med försämrad talfunktion på grund av afasi eller dysartri. Metod: En beskrivande litteraturstudie där 12 vetenskapliga artiklar låg till grund för resultatet. Samtliga artiklar var av kvalitativ ansats. Huvudresultat: Resultatet har påvisat att livssituationen har förändrats för personer med talsvårigheter, de påverkades emotionellt negativt samt tvingades att hitta nya strategier och hanteringssätt för att handskas med sina talsvårigheter. Synen på framtiden var mycket individuell och skildes från person till person. Personer med talsvårigheter erfor både positiva och negativa förändringar i relationer till familj, vänner och omgivningen. I kontakten med vården har personer med talsvårigheter erfarit både positiva och negativa upplevelser. Slutsats: Gott bemötande och goda relationer till vårdpersonal har spelat en viktig roll i återhämtningsprocessen för personer med afasi och dysartri, därför bör sjuksköterskor vara medveten om detta för att ha möjligheten kunna skapa de bästa förutsättningar för patienten. / Background: Communication is about mediate information between individuals. Speech difficulties can occur as a result of aphasia or dysarthria. Dysarthria means that articulation is affected due to paralysis in speech muscles while aphasia is due to an injury in the brain's speech center. In order to achieve good nursing of people with speech difficulties, it was important for the individual to feel seen and heard. Great emphasis was then placed on the nurse and her ability to perceive what the person with aphasia wants to convey both verbally and non-verbally. It was therefore important to pay attention to people's experiences of living with speech difficulties. Aim: The aim of this literature study was to describe people's experiences of living with impaired speech function due to aphasia or dysarthria. Method: A descriptive literature study where 12 scientific articles were the basis for the result. All articles were of a qualitative approach. Main result: The result has shown that the life situation has changed for people with speech difficulties, they were affected emotionally negatively and forced to find new strategies and ways of dealing with their speech difficulties. The view of the future was very individual. People with speech difficulties experience both positive and negative changes in relationships with family, friends and the environment. In contact with health care, people with speech difficulties have experienced both positive and negative experiences. Conclusion: Good encounters and good relationships with health care professionals has played an important role in the recovery process for people with speech difficulties, therefore the nurse should be aware of this in order to be able to create the best conditions for the patient.

This Master's thesis explores how developmental dysarthria and communication disability effect the socialization and communication abilities of people with cerebral palsy. The thesis is divided into two primary sections: theoretical and empirical. The theoretical part is divided into four sections (cerebral palsy, disrupted communication abilities in people with cerebral palsy, dysarthria, communication and socialization in people with cerebral palsy). The next part of the work presents the analysis of dysarthria and disrupted communication abilities effect of the socialization and communication abilities in people with cerebral palsy. The empirical section is based on original research, primarily employing qualitative methods, namely semi-⁠structured interviews. I interviewed six individuals all of whom are affected by cerebral palsy and developmental dysarthria. Research goals included how disrupted communication skills, known as developmental dysarthria, affect the individuals' communication and socialization skills, how it affects them in daily situations, what the main hallmarks of these situations are, what these situations have in common and how developmental dysarthria affects the individuals' motivation towards socializing. The results showed that the degree to which disrupted...

Diploma thesis is focused on the acoustic analysis of poetry recitation in patients with Parkinson's disease. This disease is associated with speech disorder called hypokinetic dysarthria. One objective of this thesis was familiarization with process, symptoms and treatment of these diseases. In thesis is described preprocessing and parametrization of the speech signal and the binary classification methods. Subsequently, it is the above proposal modular system of auto-diagnosis of Parkinson's disease based on acoustic analysis of the speech. The proposed system is implemented in MATLAB. Classification of calculated parameters is realized using the method of Random forest and Support vector machine. The results of these methods are compared and listed in the thesis. The main objective and the result of this thesis is a system of automatic diagnosis of Parkinson's disease based on acoustic analysis of the poem recitation.

This thesis analyzes what acoustically sets apart recordings of healthy people from recordings of people afflicted with multiple sclerosis, and how this distinction can be used to automatically detect multiple sclerosis from fairly simple recordings of a subject's voice, potentially discovering early cases of this disease. Chapter 1 includes the theoretical background of the effect of multiple sclerosis on speech and the descriptions of the data, software, hypotheses and assumptions used here. Two sets recordings of read speech were used, a corpus of afflicted speakers and a control corpus of healthy speakers, totalling 250 individuals. A subset of this corpus was manually annotated, resulting in one dataset. Simultaneously, these entire corpora were also annotated automatically, resulting in another dataset, which was created to explore the possibility of detecting multiple sclerosis automatically. Chapter 2 describes the 13 acoustic parameters used in this thesis, their exact hypothesized relationships with the symptoms of multiple sclerosis and the ways they were calculated. Chapter 3 elaborates on the statistical testing of the aforementioned parameters, their interpretation, the success rate of the two machine learning models used to assess their total predictive power, and a potential way to apply the...