六字诀功法训练联合重复经颅磁刺激对痉挛型脑卒中后构音障碍的影响OA

Objective To observe the efficacy of Liuzijue Qigong exercise combined with repetitive transcranial magnetic stimulation(rTMS)on spastic post-stroke dysarthria(PSD).Methods A total of 80 patients diagnosed with spastic PSD admitted to the Department of Rehabilitation Medicine,the First People's Hospital of Yibin,from September 2024 to September 2025 were recruited and randomly divided into a control group and an observation group using a random number table method,with 40 cases in each group.During the study,3 cases dropped out,resulting in 39 cases in the control group and 38 cases in the observation group.Both groups received conventional treatment.The control group additionally received high-frequency rTMS over the left Broca's area and low-frequency rTMS over the right Broca's mirror area,while the observation group received the identical rTMS protocol combined with Liuzijue Qigong exercise.Both groups were treated continuously for 8 weeks.Before and after treatment,the modi‐fied Frenchay Dysarthria Assessment Scale(m-FDA)was used to assess the severity of dysarthria;the speech intelligibility(SI)assessment was used to assess speech clarity;the Voice Handicap Index-10(VHI-10)was used to assess voice function;the Commu‐nication Effectiveness Index(CETI)was used to assess communication ability;phonetic analysis software and a decibel meter were used to assess acoustic parameters and speech loudness;the Chinese version of Stroke and Aphasia Quality of Life Scale(SAQOL)was used to evaluate quality of life;and the Self-rating Anxiety Scale(SAS)and Self-rating Depression Scale(SDS)were used to assess mental health status.Results(1)m-FDA scores:compared with those before treatment,all m-FDA dimension scores and total scores in both groups decreased significantly after treatment(P<0.05).Compared with the control group,subscores of reflex function,respiratory function,jaw position,tongue function and speech function,and total m-FDA scores in the observation group were lower after treatment(P<0.05).(2)SI,VHI-10,and CETI scores:compared with those before treatment,SI and CETI scores in both groups increased significantly after treatment(P<0.05),while VHI-10 scores decreased significantly(P<0.05).Compared with the control group,SI and CETI scores in the observation group were higher after treatment(P<0.05),and VHI-10 scores was lower(P<0.05).(3)Acoustic parameters:compared with those before treatment,second formant(F2),vowel articulation index(VAI),maxi‐mum phonation time(MPT),maximum counting ability(MCA),and speech loudness in both groups increased significantly after treatment(P<0.05),while first formant(F1)and formant centralization ratio(FCR)decreased significantly(P<0.05).Compared with the control group,F2,VAI,MPT,MCA,and speech loudness in the observation group were higher after treatment(P<0.05),while F1 and FCR were lower(P<0.05).(4)SAQOL,SAS and SDS scores:compared with those before treatment,SAQOL scores in both groups increased significantly after treatment(P<0.05),while SAS and SDS scores decreased significantly(P<0.05).Compared with the control group,SAQOL scores in the observation group was higher after treatment(P<0.05),while SAS and SDS scores were lower(P<0.05).Conclusion Liuzijue Qigong exercise combined with high-frequency and low-frequency rTMS can effectively reduce the severity of dysarthria,enhance speech clarity,and improve quality of life and mental health status in patients with spastic PSD.