Method of correction of speech in stuttering
(57) Abstract:The invention relates to medicine, physiotherapy. Conduct speech therapy classes, psychotherapy, drug therapy. Exercise effects on the patient by conducting transcranial micropolarization. The current strength of 0.8 to 1.5 mA. The exposure time is 25-30 minutes Method increases the remission period. The invention relates to medicine, more specifically, neurology, and may find application in the treatment of speech disorders of various etiologies.Stuttering is a speech of a convulsive character, widespread in all countries of the world among children and adults. Throughout the long history of research and treatment of stuttering representatives of various schools and trends expressed different opinions about the etiology and pathogenesis of this speech disorder. As etiological factors most authors recognized hereditary constitutional and assogenerici. Both etiological factor only cause a predisposition to stuttering. Often the basis for the predisposition to stuttering is the combination of these two factors. The immediate cause of stuttering is disharmonious development rejecteda stuttering as transient functional impairment of the Central nervous system, many authors consider this form of speech disorders as a variant of neurosis - logoneurosis.If the etiology of stuttering is currently known, the pathogenesis of specific cerebral mechanisms of speech convulsions) at the present time not yet studied. In particular, it is not clear morphological and functional failure which cerebral structures is based speech disorders, convulsive character. What is certain is that stuttering is not limited to recidivating disorders, but usually develops on the background of already existing emotional-autonomic dysfunction and often leads to the formation of secondary psychogenic disorders. Hence, the most competent specialists in favour of an integrated approach, taking into account the peculiarities of the personality and character of related neurotic and residual organic syndromes.The most widespread type of correction of speech in stuttering outpatient care remains traditional speech therapy method, which is a set of speech exercises aimed at the rehabilitation of speech disorders . Speech therapy classes include exercises, nproj muscles, the production of expressive speech intonation.In the initial stages of logopedic correction to reduce speech convulsions fulfill the stereotype itemizedoverlay speech, at the same time carry out the normalization of speech breathing. After running out itemizedoverlay speech conduct exercises on relaxation pathologically tense muscles. Then, as the assimilation of sick tricks arbitrary and automated speech relaxation of the muscles, producing a gradual transition to free speech. During this period, improve the skills of expressive intonation. Lessons are conducted individually and in a group, usually 2-3 times a week for 1.5-2 hours total duration of 2-8 months.The main disadvantage of this method is the lack of psychiatric care, which is the reason for the frequent recurrence of stuttering .There is a method of correction of speech in stuttering , which consists in conducting therapy sessions itemizedoverlay speech with a frequency determined based on the analysis of EEG particular patient. Pre EEG allocate zone residually lesions speech and related structures, determine the main or her brief frequency of communication between the affected whom affect the patient during the session logopedic correction. Treatment is supported psychopharmacologically means (respiratory analeptic - atimetool) before and during treatment and suggestive psychotherapy. These healing sessions are conducted in the form of group and individual lessons at least 3 times for 2-4 hours each total duration of 20-25 sessions. This method of treatment allows to obtain a positive therapeutic effect in 90% of cases. The disadvantages of this method are the need for long-term (after treatment) communication exclusively with itemizedoverlay speech, which is extremely unnatural and often cause unwanted reactions from others. Self-transition of the patient in the usual form of speech often may cause stuttering relapse .Closest to the present invention is a method of treatment of stuttering on methodological recommendations, approved by the USSR Ministry of health in 1980 . This method is taken as a prototype. It consists of 4 stages of treatment, for a total duration of 2 months.The first, preparatory phase aims at the adaptation of patients to the hospital and the clinical and laboratory examination to determine nosological forms of psychopathological disorders, according to the uniform treatment of stuttering by lookalikey, psychotherapy, pharmacotherapy and physiotherapy.Pharmacotherapy perform differentially in accordance with defined at the first stage nosological form accompanying stuttering disorders, assigning this sedatives, and/or dehydration means, and/or antipsychotics and/or antidepressants and all patients vitamins of group B.Physiotherapy includes one of the usual physiotherapeutic procedures.Psychotherapy consists of individual (4 times a week for 1-1 .5 hours) and group (2 times a week for 2 hours) lessons aimed at helping the patient confidence in the ability to speak correctly. Preferred at this stage is the use of rational psychotherapy (an explanation of the pathogenesis of stuttering and mechanisms of logomarca in an accessible form), autogenic training (training the patient to manage emotional States), direct and indirect suggestions.Lookalike is to carry out progressively more sophisticated training speech in the form of 20 individual and 20 group sessions lasting 1.5 hours.At the third stage - active training under the supervision of psychotherapists and Novoportovskoye and reinforcing skills free dialogical speech in a real situation - the phone conversations with passers-by on the street, in a shop, post office, etc.The fourth stage contains the most sophisticated voice load - individual and collective performances in front of an audience. Psychotherapy built on the skills of autogenic training. Speech therapy classes devoted to the learning of complex texts, poems and songs. Voice load does not exceed the capabilities of the patient.This method provides for the formation of free speech and rehabilitation of patients within 2 months. The disadvantage of this method of treatment of stuttering is unsustainable received treatment and correctional results [1, 2]. In repeated surveys in 1.5-2 years not more than 54% of the cases observed retention remission (30% of cases) or a slight deterioration of speech (24% of patients). In 26% of cases there is a significant deterioration in speech, requiring re-treatment, and not less than 20% of patients who received integrated treatment, the full recurrence or further aggravation of stuttering. However, 10% of all stuttering relapse is observed already after 2-4 months after completion of the course of complex treatment [2, 4].The technical result of the present from which Itachi (TCMP).This result is achieved by the fact that speech therapy classes, psychotherapy and pharmacotherapy is complemented by transcranial micropolarization (TCMP) amperage 0,8-1,5 mA through 4 electrodes, which impose one cathode on the right forehead area corresponding to the projection of the orbital cortex of the frontal lobe, the other on the fronto-temporal region of the right hemisphere, corresponding to the projection of the lower 1/3 precentral gyrus, and the anodes of one in the area of the right mastoid process, the other on the forehead, the corresponding projection of the cortex of the left frontal lobe, and such micropolarization conduct sessions for 25-30 minutes every, 1-2 days for 25-30 days.Doing a long time of practical activities for the diagnosis and correction of various speech disorders, as well as on the basis of studying the peculiarities of cortical activity by computer methods of analysis of background EEG in patients with various nosological forms of speech disorders (Allie, dysgraphia, dysarthria, dysgraphia) we found that patients suffering from stuttering observed specific changes in topography of the functional activity of the cerebral cortex. On the basis of correlation and coherence analysis of background EEG in patients with stuttering neprezentare gyrus - Broca's area). Noted they have a pathological increase in the activity of fronto-temporal cortex of the left hemisphere, according to our observations, was accompanied by a decrease in functional tone of fronto-temporal cortex of the right hemisphere and frontal areas of the cortex of both hemispheres. Comparison of EEG data with clinical manifestations of convulsive disorders speech helped to identify a direct relationship between the level of left-hemispheric asymmetry activity of fronto-temporal divisions of the cortex and the severity of speech convulsions. The degree of functional failure of the frontal sections of the cortex of the left hemisphere was correlated with the severity of secondary neurotic disorders - anxiety, emotional imbalance and fear speech. Underactive frontal cortex of the right hemisphere, as a rule, was associated with impaired speech rate, speech intonation (expressive speech), increased motor excitability. Based on these observations, we hypothesized that normalization of relief activity of brain cortex via activation of functionally impaired brain structures in patients with stuttering may facilitate the implementation of its own compensatory mechanisms of the brain and, thus, to contribute to reducti is Delov crust we chose transcranial micropolarization. Method of transcranial micropolarization currently used in the clinic for treatment and rehabilitation of children suffering from mental retardation, mentally retarded and cerebral palsy. This method at the given pathology allows to correct the behavior, emotional disturbances, attention, memory, movement disorders  . Based psycho effect of this method is sustainable local activation of the polarizable structures of the cortex, the function of which was previously disturbed due to the influence of perinatal exogenous-organic factors. In the literature there is no indication of the existence of this method of contraindications and side effects.We tried to apply transcranial micropolarization (TCMP) in children suffering from stuttering in the complex therapy, namely in combination with psychotherapy, speech therapy classes and pharmacotherapy.It turned out that the conduct of the TCMP has a positive effect on the reduction of speech cramps, lowers anxiety and fears, which has a positive effect on treatment results.The polarization of the right frontal region corresponding to the projection of the orbital cortex of the right prosodic to the weakening of speech convulsions, depending on the emotional saturation of speech.The polarization of the right fronto-temporal division corresponding to the projection of the lower 1/3 precentral gyrus causes reciprocal inhibition of the contralateral structures - zone Brock, characterized by increased activity in patients with stuttering. This prevents speech convulsions, normalizes the rate of speech increases its expressiveness.The polarization of the left frontal region corresponding to projection convexities surface of the prefrontal cortex, as we have noted, facilitates articulation, improves speech activity, reduces the fear of speech, thus providing a rapid formation of free of speech. In addition, the polarization of this area, according to the EEG, increase the threshold of convulsive readiness in the presence of organic brain damage.Holding TCMP amperage 0,8-1,5 mA, as we have shown in the treatment of patients, provides a soft activation of the polarizable us Department of cortex without causing adverse reactions. The current is less than 0.8 mA not provided in our research the sustainability of activation, the power voltage higher than 1.5 mA cause skin irritation when applying electrodes.
1. Vlasova N. A., Becker K. P. / Monograph/, M, 1983.2. Suckers M. I. /Monograph/, St. Petersburg, 1994.3. Methodical recommendations of the Ministry of health of the USSR for the integrated treatment of stuttering, M., 1980.4. Kiselev M, /Monograph/, M, 1967.5. Pinchuk D. Y. /Autorepair. Prof. dessert./, M., 1997.6. Mashkovsky M. D. /Handbook/, M., 1992. Method of correction of speech in stuttering, including speech therapy classes, psychotherapy, pharmacotherapy and physiotherapy, characterized in that as physiotherapy using transcranial micropolarization amperage 0,8 - 1,5 mA through four electrodes that n is on the fronto-temporal region of the right hemisphere, the corresponding projection 1/3 precentral gyrus, and the anodes of one in the area of the right mastoid process, the other on the forehead, the corresponding projection convexities cortex of the left frontal lobe, and such micropolarization conduct sessions for 25 to 30 minutes every 1 to 2 days for 25 - 30 days.
SUBSTANCE: method involves carrying out transcranial micro polarizations once a week during 4-6 weeks in 15-20 min long sessions with 80-200 mcA large current over 2 electrodes. Anode is applied to the boundary of posterior region of superior temporal convolution and inferior parietal zone of the left hemisphere. The electrode is applied in later sessions to the boundary of inferior frontal region and anterior regions of superior temporal convolution and to projection of motor area of the left hemisphere cortex. The cathode is applied to the inferior regions of the left occipital area. Logopedic lessons are combined with psychological training during and between the transcranial micro polarization sessions. The treatment course is repeated when needed not more than 2-3 times a year.
EFFECT: enhanced effectiveness of treatment.
FIELD: medicine, neurology, reflexotherapy.
SUBSTANCE: the method deals with affecting biologically active points out of the following row: VB44, TR1, TR17, TR23, E1, GI20, E7, E6, E2, CI19, E4. Then comes pharmacopuncture due to applying the solution of hydrocortisone succinate. Impact should be performed with direct current through needles introduced into biologically active points.
EFFECT: shortened terms of therapy.
FIELD: medicine, surgery, surgical hepatology, intervention radiation diagnostics.
SUBSTANCE: due to ultrasound control one should introduce monopolar electrodes being parallel to the direction of vessels. Moreover, a cathode is being at the distance of 10 mm against vascular wall. Then comes electrochemical lysis (ECL) for 20 min, not more after the contact of echo-positive formation appeared during the lysis with vascular wall at the distance for not less than 1.3 against metastase diameter. The innovation enables to carry out efficient metastatic lysis near large hepatic vessels at no risk of hemorrhagic growth due to US-criteria of tissue lysis sufficiency being near the vessel without any disorders in muscular layers of vascular wall.
EFFECT: higher efficiency of therapy.
2 dwg, 1 ex
FIELD: physiotherapy and health resort treatment.
SUBSTANCE: before treatment, condition of vegetative nervous system is examined and, when initial vegetative tonus is regarded as sympathicotonia and hypersympathicotonia, galvanization of collar region according to Shcherbak and common-use pearl bathes are recommended. When initial vegetative tonus is regarded as vagotonia, microwave therapy and common-use radon bathes are recommended.
EFFECT: increased treatment efficiency due to improved vegetative nervous system condition as well as general hemodynamic and biochemical and hormonal investigation characteristics.
5 cl, 7 tbl, 3 ex
SUBSTANCE: method involves applying combined trans-spinal micro-polarization and pulsed stimulation. The trans-spinal micro-polarization is carried out using constant current of 100-300 mcA by applying skin electrodes of 20-35 cm large area. The trans-spinal micro-polarization is carried out during 30-40 min. Anode is placed lateral with respect to spinal process of the seventh vertebra C7 and cathode is placed contralaterally with respect to the anode in lumbosacral zone at the level of spinal processes of L5-S1. Magnetic pulsed stimulation is carried out with short pulses having two in every emitted package. Magnetic induction amplitude of the first pulse is equal to 1400 mTesla units and of the second one is less by 55%. The pulses are sent along the right and left side of the vertebral column in turn giving 3-4 packages per each spine segment. Stimulation is started beginning from cervical segment. The total treatment course is 6-7 procedures long with pauses being not longer than 2 days.
EFFECT: enhanced effectiveness of treatment.
SUBSTANCE: method involves treating immunocompetent organ regions with low frequency electric current for instance in animal groups like rats during 2 weeks. Drug-induced immunodeficiency is modeled in the animals 2 days later, after the treatment course is over, by intraperitoneally introducing 2% cyclophosphan solution once per 3 days (the total preparation dose is equal to 42 mg). Spleen and thymus mass, antibody-forming cells quantity in spleen and phagocytic activity of leukocytes are determined. Prophylactic action of factor of physical nature is evaluated by calculating prophylaxis index by dividing product of spleen mass, antibody-forming cells and phagocytic activity of leukocytes per thymus mass. The result is to be divided by 103. The prophylaxis index value exceeding 8.0, prophylaxis effectiveness is considered to be available.
EFFECT: high accuracy of estimates.
FIELD: medicine, neurology, physiotherapy.
SUBSTANCE: contact action by electric current on the region of the forehead and mastoid processes and contact action by magnetic field along the vertebral column are performed simultaneously. The action on the region of the forehead and mastoid processes is effected by direct current, 1 to 7 mA strong, modulated by low-frequency square pulses. A frequency within 0.5 to 550 Hz causing a change of the electrodermal resistance in the biologically active points is assigned as operating frequency. Action along the vertebras is effected by a pulse field with amplitude of magnetic induction up to 1 T and pulse frequency up to 100 Hz. The dominant frequency by the results of the electroencephalography is assigned as operating frequency, and the time of action is set to be equal to 35+-5 min. The device has an electrostimulator unit, whose output is made for connection to the electrodes in the patient's circuit, and a magnetic field forming unit with a solenoid, with a magnetic field forming unit with a solenoid, with power units each. The electrostimulator unit has a transducer of a series-connected master oscillator, transformer-coupled amplifier and a rectifier. The rectifier output is connected to the input of the first gate and made as the output of the electrostimulator unit. The device has a pulse shaper, whose output is connected to the input of the first gate, an output current level controller made for starting from the master oscillator, and whose output via the second gate and a ripple filter is connected to the transformer-coupled amplifier and the adder. The adder output is connected to the output of the first gate and the current meter. The magnetic field forming unit has a capacitor connected to the solenoid winding and via the switching unit - to the power unit. The switching unit is connected to the output of the control unit. The input of the pulse shaper of the electrostimulator unit and the input of the control unit of the magnetic field forming unit are made for connection to a personal computer via galvanic isolators.
EFFECT: reduced degree of disintegration in the structures of the limbic-reticular complex producing an optimizing action on the neurodynamics.
3 cl, 5 ex, 2 dwg
FIELD: medicine, reflexotherapy.
SUBSTANCE: one should match biologically active points and with subsequent impact upon them. One should choose biologically active point that corresponds to an organ with pathological cell proliferation. Then on should measure the potential of chosen biologically active point against a reference point. Then it is necessary to switch on the external source of direct electric field to chosen points. The poles of this source should be opposite by sign to those of points, and its absolute value is equal to the difference of absolute values of measured potential and a potential corresponding to healthy organ in chosen point. The impact should be performed up to the value of membranous potential of cancer cell being equal to the value of membranous potential of corresponding healthy organ. The innovation suggested simplifies therapeutic technique.
EFFECT: higher efficiency of therapy.
FIELD: medicine, gynecology.
SUBSTANCE: one should carry out galvanization during 15 min due to applying electrodes along abdominal-sacral technique. Just before galvanization one should introduce 15 ml 2%-chitosan ascorbate gel containing metronidasol at the dosage of 2 mg/ml gel, intravaginally at 36-38° C. Procedures should be carried out once daily, therapy course lasts for about 7-8 d. The innovation suggested provides total curative effect of antibacterial remedies and galvanization at decreased dosage of metronidasol and, thus, enables to obtain stable remission of salpingo-oophoritis.
EFFECT: higher efficiency of therapy.
1 ex, 1 tbl
FIELD: medicine, gynecology, immunology.
SUBSTANCE: for microenemas carried out just before galvanization according to abdominal-sacral technique one should apply 1%-chitosan ascorbate gel at the quantity of 20 ml, at temperature of 36-38° C, once daily, about 8-9 procedures/course. The present innovation enables to decrease inflammatory conglomerate and prevent massive adhesion-formation due to creating rectal enterosorbent depot that enables to enhance the sorption of toxic products through rectal wall out of inflammation focus.
EFFECT: higher efficiency of therapy.
1 ex, 3 tbl