Dysarthria was diagnosed using the Urimal Test of Articulation and Phonation (U-TAP). The patients with subacute stroke more than 2 weeks and within 1 month after stroke onset were chosen for vowel space assessment and videofluoroscopic swallowing study (VFSS). We retrospectively gathered data on stroke patients with dysphagia and dysarthria who were admitted to the Kyung Hee University Hospital at Gangdong between March 2018 and March 2020. Therefore, it is necessary to evaluate the meaning of vowel space destruction for dysphagia, which can help evaluate swallowing function through objective acoustic assessment and provide evidence on the need for rehabilitation. Additionally, in some cases, it is impossible to measure the VSA because the area of the vowel space of the stroke patient is severely distorted ( Figure 1 and Figure 2). Vowel formant concentration could result from this undershoot, and formant centralization ratio (FCR) indicates the degree of this centralization. The main feature of dysarthria is a narrowed range of articulation, which makes it difficult to achieve the desired position and intensity of vocal fold contractions. Centralization of formant frequency has also been shown in vowel production of patients with dysarthria. The vowel space area (VSA) is related to intelligibility and proper articulation of vowels. To evaluate vowel production, the quadrilateral vowel space can be measured as an objective acoustical evaluation.
The quadrilateral vowel space created by the motion of these muscles can be measured as an objective acoustical evaluation. The extrinsic muscles of the tongue, such as the styloglossus, palatoglossus, genioglossus, and hyoglossus are important for vowel production. Reduced excursion and velocity of lip, lingual, and jaw motions, as well as aberrant motion timing, are implicated in speech problems associated with vowel production deficiencies. Vowel space destruction has characteristics similar to VSA reduction at a moderate-to-severe degree and has utility as an indicator of dysphagia severity. VSA and FCR values correlated with swallowing function. One-way ANOVA revealed significant differences in VDS, FCR, and age between the VSA groups and no significant differences in VDS between mild and moderate VSA reduction and vowel space destruction groups. Groups were separated based on mean and standard deviation of VSA. VSA and FCR were negatively and positively correlated with VDS, respectively. Subgroups were created based on VSA vowel space destruction groups were compared using ANOVA and Scheffe’s test. Pearson’s correlation and linear regression were used to determine the correlation between VSA, FCR, and VDS. Swallowing function was assessed using the videofluoroscopic dysphagia scale (VDS) during videofluoroscopic swallowing studies. For /a/, /ae/, /i/, and /u/ vowels, we determined formant parameter (it reflects vocal tract resonance frequency as a two-dimensional coordinate point), formant centralization ratio (FCR), and quadrilateral vowel space area (VSA). Seventy-four individuals with dysphagia and dysarthria who had experienced stroke were enrolled. We determined the correlation of destruction of acoustic vowel space with dysphagia in stroke patients.
Vowel space decreases in stroke patients with dysarthria destruction of the vowel space is often observed. Dysphagia is associated with dysarthria in stroke patients.
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