oral diadochokinesis,標準偏差,変動係数による失調性構音障害の評価における問題点

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  • Problems in Using Oral Diadochokinesis, its Standard Deviation and Coefficient of Variation for Evaluating Ataxic Dysarthria

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We carried out 35 measurements using two methods of evaluation -auditory impressions of everyday conversation; and oral diadochokinesis, its standard deviation (SD) and coefficient of variation (CV) - in patients with ataxic dysarthria associated with spinal cerebellar degeneration (SCD), brain stem infarction, etc. Relative severity of dysarthric conditions was assessed using the method of paired comparison, and the results of the two evaluations were compared. We found that the results of the two evaluations were not consistent in about 60% of the pairs. The following major problems in evaluating conditions of ataxic dysarthria using oral diadochokinesis, SD and CV were speculated.<BR>1. Some patients with ataxic dysarthria exhibit a slower repetition rate, with more stability and less irregularity.<BR>2. Oral diadochokinesis is not a method suitable for investigating irregularity of repetition, but for investigating maximum repetition rate.<BR>3. Patients with a slower repetition rate display reduced CV (SD/average period), causing their dysarthria to be evaluated as milder.<BR>Here, we propose several necessary modifications to methods for evaluating ataxic dysarthria.

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