Unità Operativa di Recupero e Rieducazione Funzionale, Fondazione Salvatore Maugeri IRCCS, Via Giuseppe Mazzini 129, 25066, Lumezzane, BS, Italy,
J Neurol. 2011 Feb;258(2):343-9. doi: 10.1007/s00415-010-5868-x. Epub 2010 Dec 23.
Available studies did not clarify whether a language examination may predict functional and motor outcome in patients with aphasia undergoing rehabilitation. This was the aim of the current study. Language examination considered in this study was the Aachen Aphasia Test (AAT). One hundred fifty-six patients with a primary diagnosis of acute cerebrovascular accident of left hemisphere were included: 105 with and 51 without aphasia. Backward stepwise regression analysis was used to predict final scores in total-, motor-, and cognitive-Functional Independence Measure (FIM). The independent variables were age, gender, stroke type, stroke lesion size, onset to admission interval, National Institute of Health Stroke Scale, Fugl-Meyer Scale, Trunk Control Test, initial motor-FIM, and AAT (spontaneous speech, token test, repetition, written language, confrontation naming, comprehension). In the multivariate regression analysis, comprehension was the only function of the language to be predictor of the final total-FIM (β = +0.35) and final cognitive-FIM (β = +0.61). Comprehension was a predictor of total-FIM (β = +0.27) and cognitive-FIM (β = +0.54) as well, when additional backward stepwise regression analysis (which did not include comprehension and expression scores in the final total- and cognitive-FIM) was performed. When multivariate regression analysis took into consideration only language functions as independent variables, spontaneous speech (β = +0.41) only was the predictor of motor-FIM. The study highlights that AAT is the predictor of functional outcome in the patient with aphasia. Among the functions of language, comprehension seems to be the most important predictive factor of total- and cognitive-FIM, while spontaneous speech seems to be a predictor of motor-FIM.
现有研究尚未阐明语言检查是否可预测接受康复治疗的失语症患者的功能和运动预后。这是当前研究的目的。本研究中考虑的语言检查是 Aachen 失语症测试（AAT）。共纳入 156 例原发性左侧半球急性脑血管意外患者：105 例有失语症，51 例无失语症。采用向后逐步回归分析预测总、运动和认知功能独立性测量（FIM）的最终评分。自变量为年龄、性别、卒中类型、卒中病灶大小、发病至入院时间间隔、国立卫生研究院卒中量表、Fugl-Meyer 量表、躯干控制测试、初始运动 FIM 和 AAT（自发言语、代币测试、重复、书面语言、命名、理解）。在多元回归分析中，理解是语言的唯一功能，是最终总 FIM（β=+0.35）和最终认知 FIM（β=+0.61）的预测因素。当进行额外的向后逐步回归分析（最终总 FIM 和认知 FIM 不包括理解和表达评分）时，理解也是总 FIM（β=+0.27）和认知 FIM（β=+0.54）的预测因素。当多元回归分析仅将语言功能作为自变量时，只有自发言语（β=+0.41）是运动 FIM 的预测因素。该研究强调 AAT 是失语症患者功能预后的预测因素。在语言功能中，理解似乎是总 FIM 和认知 FIM 的最重要预测因素，而自发言语似乎是运动 FIM 的预测因素。
