Ginex Valeria, Veronelli Laura, Vanacore Nicola, Lacorte Eleonora, Monti Alessia, Corbo Massimo
a Department of Neurorehabilitation Sciences , Casa Cura Policlinico , Milan , Italy.
b National Centre for Epidemiology, Surveillance, and Health Promotion Italian, National Institute of Health , Rome , Italy.
Top Stroke Rehabil. 2017 Sep;24(6):428-434. doi: 10.1080/10749357.2017.1305654. Epub 2017 Mar 21.
Aphasia is a serious consequence of stroke but aphasics patients have been routinely excluded from participation in some areas of stroke research.
To assess the role of specific linguistic and non-verbal cognitive abilities on the short-term motor recovery of patients with aphasia due to first-ever stroke to the left hemisphere after an intensive rehabilitation treatment.
48 post-acute aphasic patients, who underwent physiotherapy and speech language therapy, were enrolled for this retrospective cohort-study. Four types of possible predictive factors were taken into account: clinical variables, functional status, language and non-verbal cognitive abilities. The motor FIM at discharge was used as the main dependent variable.
Patients were classified as follows: 6 amnestic, 9 Broca's, 7 Wernicke's, and 26 global aphasics. Motor FIM at admission (p = 0.003) and at discharge (p = 0.042), all linguistic subtests of Aachener AphasieTest (p = 0.001), and non-verbal reasoning abilities (Raven's CPM, p = 0.006) resulted significantly different across different types of aphasia. Post-hoc analyses showed differences only between global aphasia and the other groups. A Multiple Linear Regression shows that admission motor FIM (p = 0.001) and Token test (p = 0.040), adjusted for clinical, language, and non-verbal reasoning variables, resulted as independent predictors of motor FIM scores at discharge, while Raven's CPM resulted close to statistical significance.
Motor function at admission resulted as the variable that most affects the motor recovery of post-stroke patients with aphasia after rehabilitation. A linguistic test requiring also non-linguistic abilities, including attention and working memory (i.e. Token test) is an independent predictor as well.
失语症是中风的严重后果，但失语症患者通常被排除在某些中风研究领域之外。
评估特定语言和非语言认知能力对首次左侧半球中风后失语症患者在强化康复治疗后的短期运动恢复的作用。
48名接受物理治疗和言语治疗的急性后期失语症患者被纳入这项回顾性队列研究。考虑了四种可能的预测因素：临床变量、功能状态、语言和非语言认知能力。出院时的运动功能独立性测量（FIM）用作主要因变量。
患者分类如下：6名遗忘型失语症患者、9名布罗卡失语症患者、7名韦尼克失语症患者和26名完全性失语症患者。入院时（p = 0.003）和出院时（p = 0.042）的运动FIM、亚琛失语症测试的所有语言子测试（p = 0.001）以及非语言推理能力（瑞文彩色渐进矩阵测验，p = 0.006）在不同类型的失语症之间存在显著差异。事后分析显示仅在完全性失语症与其他组之间存在差异。多元线性回归显示，在调整临床、语言和非语言推理变量后，入院时的运动FIM（p = 0.001）和代币测试（p = 0.040）是出院时运动FIM评分的独立预测因素，而瑞文彩色渐进矩阵测验接近统计学意义。
入院时的运动功能是康复后最影响中风后失语症患者运动恢复的变量。一项同时需要非语言能力（包括注意力和工作记忆）的语言测试（即代币测试）也是一个独立预测因素。
