Lemmetyinen Sanna, Hokkanen Laura, Vehviläinen Viivi, Klippi Anu
Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland.
Services of Speech and Language Therapy, Wellbeing Services County of North Karelia, Joensuu, Finland.
Appl Neuropsychol Adult. 2024 May 27:1-12. doi: 10.1080/23279095.2024.2355668.
Persons with severe non-fluent aphasia would benefit from using gestures to substitute for their absent powers of speech. The use of gestures, however, is challenging for persons with aphasia and concomitant limb apraxia. Research on the long-term recovery of gestures is scant, and it is unclear whether gesture performance can show recovery over time. This study evaluated the recovery of emblems and tool use pantomimes of persons with severe non-fluent aphasia and limb apraxia after a left hemisphere stroke. The Florida Apraxia Screening Test-Revised (FAST-R) was used for measurements. The test includes 30 gestures to be performed (i) after an oral request, (ii) with the aid of a pictorial cue, or (iii) as an imitation. The gestures were rated on their degree of comprehensibility. The comprehensibility of gestures after an oral request improved significantly in five out of seven participants between the first (1-3 months after the stroke) and the last (3 years after) examination. Improvement continued for all five in the period between six months and three years. The imitation model did improve the comprehensibility of gestures for all participants, whereas the pictorial cue did so just slightly. The skill of producing gestures can improve even in the late phase post-stroke. Because of this potential, we suggest that gesture training should be systematically included in the rehabilitation of communication for persons with severe non-fluent aphasia.
患有严重非流畅性失语症的人可以通过使用手势来替代其丧失的言语能力而受益。然而，对于患有失语症并伴有肢体失用症的人来说，手势的使用具有挑战性。关于手势长期恢复的研究很少，而且尚不清楚手势表现是否会随着时间推移而恢复。本研究评估了左半球中风后患有严重非流畅性失语症和肢体失用症的患者的象征手势和工具使用哑剧的恢复情况。使用修订后的佛罗里达失用症筛查测试（FAST-R）进行测量。该测试包括30个要执行的手势：（i）在口头请求后，（ii）借助图片提示，或（iii）作为模仿。对手势的可理解程度进行评分。在七名参与者中，有五名在首次检查（中风后1 - 3个月）和最后一次检查（中风后3年）之间，口头请求后手势的可理解性显著提高。在六个月至三年期间，这五名参与者的可理解性持续改善。模仿模式确实提高了所有参与者手势的可理解性，而图片提示的作用则稍小。即使在中风后期，产生手势的技能也可以提高。鉴于这种潜力，我们建议在严重非流畅性失语症患者的沟通康复中应系统地纳入手势训练。
