Psychosomatic and Physical Well-Being Factors After Mind-Body Interventions in a Hospital Setting.

CONTEXT: Mind-body interventions encompass a variety of treatments that directly affect health. Researchers have found that yoga can decrease symptoms of depression and anxiety as well as improve dietary patterns, enhance physical function and capacity, and enrich sleep. Research has shown that mindfulness can have psychological and physiological benefits and treat symptoms of anxiety and depression. OBJECTIVE: This study intended to compare the benefits of 2 mind-body interventions-yoga and mindfulness-in a hospital setting. DESIGN: The research team performed a retrospective analysis of outcome data obtained from a hospital's programs. SETTING: The study took place at a mind-body center at a hospital in Athens, GA (USA). PARTICIPANTS: Participants were 46 individuals enrolled either in a yoga (n = 24) or a mindfulness (n = 22) intervention program at the hospital. INTERVENTION: Participants self-selected a mind-body-intervention program offered at the hospital: yoga or mindfulness. They received guided training in their chosen intervention at weekly 2-h sessions for 6 to 9 wk. OUTCOME MEASURES: Participants completed measures of anxiety, depression, mindfulness, and quality of life at 2 points during the mind-body programs, at baseline and postintervention. The programs used the Beck Anxiety Inventory (BAI), Beck Depression Inventory-II (BDI-II), Freiburg-Mindfulness Inventory (FMI), Automatic Thought Questionnaire (ATQ), and RAND 36-Item Short Form Health Survey (SF-36). RESULTS: The results showed significant decreases between baseline and postintervention in depression (on BDI-II) and anxiety (on BAI) levels for participants in both groups; however, only participants in the mindfulness group showed significant increases in mindfulness (on FMI) and quality of life and decreases in the frequency of negative thoughts (on ATQ) and significant improvements in some health-related measures (on SF-36; all P < .05). However, a significant difference between the groups existed at postintervention only for limitations due to physical health on the SF-36. CONCLUSIONS: The overall findings suggest that both the programs are effective. Although significant differences existed between the groups only for limitations due to physical health, the significant increases in categories other than anxiety and depression for the mindfulness group suggest that mindfulness can offer a more encompassing intervention for improving psychosomatic well-being, although further research is needed.

Yogic breathing and Ayurveda in aphasia: a case study.

PURPOSE: We present a case study of a woman who used yogic breathing as Ayurvedic medicine in her recovery from poststroke aphasia. Ayurvedic medicine is one of the most ancient medicines of the world, but it is not widely used for aphasia rehabilitation in many Western countries. The description of this case aims to further the understanding of the benefits that this type of medicine may provide to poststroke patients living with aphasia. METHOD: After her stroke, the patient received brief conventional language therapy for her aphasia. At 5 weeks post stroke, she received no further conventional rehabilitation; instead, she consulted with a Vedic priest. She followed a regimen of different body manipulations, yogic breathing techniques, and ingestion of coconut oil. Cognitive and language testing was performed throughout a 3-month period while she was involved in this therapy. RESULTS: Overall, improvement was noted in language, visual attention, and some mood measures. CONCLUSION: Although case studies lead to limited conclusions, changes were observed for this individual using Ayurvedic medicine. Given the changes in language and some aspects of cognition seen in this patient, further exploration of the effectiveness of yogic breathing and Ayurvedic medicine in the treatment of poststroke aphasia is warranted.

Expanding the scope: multimodal dimensions in aphasia discourse analysis-preliminary findings.

Background: Aphasia, resulting from acquired brain injury, disrupts language processing and usage, significantly impacting individuals' social communication and life participation. Given the limitations of traditional assessments in capturing the nuanced challenges faced by individuals with aphasia, this study seeks to explore the potential benefits of integrating multimodal communication elements into discourse analysis to better capture narrative proficiency in this population. Objective: This study examined how incorporating multimodal communication elements (e.g., physical gestures, writing, drawing) into discourse analysis may affect the narrative outcomes of persons with aphasia compared to those observed using methods that exclude multimodal considerations. Methods: Participants included individuals with chronic aphasia and age-and education-matched healthy controls who completed a storytelling task-the Bear and the Fly story. Macrolinguistic scores were obtained using verbal-only and multimodal scoring approaches. Additionally, the frequency and type of multimodal communication use during storytelling were examined in relation to aphasia characteristics. Statistical analyses included both within-group and between-group comparisons as well as correlational analyses. Results: Individuals with aphasia scored significantly higher in terms of their macrolinguistic abilities when multimodal scoring was considered compared to verbal-only scoring. Within the aphasia group, there were prominent differences noted in macrolinguistic scores for both fluent and nonfluent aphasia. Specifically, both groups scored higher on Main Concepts when multimodal scoring was considered, with the nonfluent group demonstrating significantly higher Main Concept and total macrolinguistic rubric scores in multimodal scoring compared to verbal scoring on the storytelling task. Additionally, aphasia severity showed moderate positive correlations with total macrolinguistic scores, indicating that individuals with less severe aphasia tended to produce higher quality narratives. Lastly, although persons with aphasia used different types of nonverbal modalities (i.e., drawing, writing), the use of meaning-laden gestures was most predominant during storytelling, emphasizing the importance of multimodal elements in communication for individuals with aphasia. Conclusion: Our preliminary study findings underscore the importance of considering multimodal communication in assessing discourse performance among individuals with aphasia. Tailoring assessment approaches based on aphasia subtypes can provide valuable insights into linguistic abilities and inform targeted intervention strategies for improving communication outcomes.

Linear Mixed-Model Analysis Better Captures Subcomponents of Attention in a Small Sample Size of Persons With Aphasia.

PURPOSE: Although there are several reports of attention deficits in aphasia, studies are typically limited to a single component within this complex domain. Furthermore, interpretation of results is affected by small sample size, intraindividual variability, task complexity, or nonparametric statistical models of performance comparison. The purpose of this study is to explore multiple subcomponents of attention in persons with aphasia (PWA) and compare findings and implications from various statistical methods-nonparametric, mixed analysis of variance (ANOVA), and linear mixed-effects model (LMEM)-when applied to a small sample size. METHOD: Eleven PWA and nine age- and education-matched healthy controls (HCs) completed the computer-based Attention Network Test (ANT). ANT examines the effects of four types of warning cues (no, double, central, spatial) and two flanker conditions (congruent, incongruent) to provide an efficient way to assess the three subcomponents of attention (alerting, orienting, and executive control). Individual response time and accuracy data from each participant are considered for data analysis. RESULTS: Nonparametric analyses showed no significant differences between the groups on the three subcomponents of attention. Both mixed ANOVA and LMEM showed statistical significance on alerting effect in HCs, orienting effect in PWA, and executive control effect in both PWA and HCs. However, LMEM analyses additionally highlighted significant differences between the groups (PWA vs. HCs) for executive control effect, which were not evident on either ANOVA or nonparametric tests. CONCLUSIONS: By considering the random effect of participant ID, LMEM was able to show deficits in alerting and executive control ability in PWA when compared to HCs. LMEM accounts for the intraindividual variability based on individual response time performances instead of relying on measures of central tendencies.

Moving Toward Accurate Assessment of Working Memory in Adults With Neurogenically Based Communication Disorders.

Purpose This article presents a viewpoint highlighting concerns regarding currently available assessments of working memory in adults with neurogenic communication disorders. Additionally, we provide recommendations for improving working memory assessment in this population. Method This viewpoint includes a critique of clinical and experimental working memory tests relevant to speech-language pathologists. We consider the terminology used to describe memory, as well as discuss language demands and test construction. Results Clinical and experimental testing of working memory in adults with neurogenic communication disorders is challenged due to theoretical, methodological, and practical limitations. The major limitations are characterized as linguistic and task demands, presentation and response modality effects, test administration, and scoring parameters. Taking these limitations into consideration, several modifications to working memory testing and their relevance to neurogenic populations are discussed. Conclusions The recommendations provided in this article can better guide clinicians and researchers to advocate for improved tests of working memory in adults with neurogenic communication disorders. Future research should continue to address these concerns and consider our recommendations.

Speech-Language Pathologists' Role in the Multi-Disciplinary Management and Rehabilitation of Patients with Covid-19.

Respiratory and neurological complications in patients in various stages of COVID-19 emphasize the role of speech-language pathologists in the assessment and management of swallowing and communication deficits in these patients. The speech-language pathologist works within a multidisciplinary team to identify these deficits, and aims to improve swallowing, nutrition, hydration, speech, and quality of life in the medical settings. This paper describes the unique symptoms and complications associated with COVID-19 that require speech-language pathologist services in medical (acute care, inpatient, and outpatient rehabilitation) facilities. The speech-language pathologist is primarily responsible for dysphagia screening and diagnosis in the acute care units, dysphagia and tracheostomy management in the inpatient units, and swallowing, speech and voice rehabilitation and neurocognitive management in the outpatient units. This paper also discusses the current therapeutic services and the precautions that speech-language pathologists must take to reduce transmission of the virus.

Performance differences between aphasia and healthy aging on an executive function test battery.

Purpose: Executive function (EF) deficits commonly co-occur with other linguistic and non-linguistic deficits in aphasia. The questions about whether, and to what extent, people with aphasia (PWA) present deficits on different executive functions (EFs) is relatively understudied.Method: In this study, four EFs, set-switching, updating, inhibition, and dual task processing were evaluated in aphasia and healthy groups. Three groups of participants: 30 healthy young, 30 healthy old, and 10 PWA were assessed on four tasks, Colour Trails Test (CTT 1 and 2), Conners' Continuous Performance Test II (CPT II), n-back (1- and 2-back), and divided attention task that tapped into different EFs. In order to examine performance differences on the EF tasks between the participant groups, repeated measures and multivariate analysis of variances with follow-up pairwise comparisons were computed. Pearson product-moment correlations were conducted to evaluate the strength and direction of the association between aphasia severity (on Western Aphasia Battery-Revised) and executive functioning.Result: PWA demonstrated significantly diminished performance on all EF tasks in comparison to healthy groups and differences were distinct on the higher-level complexity tasks such as the 2-back and CTT 2. The healthy older group demonstrated elevated response times on the CTT, CPT II, and divided attention tasks, and decreased sensitivity scores on the CPT II and n-back in comparison to the younger group. Also, aphasia severity correlated with reduced performance on selective EF measures.Conclusion: This study emphasises the importance of investigating EF deficits in PWA and its potential relationship to language behaviour. Understanding EF is critical for comprehension of linguistic and non-linguistic deficits and in planning treatment for PWA.

Shedding Light on Dysphagia Associated With COVID-19: The What and Why.

The most common symptom of COVID-19 in critically ill patients is ARDS (acute respiratory distress syndrome), with many patients requiring invasive or noninvasive respiratory support in the intensive care unit. Oropharyngeal dysphagia may be a consequence of the respiratory-swallowing incoordination common in ARDS or may occur following the respiratory support interventions. In this commentary, we highlight the risk and complications of oropharyngeal dysphagia in patients with COVID-19 and urge medical and rehabilitation professionals to consider dysphagia a prognostic complication, provide appropriate referrals, and initiate early interventions as appropriate.

Dysarthria Consequent to Cervical Spinal Cord Injury and Recurrent Laryngeal Nerve Damage: A Case Report.

OBJECTIVE: To assess and describe the involvement of all speech subsystems, including respiration, phonation, articulation, resonance, and prosody, in an individual with cervical spinal cord injury. METHODS: Detailed speech and voice assessment was performed that included Frenchay Dysarthria Assessment, cranial nerve examination, voice (per-ceptual and instrumental) and nasometric evalua-tion, and intelligibility and communicative effecti-veness. RESULTS: Impaired respiratory and phonatory con-trol correlated with the physical impairment of C4 and C5 prolapsed intervertebral disc. Cranial nerve examination indicated nerve IX and XI pathology. Phonatory deficits such as imprecise consonants and mild sibilant distortions were apparent. Voice analysis revealed a hoarse, breathy voice with re-duced loudness and no problems with resonance. Reading and speaking rate was reduced, and over-all a mild reduction in communicative effectiveness was perceived. CONCLUSION: Assessment of the speech subsystems produced a comprehensive picture of the patient's condition and impairments in one or more areas was identified. Treatment options to improve speech outcomes were provided.

Integrative intervention: a new perspective and brief review in aphasia.

PURPOSE: While integrative treatment practices have become a popular treatment in different areas of study, its use in the field of aphasiology is still limited. The following paper is an attempt to address the different alternative practices that could potentially be used to remediate aphasia. METHOD: A narrative review was completed regarding integrative intervention that could potentially apply to aphasia population. RESULTS: Through this article we have explored various treatment options for integrative health care in aphasiology. Integrative treatments including brain specific antioxidants, progesterone and estradiol therapy, nutrition, synbiotic treatment, exercise, yoga, meditation and positive mood states have demonstrated positive changes in health and behavior in healthy aging or disorders such as stroke and aphasia. Offering integrative treatment for people with aphasia allows potential for high impact gains when combined with current speech language therapeutic practices. CONCLUSION: This paper highlights the rehabilitation possibilities for aphasia therapy. Combining complementary and traditional treatment approaches could be viewed as one of the contemporary approaches to clinical practice and research for practitioners and health care systems. Implications for Rehabilitation There has been very little research that explores the potential of various types of integrative treatment for individuals with aphasia. An integrative approach to the treatment of aphasia has potential for future clinical application. Combining treatment approaches could be viewed as a viable approach to clinical practice and in the health care system.

Status of newborn hearing screening program in India.

OBJECTIVES: The present study is aimed at figuring out the status of new-born hearing screening program being conducted in India, estimate the use of different screening instruments used and tests practiced, study the role of various professionals involved and document the current practices of audiologists in the country. METHOD: A questionnaire on "Newborn Hearing Screening Survey" was sent to 185 institutions (165 medical colleges and 20 Speech and hearing centers) all over India and the information gathered was subjected to appropriate analyses. RESULTS: On a 16.75% return rate of the questionnaire, almost half of the colleges have their annual birthing census more than 2000. The majority of sites (57.13%) report an average length of stay for a vaginal delivery to be more than 24 hours with 78.94% also reporting of a NICU of Level II/III type. Only 38.09% of the medical colleges have a universal Newborn Hearing screening program (NBHS) in comparison to 80% of the Speech and Hearing centers. Again 43.8% of the medical colleges who conduct NBHS program have an audiologist and majority of them work towards screening. Almost 63% of the speech and hearing centers use physiological tests like ABR, OAE or their combination to screen newborns. Both medical and speech and hearing organizations prefer that the audiologist inform and even give a written material regarding the results of the tests to the parents. Only 62.65% of the institutions refer less than 11% of their clients for further testing at the time of discharge. In 50% of the medical colleges the results of a test are reported to the parents and primary care physicians/doctors and in 37.5% of the speech and hearing centers the results are informed to the parents. CONCLUSIONS: While keeping in mind the incidence of hearing impairment in the neonatal population of India, the results of this survey warrant the need for an urgent implementation of universal neonatal hearing screening in all the health care facilities in the country, at large.