Religiosity, Spirituality, Healthcare, and Aphasia Rehabilitation.

Awareness of the intersectionality of a person's religious and spiritual belief system with their mental and physical health is slowly being elevated within the Western healthcare system. There are many opportunities for better understanding and incorporation of religious and spiritual beliefs into aphasia rehabilitation. To extend the recognition of religion and spirituality's importance in healthcare to persons living with post-stroke aphasia while emphasizing the diversity of beliefs, the current article seeks to provide a brief overview of the global religions; explain the intersection of religion, spirituality, and health; review the existing literature in the area of aphasia and religion, spirituality, and spiritual care; discuss the clinical importance and implications of religion and spirituality; and finally, lay out a forward view of the direction this area of exploration may take within aphasiology.

Spirituality and Post-Stroke Aphasia Recovery.

The role of spirituality in post-stroke aphasia recovery has been ignored despite its potential contribution to positive health outcomes, particularly stroke recovery. The present study examines the spiritual experience of adults with aphasia in an effort to better understand the role of one's spirituality in the aphasia recovery process. Thirteen adults with aphasia completed a modified spirituality questionnaire and participated in semi-structured interviews. All participants considered themselves spiritual and reported improvements in communication during post-stroke recovery. Two themes related to spirituality that emerged from the interviews were (a) a greater power being in control of events and (b) a greater power as helper.

Brief mindfulness meditation group training in aphasia: exploring attention, language and psychophysiological outcomes.

BACKGROUND: Stroke is currently the leading cause of long-term disability in adults in the United States. There is a need for accessible, low-cost treatments of stroke-related disabilities such as aphasia. AIMS: To explore an intervention for aphasia utilizing mindfulness meditation (MM). This preliminary study examines the feasibility of teaching MM to individuals with aphasia. Since physiological measures have not been collected for those with aphasia, the study was also an exploration of the potential attention, language and physiological changes after MM in adults with aphasia during a brief, daily group training. METHODS & PROCEDURES: A 5-day MM group training was provided to adults with aphasia (n = 5) with a waitlist control group (n = (3) who engaged in 'mind wandering'. Participants were assigned to groups in a pseudo-random manner. A double baseline (2 days apart) was administered prior to the training and/or control group beginning. Both the training and the control groups met in a group setting. Salivary cortisol, heart rate and heart rate variability were measured during each day for both groups. Measures of attention, auditory comprehension and fluency were collected immediately after the study period and 1 week post-completion. OUTCOME & RESULTS: This study reinforces findings from previous work indicating that adults with aphasia can learn MM. Although not statistically significant, the training group demonstrated improved fluency immediately after MM; however, changes were not maintained at follow-up. Physiological measures showed little effect associated with MM training. No changes in attention were observed for either group. CONCLUSION & IMPLICATIONS: This is an emerging area of interest due to the potential low cost of MM training. Furthermore, MM is easily taught to patients, suggesting the possibility for widespread use in clinical practice as a supplement to existing language-focused interventions.

Mindfulness meditation in aphasia: A case report.

BACKGROUND: Despite the potential behavioral and neurological benefits of Mindfulness Meditation (MM), its use in treating stroke related communication disabilities appears to be underexplored. Specifically, aphasia, a language disorder resulting from stroke, may be amenable to the benefits of MM because of the observed attention problems often underlying the language symptoms. OBJECTIVE: The current paper presents a case report of an adult with aphasia who was trained in MM. METHOD: An adult with aphasia completed a five-day mindfulness training, and was assessed on measures of language, attention, and physiological measures of cortisol and heart rate variability. She completed four assessments: two baseline measures, immediately post training, and one week post training (maintenance). RESULTS: Overall, changes were observed in both psychophysiological measures (heart rate and heart rate variability) and behavioral measures (word productivity, phrase length, word generation, decreased impulsivity, and increased attention). CONCLUSION: Given the psychophysiological and behavioral changes observed in this individual, further exploration of the influence of MM in the treatment of post-stroke aphasia is warranted.

Unilateral forced nostril breathing and aphasia--exploring unilateral forced nostril breathing as an adjunct to aphasia treatment: a case series.

BACKGROUND AND PURPOSE: Unilateral forced nostril breathing (UFNB), a yogic pranayama technique, improves verbal and spatial cognition in healthy adults. The use of UFNB as an adjunct in aphasia recovery has not been explored. The current study investigated the use and potential benefit of combining UFNB with conventional speech-language therapy. METHODS: A multiple baseline single-subject AB design was conducted across three participants with stroke and aphasia. All participants practiced 40 minutes of UFNB daily at home, after instruction, and received conventional aphasia therapy. Speech and language skills were assessed before and after intervention, with individualized assessments throughout the period. Assessments included the Western Aphasia Battery-R (WAB-R) and the Communication Abilities of Daily Living-2 (CADL-2), as well as the Apraxia Battery for Adults if a diagnosis of apraxia was present. The Color Trails Test was performed and language samples collected for Correct Information Unit (CIU) and word productivity analyses. RESULTS: For the pre- and postassessments, visual inspection revealed an increase in CADL-2 scores for participants A2 and A3. In addition, A1 and A3 had a slight trend of increasing WAB-R aphasia quotients. Some change was observed for total number of CIUs and word productivity in two of the three participants. Attention did not markedly improve from baseline to treatment phase. CONCLUSION: This study suggests that UFNB combined with speech-language therapy may benefit overall language production and functional communication. Further investigation on use of UFNB treatment alongside traditional speech-language therapy is warranted.

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.