Study on Language Rehabilitation for Aphasia.

OBJECTIVE: The aim is to update our clinical recommendations for evidence-based language rehabilitation of people with aphasia, based on a systematic review of the literature from 1999 to 2015. DATA SOURCES: Articles referred to in this systematic review of the Medline and PubMed published in English language literatures were from 1998 to 2015. The terms used in the literature searches were aphasia and evidenced-based. STUDY SELECTION: The task force initially identified citations for 51 published articles. Of the 51 articles, 44 studies were selected after further detailed review. Six articles, which were not written in English, and one study related to laryngectomy rehabilitation interventions, were excluded from the study. This study referred to all the important and English literature in full. RESULTS: Aphasia is the linguistic disability, which usually results from injuries to the dominant hemisphere of the brain. The rehabilitation of aphasia is until in the process of being debated and researched. Evidence-based medicine (EBM), EBM based on the clinical evidence, promotes the practice of combining the clinicians' first-hand experience and the existing objective and scientific evidence encouraging making decisions based on both empirical evidence and the scientific evidence. Currently, EBM is being gradually implemented in the clinical practice as the aim of the development of modern medicine. CONCLUSIONS: At present, the research for the aphasia rehabilitation mainly focuses on the cognitive language rehabilitation and the intensive treatment and the precise treatment, etc. There is now sufficient information to support evidence-based protocols and implement empirically-supported treatments for linguistic disability after traumatic brain injury and stroke, which can be used to develop linguistic rehabilitation guidelines for patients with aphasia.

Clinical application of Loewenstein Occupational Therapy Cognitive Assessment Battery-Second Edition in evaluating of cognitive function of Chinese patients with post-stroke aphasia.

OBJECTIVE: To investigate the clinical application value of Loewenstein Occupational Therapy Cognitive Assessment battery in Chinese patients with post-stroke aphasia. METHODS: Cognitive functions of 59 Chinese patients with aphasia following a stroke were assessed with the Chinese version of the second edition of LOTCA battery and their linguistic functions were tested with the Western Aphasia Battery (WAB) Scale, respectively. The Results of LOTCA were analyzed and compared across different groups, in the light of gender, age, educational background, the length of illness, and the degree of aphasia. RESULTS: Neither the score of subtests of the LOTCA nor the overall scores of LOTCA of aphasia patients with different gender and educational background differed (all P>0.05). In different age groups, apart from thinking operation (F=3.373, P=0.016), visuomotor organization (F=3.124, P=0.022), attention (F=3.729, P=0.009) and the total score (F=2.683, P=0.041), there was no difference in terms of the other subtest scores of LOTCA (all P>0.05). In the groups of different length of time with illness, apart from orientation (F=2.982, P=0.039) and attention (F=3.485, P=0.022), the score of other subtests and the total score of LOTCA were not different (all P>0.05). In the groups of different degree of aphasia, apart from attention (F=2.061, P=0.074), both the score of other subtests and the total score of LOTCA differed (all P<0.05). CONCLUSION: LOTCA might be suitable to assessing the cognitive ability of post-stroke Chinese patients with aphasia.

Relationship between linguistic functions and cognitive functions in a clinical study of Chinese patients with post-stroke aphasia.

BACKGROUND: There has been a long debate among scholars surrounding the relationship between language and cognition. The worldwide study of aphasia is actively exploring the function of language from cognitive point of view. This study aimed to investigate the relationship between linguistic functions and cognitive functions in a clinical study of Chinese patients with post-stroke aphasia. METHODS: Cognitive functions of 63 Chinese patients with aphasia following a stroke were assessed with the Chinese version of the second edition of Loewenstein Occupational Therapy Cognitive Assessment (LOTCA) battery and their linguistic functions were tested with the Western Aphasia Battery (WAB) Scale, respectively. The correlation between the results observed on the LOTCA battery and those on the WAB was analyzed. Aphasia quotient, performance quotient, cortical quotient, and linguistic function of the patients were compared. Then, each language function was analyzed by way of dependent adopt multiple regression analysis. RESULTS: The total score of 63 patients as shown on the LOTCA battery was significantly correlated with the aphasia quotient, performance quotient, and cortical quotient observed on the WAB Scale (P < 0.05, P < 0.01). However, the correlation between visuomotor organization under LOTCA and repeat under WAB was not significant (P > 0.05). The attention of LOTCA and WAB's spontaneous speech, repeat, naming, and aphasia quotient was not relevant either (P > 0.05). In addition, correlations between the results observed on the LOTCA battery and the WAB were significant (P < 0.05, P < 0.01). Among the significant variables finally entered into the standardized canonical discriminant functions, main factors affected the aphasia. Multiple regression analysis showed that orientation, spatial perception, and visual perception had a notable influence on aphasia quotient and naming. Orientation and thinking operation was found to have a notable influence on spontaneous speech. Spatial perception and visual perception was found to have a notable influence on auditory comprehension. Thinking operation and orientation was found to have an obvious influence on reading. Thinking operation, spatial perception, and attention was found to have a notable effect on writing (P < 0.01). CONCLUSION: There exists a close relationship between linguistic functions and cognitive orientation, spatial perception, visual perception, and thinking operation in a clinical study of Chinese patients with post-stroke aphasia.

[Effectiveness of backward walking treadmill training in lower extremity function after stroke].

OBJECTIVE: To examine the effectiveness of backward walking treadmill training for restoration of motor function, balance and walking speed in patients with stroke. METHODS: Twenty-six patients with stroke, 17 males and 9 females, aged 36 - 64, with the lower extremity Brunnstrom motor recovery stage at 3 or 4, able to walk for 10 m without walking aid or orthosis, were randomly divided into two equal groups: The patients in the control group were to participate in a 60-minutes conventional training five times a week for three weeks, and the patients in the experimental group received 30-minute conventional training and then 30-minute backward walking training five times a week for three weeks. Before the training and 3 weeks after the training, Fugl-Meyer assessment was used to assess the motor function of the lower extremity (FMA-L), Berg balance scale (BBS) was used to assess the balance function, and 10 m maximum walking speed was measured. RESULTS: After the three-week training period, the FMA-L score of the experimental group was 28.0 +/- 3.3, significantly higher than that of the control group (25.5 +/- 2.3, P = 0.033); the BBS score of the experimental group was 51.4 +/- 1.8, significantly higher than that of the control group (47.3 +/- 3.7, P = 0.001, and 10 m MWS of the experimental group was 57 +/- 17, significantly higher than that of the control group (43 +/- 16, P = 0.034). CONCLUSION: A safe and feasible intervention, additional backward walking therapy helps improve the damaged motor function, balance, and walking speed of the patients with stroke.