Highlights
- •Interactions between cognitive and motor recovery after stroke is still neglected.
- •Patients with concurrent motor and language deficit (aphasia) were investigated.
- •An additive interaction between motor and language improvements emerged.
- •35% patients showed a significant simultaneous improvement in both functions.
- •The 2 functions could grounds on the same mechanisms in the recovery process.
Abstract
Objective
To analyze the nature of the interaction between motor and language recovery in patients
with motor impairment and aphasia following left hemispheric stroke and to investigate
prognostic factors of best recovery, that is, the significant recovery of both functions
simultaneously.
Design
Retrospective cohort study.
Setting
Specialized inpatient rehabilitation facility.
Participants
Patients (N=435) with left hemispheric stroke in the postacute phase with motor impairment
and aphasia.
Intervention
Not applicable.
Main Outcome Measure
Patients who reached the minimal clinically important difference in the motor-FIM
(M-FIM) were classified as motor responders, patients who reached a significant change
in Aachen Aphasia Test were classified as language responders, and patients who reached
a simultaneous and significant improvement in both functions were classified as motor
and language responders.
Results
Of the sample 45% were motor responders, 58% were language responders, and 35% were
motor and language responders. Responder groups showed lower motor impairment and
less severe aphasia at admission and greater improvement in both functions at discharge
compared with nonresponder groups. Premorbid autonomy, dysphagia, apraxia, and number
of rehabilitative sessions were also significantly different between groups. A logistic
regression model identified M-FIM, repetition abilities, and number of sessions of
speech and language therapy as independent predictors of best response (ie, motor
and language responders).
Conclusions
This study provides evidence about a possible interaction between motor and language
recovery after stroke. The improvement in one function was never associated with deterioration
in the other. The results actually suggest a synergic effect between the amelioration
of the 2 functions, with an overall increased efficiency when the 2 recovery pathways
are combined.
Keywords
List of abbreviations:
AAT (Aachen Aphasia Test), IRF (inpatient rehabilitation facility), MCID (minimal clinically important difference), M-FIM (motor FIM), OT (occupational therapy), PT (physical therapy), SLT (speech and language therapy), T-FIM (total FIM), TPO (time post onset, days from stroke onset to admission)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: May 14, 2020
Footnotes
Disclosures: none.
Identification
Copyright
© 2020 by the American Congress of Rehabilitation Medicine
