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Interaction Between Recovery of Motor and Language Abilities After Stroke

      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)
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