Open AccessDynamics of recovery of speech and cognitive impairment in different periods of ischemic stroke
Author(s) -
В. И. Гузева,
В. И. Гузева,
Olha Bykova,
Olha Bykova,
В. В. Гузева,
В. В. Гузева,
О. В. Гузева,
О. В. Гузева,
Valeria Smirnova,
Valeria Smirnova,
Nadezhda Pavlova,
Nadezhda Pavlova
Publication year - 2018
Publication title -
vestnik rossijskoj voenno-medicinskoj akademii
Language(s) - English
Resource type - Journals
eISSN - 2687-1424
pISSN - 1682-7392
DOI - 10.17816/brmma12229
Subject(s) - aphasia , rehabilitation , stroke (engine) , cognition , audiology , medicine , ischemic stroke , speech therapy , psychology , cardiology , physical therapy , ischemia , psychiatry , mechanical engineering , engineering
The results of the dynamics of speech and other cognitive functions restoration in all periods of ischemic stroke have been established. In the study of speech functions, the motor form of aphasia was more often diagnosed (in 59,1% of cases). In the acute period of ischemic stroke in 80% of cases, speech disorders of severe severity were detected. It was statistically proved that the motor component of speech recovered faster than the touch one. For example, all patients, suffering from sensory aphasia the earlier rehabilitation period ischemic stroke, a volume of understanding speeches sufficiently limited. Parognosia was diagnosed with 50% of patients, in 25% of cases, a violation of phonemic hearing was reviled. At follow-up study there is a positive dynamic in the form of restoration of the impressive component of speech, 75% of patients relatively freely understand human speech. At an in the acute period of ischemic stroke spontaneous speech is changed (lateral and verbal paraphasia is diagnosed in all patients). Polyphasia phenomena had been diagnosed with 50% of patients. Repetitive and dialogue form of speech highly limited. In a late period, polyphasia had been diagnosed with 25% examined. Improvement in the form of a decrease in the number of literal and verbal paraphases was reviled with 75% of patients. 80% of patients were able to dialogue form of speech. In general dynamics of indicators of the degree of speech recovery in women is slightly higher than in men, and does not depend on the age of patients. It was revealed that the most effective speech was restored in the first year after the acute cerebrovascular accident. The restoration of the impressive component of speech was faster in all forms of aphasia. A high level of quality of life was noted in patients with baseline less impaired mobility (an index of Riverbed, Rs=0,68; p=0,01) and less dependent on others (Barthel index, Rs=0,43; p=0,003). Prognostically unfavourable facts for speech restoration include the area of ischemic focus more than 0,8 cm. When assessing cognitive functions in the residual period, 85% of patients were diagnosed with moderate disorders, 15% of patients were diagnosed with mild cognitive impairment. The obtained data substantiate the need to optimize speech therapy assistance in all periods of ischemic stroke.