词联导航训练法在社区言语康复中的应用研究

Application Study of Word Association Navigation Training for Speech Rehabilitation in Patients with Aphasia in Community

目的探讨治疗师和家属采用词联导航训练法(WANT)对失语症患者言语功能改善的作用。方法 35例失语症患者首先根据训练实施者和训练方法中有无词联关系,随机分为治疗师-词联导航组(ST-WANT,n=9)、治疗师-词联无关组(ST-WNNT,n=8)、家属-词联导航组(LT-WANT,n=9)和家属-词联无关组(LT-WNNT,n=9)。在西方成套失语症检查和简易精神状态检查基线测试后,分别由治疗师和家属对患者进行为期10 d,每天1次言语训练。治疗前后应用75张训练图和45张拓展图评估患者命名能力。结果治疗后除ST-WNNT和LT-WNNT两组拓展词外,其余各组正确反应数均显著增加。治疗后ST-WANT和LT-WANT两组训练词正确反应数分别显著高于ST-WNNT和LT-WNNT两组,而LT-WANT组拓展词正确反应数显著高于LT-WNNT组。结论治疗师和家属采用WANT均可有效改善失语症患者的命名能力,且在词汇拓展能力方面家属训练优于治疗师,提示WANT可以适用于家庭和社区的言语康复治疗。

Objective To explore the effects of word association navigation training（WANT） applied by speech therapists and laypersons on the improvement of speech function in patients with aphasia. Methods Thirty five patients with aphasia were randomly divided into speech therapist with WANT （ ST-WANT, n = 9 ） , speech therapist with word non-association navigation training （ ST-WNNT, n = 8 ） , layperson with WANT （ LT-WANT, n = 9 ） and layperson with WNNT （ LT-WNNT, n = 9 ） , according to the administrators and therapy strategy. After baseline tests of Western Aphasia Battery （WAB） and Mini Mental Status Exami- nation（ MMSE）, all the patients with aphasia received speech training daily for 10 consecutive days implemented by speech thera- pists and laypersons respectively. The naming ability was evaluated with 75 pictures before and after training respectively in all the patients. Results Except for the expand words ST-WNNT and LT-WNNT, the numbers of correct responses after training inother groups were significantly higher than that before training in the same group. The numbers of correct responses of the trained words after training with WANT by ST and LT were significantly higher than that after training with WNNT by ST and LT, and the num- bers of correct responses of the expand words after training in the group of LT-WANT were significantly higher than that after training in the group of LT-WNNT. Conclusion WANT implemented by speech therapists and laypersons may both effectively increase the naming ability in patients with aphasia. LT is better than ST in vocabulary development ability. It is suggested that WANT can be Used for speech rehabilitation therapy in family and community.