两种手动作视频对脑卒中慢性非流畅性失语症患者言语功能的影响

Effect of two hand action videos on language function of patients with chronic non-fluent aphasia after stroke

目的探讨目标导向与非目标导向手动作视频对脑卒中慢性非流畅性失语症患者语言功能的影响。方法选择2018年1月-2020年1月在首都医科大学友谊医院平谷医院治疗的42例脑卒中慢性非流畅性失语患者,采用随机数字表法分为对照组和观察组,每组各21例。观察组患者采用非目标导向手动作视频+描述动作的语音提示+动词复述,对照组患者采用目标导向手动作视频+描述动作的语音提示+动词复述。2组患者每周连续训练6 d,连续训练4周,采用西方失语症成套测验(WAB)、失语商评分(AQ)和日常生活交流能力评分(CADL)对2组患者训练前后的语言功能、言语流畅性和日常生活交流能力进行评价并比较。结果 2组患者训练后WAB测验中自发言语、听觉理解及复述维度评分均较训练前明显增高(P均<0.05),且观察组患者的各维度评分均明显高于对照组(P均<0.05),但2组患者命名维度的评分训练前后比较差异均无统计学意义(P均>0.05);2组患者训练后言语流畅性评分、AQ评分及CADL评分均较训练前明显增高(P均<0.05),且观察组患者言语流畅性评分、AQ评分及CADL评分均明显高于对照组(P均<0.05)。结论目标导向与非目标导向手动作视频训练均有利于脑卒中慢性非流畅性失语症患者语言功能的恢复,而非目标导向手动作视频训练更有利于言语流畅度、复述、听理解及日常生活交流能力的改善。

Objective It is to explore the effect of goal-directed and non goal-directed hand motion video on language function of stroke patients with chronic non-fluent aphasia.Methods Forty-two stroke patients with non-fluent aphasia who were treated in Beijing Pinggu District Hospital from January 2018 to January 2020 were selected and randomly divided into control group and observation group by random number method,with 21 cases in each group.The patients in the observation group were treated with non goal-directed hand motion video+voice prompt for describing the movement+verb retelling,the patients in the control group were treated with goal-directed hand motion video+voice prompt for describing the movement+verb retelling.The patients in the two groups were trained for 6 consecutive days per week and trained for 4 consecutive weeks.The patients'language function,verbal fluency performance,daily communication skills of the two groups were evaluated and compared with western aphasia battery(WAB),aphasiaquotient(AQ)and communicative abilities in daily living(CADL).Results After training,the scores of self speech,auditory comprehension and retelling in WAB test in the two groups were significantly higher than those before training(all P<0.05),and the scores of all dimensions in the observation group were significantly higher than those in the control group(all P<0.05),but there was no significant difference in the scores of naming dimensions between the two groups before and after training(P>0.05);the scores of speech fluency,AQ and CADL after training were all higher than those before training in the two groups(all P<0.05),and the scores of speech fluency,AQ and CADL in the observation group were significantly higher than those in the control group after training(P<0.05).Conclusion Both goal-directed and non goal-directed hand motion video training are beneficial to the recovery of language function in patients with chronic non fluent aphasia after stroke,non goal-directed hand action video training is more beneficial to improve speech fluency,retelling,listening comprehension and daily life communication ability.