Speech and language therapy for aphasia following subacute stroke

The aim of this study was to investigate the time window, duration and intensity of optimal speech and language therapy applied to aphasic patients with subacute stroke in our hospital. The study consisted of 33 patients being hospitalized for stroke rehabilitation in our hospital with first stroke but without previous history of speech and language therapy. Sixteen sessions of impairment-based speech and language therapy were applied to the patients, 30-60 minutes per day, 2 days a week, for 8 successive weeks. Aphasia assess- ment in stroke patients was performed with Giilhane Aphasia Test-2 before and after treatment. Compared with before treatment, fluency of speech, listening comprehension, reading comprehension, oral motor evaluation, automatic speech, repetition and naming were improved after treatment. This suggests that 16 seesions of speech and language therapy, 30-60 minutes per day, 2 days a week, for 8 successive weeks, are effective in the treatment of aphasic patients with subacute stroke.

Efficacy of acupuncture as an adjuvant to speech and language therapy for aphasia after ischemic stroke:a protocol of systematic review and meta-analysis

Background:Aphasia is one of the common complications of stroke.Speech and language therapy is a conventional treatment for aphasia following stroke.However,rehabilitation often remains unsatisfactory after speech and language therapy alone.Acupuncture may be effective for aphasia after stroke.We designed this systematic review to assess the efficacy and safety of acupuncture as an adjunct to speech and language therapy for aphasia following ischemic stroke.Methods:An extensive search will be performed in databases including Cochrane Central Register of Controlled Trials,PubMed,Web of Science,EMBASE,China National Knowledge Infrastructure,Sinomed,Wei Pu Date and Wan Fang Data.No limitation will be set in language,publication date or status of the study.The primary outcomes include scores of Western Aphasia Battery and Aphasia Quotient.The secondary outcomes include Scales of Clinical Rehabilitation Research Center Aphasia Examination,Communicative Abilities in Daily Living,Aphasia Battery of Chinese,Chinese Functional Communication Profile,adverse reactions,etc.Results:All of the data will be processed with Review Manager software.Cochrane‘risk of bias’tool will be used to assess the risk of bias.Conclusion:This study will contribute to the selection of appropriate therapies for aphasia after ischemic stroke and the development of clinical guidelines on this topic.

Struggling With Sibilants： Do English Speakers Use Acceptable Alternative Tongue Placements to Pronounce/s/and/z/？

Textbooks on phonology and on teaching ESL （English as a Second Language） often present the place of articulation of the sibilant/s/and its voiced counterpart/z/as a settled matter. The/s/and/z/are described and listed in phonological charts as ＂alveolar fricatives＂, meaning that the tongue is raised and the apex approaches the alveolar ridge. Those teaching pronunciation or remediating speech problems often use these descriptions by the IPA （International Phonetic Association） as models for teaching these phonemes. A number of linguists and instructors, however, have suggested that an acceptable/s/and/z/sound can be produced in English by other means This study attempted to determine the prevalence of the acceptable alternative placements for the/s/and/z/sounds in a sample of 50 English-speaking university students. Results revealed that 64% of participants used alternate tongue positions to that described in the literature as standard. Implications for speech pathology and ESL instruction are discussed.

TREATMENT OF CEREBRAL PALSY WITH APHASIA BY LINGUISTIC TRAINING COMBINED WITH ACUPUNCTURE

Objective： To explore the best remedies for cerebral palsy with aphasia. Methods： A total of 76 cases of cerebral palsy children with aphasia were evenly randomized into control group and treatment group. Patients of treatment group were treated with “consciousness-restoring needling” plus linguistic training and these of control group treated with simple linguistic training method. Acupuncture was given once every other day, and linguistic training conducted once 6 times a week, with 10 times being a therapeutic course and the interval between two weeks being 10 - 15 days. Following 3 courses of treatment, the therapeutic effect was analyzed. Results. After 3 courses of treatment, of the two 38 cases in treatment and control groups, 27 （71.1% ） and 13 （34.2%） had remarkable improvement in their symptoms. The therapeutic effect of treatment group was significantly superior to that of control group （P 〈 0.01 ）. The developmental quotient values of speech of treatment and control groups were 56.36 ± 19.77 and 46.96± 15.63 respectively, displaying that acupuncture could significantly improve cerebral palsy patients＇ speaking ability （P〈0 05）. Conclusion. The therapeutic effect of acupuncture therapy plus linguistic training is significantly superior to that of simple linguistic training .

Effect of acupuncture on the speech and acoustics levelin patients with dysarthria

Objective To observe the effect of acupuncture combined with speech therapy on dysarthria after stroke or cerebral trauma. Methods Sixty-one cases of dysarthria were randomly divided into two groups. The observation group （30 cases） was treated with speech therapy and acupuncture at major acupoints Lianquan （廉泉 CV 23）, Jinjin （金津 EX-HN 12）, Yuye （玉夜 EX-HN 13）, Fengchi（风池 GB 20）, Yifeng （翳风 TE 17） and Wangu（完骨 GB 12）, and the control group （31 cases） was treated with speech therapy only. The changes of speech and acoustical indices were evaluated after 9 weeks treatment. Results The word articulation and the correct rate of writings in the two groups were significantly increased after treatment （both P〈0.01）. The total effective rate of 96.7%（29/30） in the observation group was superior to that of 67.7%（21/31） in the control group （P〈0.01）. The maximum phonation time （MPT） tested by a phonolaryngeal aeromechanical analyzer was significantly prolonged in both the observation group （12 cases） and the control group （11 cases） （both P〈0.01）, the improvement in the observation group being more obvious （P〈0.01）. Conclusion Acupuncture combined with speech therapy can improve the speech and acoustic level in the patient of dysarthria.

Combining electroacupuncture and transcranial direct current stimulation as an adjuvant therapy enhances spontaneous conversation and naming in subacute vascular aphasia:A retrospective analysis

Objective:Emerging evidence shows the effectiveness of speech and language therapy(SLT);however,precise therapeutic parameters remain unclear.Evidence for the use of adjunctive transcranial direct current stimulation(t DCS)to treat post-stroke aphasia(PSA)is promising;however,the utility of combining t DCS and electroacupuncture(EA)has not yet been analyzed.This study assessed the therapeutic consequences of EA and t DCS coupled with SLT in subacute PSA patients who were also undergoing hyperbaric oxygen therapy(HBOT).Methods:A retrospective analysis was conducted on subacute(<6 months)PSA patients who were divided into three groups:patients who received EA plus t DCS(acupuncture group),patients who underwent t DCS(t DCS group),and patients who experienced conventional therapy(HBOT+SLT).All subjects underwent 21 days of treatment and also received conventional treatment.The aphasia battery of Chinese(ABC)was used to score pre-and post-intervention status.Results:The analysis comprised 238 patients.Cerebral infarction was the most frequent stroke type(137[57.6%]),while motor(66[27.7%])and global aphasia(60[25.2%])were the most common types of aphasia.After 21 days of intervention,the ABC scores of all patients were improved.The acupuncture group had the highest ABC scores,but only repetition,naming,and spontaneous speech were statistically improved(P<0.01).Post-hoc tests revealed significant improvement in word retrieval in the acupuncture and t DCS groups(P<0.01,P=0.037),while the acupuncture group had additional significant improvement in spontaneous conversation(P<0.01).Conclusion:Combining acupuncture and t DCS as an adjuvant therapy for subacute PSA led to significant spontaneous speech and word retrieval improvements.Future prospective,multi-ethnic,multi-center trials are warranted.

Effects of acupuncture plus language training on language function and cerebral blood flow in patients with motor aphasia after ischemic stroke

Objective:To observe the effects of acupuncture at the Governor Vessel acupoints plus language training on the language function and cerebral blood flow in patients with motor aphasia after ischemic stroke.Methods:Eighty-six patients were randomized into a control group and an observation group,with 43 cases in each group.Conventional symptomatic treatment was offered to both groups.Besides,the control group received language training,while the observation group received language training plus additional acupuncture at the Governor Vessel acupoints.Before and after treatment,the aphasia battery of Chinese(ABC)and Chinese functional communication profile(CFCP)were tested,and the mean velocity(Vm)and resistance index(Rl)of the left middle cerebral artery(MCA)were detected.Results:The total effective rate was higher in the observation group than in the control group(P<0.05).After treatment,the observation group gained higher scores in oral expression,comprehension,repeating,naming objects,reading,and writing,as well as the general score of ABC(all P<0.Q5)f higher than those in the control group(all P<0.05).The CFCP score increased in both groups after intervention,showing significant intra-group differences(both P<0.05),and the CFCP score was higher in the observation group than in the control group(P<0.05).After treatment,Vm of the left side MCA in creased in the con trol group(P<0.05),while no significant change was observed in Rl(P>0.05);in the observation group,Vm of the left side MCA increased and Rl decreased signfiicantly compared with the baseline(both P<0.05),and were markedly different from those in the control group(both P<0.05).Conclusion:Acupuncture at the Governor Vessel acupoints plus language training can produce valid efficacy in treating motor aphasia after ischemic stroke;it can notably improve the language function,everyday oral communication ability,and in crease cere bral perfusion of the patients.