Communication impairment and activity limitation in stroke patients with severe aphasia.
OBJECTIVE
This study investigated how patients with severe aphasia communicated in daily living, which verbal and non-verbal communication skills were spared and which were impaired, and whether activity limitations in communication are related to verbal impairments.


METHODS
Twenty-seven patients with severe aphasia and 9 with moderate aphasia originating from a sample of 102 aphasic persons followed up in a French regional survey were assessed with a communication test and a communication activity limitation questionnaire 12-18 months after a first stroke.


RESULTS
Patients with severe aphasia suffered severe activity limitations in communication, with performance 3-fold lower than that of patients with moderate aphasia, and 4-fold lower than scores attained by normals. Both aphasia severity and communication disability at follow-up were related to the initial severity of aphasia. Using a phone, credit card and a chequebook, reading and filling in administrative documents, and communication behaviours involved in social life were the most severely impaired. Non-verbal communication performance was not related to aphasia severity.


CONCLUSIONS
We conclude that there is a great need for speech therapy research to develop new compensatory or alternative strategies for patients with severe aphasia.
Academic Hospital of Bordeaux and Research group EA 4136 Handicap and Nervous System, University of Bordeaux, France.
Benedicte
B
Darrigrand
Sabine
S
Dutheil
Valerie
V
Michelet
Stephanie
S
Rereau
Marc
M
Rousseaux
Jean-Michel
JM
Mazaux
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001037:Aphasia / Q000534:rehabilitation*; D003142:Communication; D005260:Female; D005602:France; D006801:Humans; D008297:Male; D008875:Middle Aged; D009042:Motivation; D009633:Nonverbal Communication; D000071939:Stroke Rehabilitation