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.
Darrigrand
Benedicte
B
Academic Hospital of Bordeaux and Research group EA 4136 Handicap and Nervous System, University of Bordeaux, France.
Dutheil
Sabine
S
Michelet
Valerie
V
Rereau
Stephanie
S
Rousseaux
Marc
M
Mazaux
Jean-Michel
JM
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