title: Dysarthria following stroke: the patient's perspective on management and rehabilitation.
abstract: OBJECTIVE
  To explore the perceptions of people with stroke-related dysarthria in relation to the management and rehabilitation of dysarthria.
  
  
  METHODS
  Qualitative semi-structured interviews.
  
  
  METHODS
  Community setting Subjects: Twenty-four people with an acquired dysarthria as a result of a stroke in the previous three years. All were living at home at the time of the interview. None exhibited a co-existing impairment (for example, aphasia, apraxia or cognitive impairment) that might have contributed to their communicative experiences.
  
  
  RESULTS
  Participants described the considerable efforts they made to maximize their communicative effectiveness prior to, and during, communicative interactions. Activities described included careful articulation and vocal projection as well as more inconspicuous strategies including pre-planning interactions, focused, effortful speech and word substitution. Communication was facilitated by a range of strategies including drafting, rehearsal, manoeuvring and ongoing monitoring and repair. Self-led speech rehabilitation activities were functionally based and often undertaken regularly. Some novel reading-aloud and speaking-aloud activities were described.
  
  
  CONCLUSIONS
  The quantity and nature of inconspicuous, internalized, cognitive activities people with dysarthria engage in to maximize their communicative effectiveness should be considered in evaluating the impact of dysarthria following stroke. Focusing upon externally observable characteristics alone is insufficient. Challenging, functionally relevant, patient-focused activities, materials and targets are more likely to be perceived by the patient as relevant and worthwhile and are thus more likely to ensure adherence to recommended rehabilitation activities.
authors: Nursing, Midwifery and Allied Health Professions Research Unit, Glasgow Caledonian University, UK. m.brady@gcu.ac.uk
authors: Marian C
authors: MC
authors: Brady
authors: Alexander M
authors: AM
authors: Clark
authors: Sylvia
authors: S
authors: Dickson
authors: Gillian
authors: G
authors: Paton
authors: Rosaline S
authors: RS
authors: Barbour
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004401:Dysarthria / Q000523:psychology / Q000534:rehabilitation*; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D008875:Middle Aged; D009042:Motivation; D033262:Narration; D010349:Patient Compliance; D057240:Patient Preference; D036301:Qualitative Research; D012606:Scotland; D012648:Self Care; D020521:Stroke / Q000523:psychology; D000071939:Stroke Rehabilitation