Aphasia and activities of daily living in stroke patients.
BACKGROUND
Few studies have investigated the relationships between aphasia and activities of daily living (ADLs) in stroke patients.


OBJECTIVE
This study was aimed firstly to determine which task within the ADLs has poorer functional recovery in stroke patients with aphasia after rehabilitation, second to identify which specific task is related to aphasia.


METHODS
This is a prospective and observational study.


METHODS
Inpatients of our Rehabilitation Unit.


METHODS
The study was carried out in 219 patients with primary diagnosis of stroke with (104) and without aphasia (115).


METHODS
All patients underwent usual rehabilitation. Aachen Aphasia Test and Functional Independence Measure scale were used to assess severity of aphasia and ADLs, respectively. Gain in ADLs was the main outcome measure.


RESULTS
At the end of rehabilitation patients with aphasia had lower gain in bathing, dressing upper body, dressing lower body, toileting, stair climbing, and higher gain in social interaction, problem solving, and memory with respect to patients without aphasia. However, when data were adjusted for side of hemiplegia, Fugl-Meyer score and trunk control test, patients with aphasia showed lower gain in dressing upper body (P=0.027), dressing lower body (P=0.009), lower toileting (P=0.027), and higher gain in social interaction (P<0.001). In the multivariate regression analysis, aphasia was an important determinant of gain in bathing (β=0.26), dressing upper body (β=0.24), dressing lower body (β=0.22), lower toileting (β=0.22), and social interaction (β=-0.29).


CONCLUSIONS
The current study points out that, after usual rehabilitation, the patients with aphasia show a poor gain in personal care activities and higher gain in social interaction.


CONCLUSIONS
Knowledge of these findings: 1) can guide the rehabilitation team in selecting specific and appropriate therapies aimed to give patient with aphasia the highest possible functional independence in ADLs; 2) is useful to family members and social rehabilitation services for domiciliary management of patients with aphasia.
Operative Unit for Recovery and Functional Rehabilitation, Scientific Institute of Lumezzane, Fondazione Salvatore Maugeri, IRCCS, Lumezzane, Brescia, Italy - gialanellab@gmail.com.
Bernardo
B
Gialanella
Operative Unit for Recovery and Functional Rehabilitation, Scientific Institute of Lumezzane, Fondazione Salvatore Maugeri, IRCCS, Lumezzane, Brescia, Italy.
Paola
P
Prometti
Operative Unit for Recovery and Functional Rehabilitation, Scientific Institute of Lumezzane, Fondazione Salvatore Maugeri, IRCCS, Lumezzane, Brescia, Italy.
Fabio
F
Vanoglio
Operative Unit for Recovery and Functional Rehabilitation, Scientific Institute of Lumezzane, Fondazione Salvatore Maugeri, IRCCS, Lumezzane, Brescia, Italy.
Laura
L
Comini
Operative Unit for Recovery and Functional Rehabilitation, Scientific Institute of Lumezzane, Fondazione Salvatore Maugeri, IRCCS, Lumezzane, Brescia, Italy.
Raffaele
R
Santoro
D000203:Activities of Daily Living; D000368:Aged; D001037:Aphasia / Q000503:physiopathology* / Q000534:rehabilitation*; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008297:Male; D011446:Prospective Studies; D020127:Recovery of Function; D000071939:Stroke Rehabilitation / Q000379:methods*; D016896:Treatment Outcome