1. ABILITY READING COMPREHENSION IN PATIENTS WITH SPEECH AND LANGUAGE IMPAIRMENTS AFTER STROKE Goran Savić, Institute of Physical Medicine and Rehabilitation "Dr Miroslav Zotovic" Banja Luka, Republic of Srpska,
Bosnia and Herzegovina,
Background Impairments of speaking caused by stroke decreases ability to express and comprehend speaking, reading and writing. Alexia is loss or impairment of ability to read brought on by brain damage, in part with the Aphasia syndrome or other cognitive neurological impairments.
Objective is to determine age, sex, education level, stroke aetiology, comorbidity, relation between locations of brain impairment after stroke with reading comprehension sentences and paragraphs in patients with impaired speaking communication.
Patients and Methods During six months, 135 patients from Neurological ward of Institute for rehabilitation ''Dr Miroslav Zotović'' in Banja Luka, have been analyzed. Subtests of Boston Diagnostic Aphasia Examination (BDAE) were used.
Aim is to determine age, sex, education level, stroke aetiology comorbidity, relation between locations of brain impairment after stroke with reading comprehension sentences and paragraphs in patients with impaired speaking communication.
Method During six months speaking of 135 patients from Neurological ward of Institute for rehabilitation ''Dr Miroslav Zotović'' in Banja Luka, have been analyzed. Subtests of Boston Diagnostic Aphasia Examination were used.
Results Average age of the patients was years. In sample were more males than females. Lesions of brain were distributed on 35 different locations. The numerous were multifocal lesions. Than left sided lesions of parietal, frontoparietal, temporal, parietal temporal, frontoparieto temporal, para and / or supra ventricular and other brain regions.
The lowest results were found on word-picture matching (average 45.40% of tests) and comprehension sentences and paragraphs (average 27,55% of tests). Understanding of read materials was lower at left sided compare to right sided brain impairments. There are high correlation between comprehension read materials with auditory understanding speech and language kao i ability nomination tested patients.
Conclusion
Ability reading comprehension in patients with speech and language impairments after stroke in examined sample is low. Degree this functions is depending at location and size brain damage and other factors.
Key words: aphasia, stroke, brain lesion, alexia, comprehension reading
Word-picture matching: Ten words are selected from card 5 to be identified on cards 2 and 3. One point is given for each correct recognition. Sentences and paragraphs: The examiner reads 10 sentences from cards 12 to 16. The client is requested to complete the ending of a sentence with a four multiple choice options. One point is given for each correct sentence.
R e s u l t s
F i g u r e no 1 The age and gender structure of the
patients with speech and language impairments after stroke
F i g u r e no 2 The presence of comorbidities,
and stroke type of the sample
Average age of the patients was years. In sample were more males than females. Brain lesions were distributed on 35 different locations. The most numerous were multifocal lesions, than left sided lesions of parietal, frontoparietal, temporal, parietal temporal, frontoparieto temporal and other brain regions.
The lowest results were found on word-picture matching (average 45.40% of tests) and comprehension sentences and paragraphs (average 27,55% of tests). Understanding of read materials was lower at left sided compare to right sided brain impairments. There are high correlation between comprehension read materials with auditory understanding speech and language such as ability nomination tested patients.
T a b l e no 1 The educational level of the sample
Education level of patients
Frequency
Percent
Primary education 57
42.2
Secondary education 52
38.5
College, Faculty, master’s or equivalent level 13
9.6
Unknown
Total
135
100.0
There is high correlation between results subtest BDAE Comprehensions Read Sentences and Paragraphs with results subtest BDAE Ability Responsive Naming (r =0.625); Naming of picture (r=0.690) and Naming of animals (categorical naming) (r= 0.665). Correlation is significant at the 0.01 level (2-tailed).
T a b l e no 2
The success of the subtest Comprehensions read Sentences and paragraphs in relation to the location of the cerebral lesion
F i g u r e no 4 Success on the subtest BDAE
Comprehension read sentences and paragraphs in
relation to neurological dysfunction side of the body
F i g u r e no 3
Success on the subtest BDAE word – picture matching in relation to neurological dysfunction side of the body
Location of brain lesion
Success to 50% of the test
Success more than 50% of the test
Total
Multifocal hotspot 20 13 33
Unknown location 9 3 12
Parietal left 2 11
Frontoparietal left
Temporal left 7 1 8
Parietotemporal left 6
Frontoparietotemporal left 5
Para and Supraventrik. left 4
Area irrigation ACM left
Frontotemporal left
Basal ganglia left
Basal ganglia booth side
Frontal left
Cerebellum right
Insula left
Temporooccipital left
Para and Supraventric..right
Paraventricular booth side
Hypertensive encephalopathy
Pons booth side
Pons left
Putamen right
Supratentorijal
Supratentorijal right
Cerebellum
Parietal right
Parietal booth side
Frontoparietal right
Frontoparietotemporal right
Parietooccipital left
Basal ganglia right
Supratentorial left
Medulla oblongata
Frontal right
Parietal Temporal right
Parietooccipitotemporal left
100 35
135
There is high correlation between Comprehensions read Sentences and paragraphs with results subtests BDAE auditory understanding: Word discrimination (r = 0.645; p = .000 ); Body part identification (r = 0.545; p = .000 ); Commands (r = 0.588; p = .000 ) and Complex ideational material (r = 0.645; p = .000).
There is high correlation between results Comprehensions read Sentences and paragraphs with results subtest BDAE: Responsive naming (r =0.625; p = .000); Visual Confrontation (r=0.690; p = .000) and Animal naming (r= 0.665; p = .000).
There is high correlation between comprehension Word-picture matching with results subtests BDAE Auditory comprehension: Word discrimination (r = 0.778; p = .000) Body part identification (r = 0.653; p = .000); Commands (r = 0.660; p = .000) and Complex ideational material (r = 0.719; p = .000).
There is high correlation between results comprehensions Word-picture matching with results subtest BDAE: Responsive naming (r =0.745; p = .000); Visual Confrontation (r=0.798; p = .000) and Animal naming (r= 0.698; p = .000).
Conclusion
Ability reading comprehension in patients with speech and language impairments after stroke in examined sample is low. Degree this functions is depending at location and size brain damage and other factors.