Communication impairment and activity limitation in stroke patients with severe aphasia

Abstract

Purpose. 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.

Keywords:

• Communication
• aphasia
• stroke
• ICF

Acknowledgments

The authors would like to thank Pr Orgogozo and Pr Rougier for help in patient inclusion, Ms MF Delair, E Douce, A François-Saint-Cyr, L Longueville, M Michot, B Ribas and J Trias for participating in assessing the patients, Pr R Cooke for editing the English, and the editor and reviewers of Disability and Rehabilitation for their helpful advice.

Declaration of interest: The study was supported by a grant of the French Programme Hospitalier Regional de Recherche Clinique d'Aquitaine N° 10062.