8 - Aphasia Treatment Flashcards

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1
Q

A high functional dynamic can be observed in the ___________ after stroke, which has been associated with reorganization processes in the ____________ network, its right-hemisphere homologues and in the vicinity of the lesion site.

A

First days and weeks

Left-lateralized language

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2
Q

What seven things can cause improvement in Aphasia post-stroke?

A

Physiological change occurring during the evolution

Behavioral-physiological relationships in aphasia recovery

Reperfusion of the ischemic penumbra

Diaschisis, disconnection and reconnection

Upregulation of right hemisphere homologues (equivalent areas in RH)

Reactivation of peri-lesional areas

Functional reorganization of language networks

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3
Q

If you don’t know why you are doing something then…

A

You probably shouldn’t be doing it.

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4
Q

Is every aphasia patient a candidate for therapy?

A

No

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5
Q

Will all patients improve with treatment?

A

No

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6
Q

How many patients will return to 100% of premorbid levels of function?

A

Very few

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7
Q

Do all patients want to be in treatment?

A

No

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8
Q

What has a major influence on our ability to provide treatment?

A

Insurance coverage

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9
Q

What is Treatment Outcome?

A

A comparison of an outcome to a later point in time

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10
Q

What is Treatment Efficacy?

A

The probability that a treatment will benefit individuals in a defined population for a given population under IDEAL conditions

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11
Q

What is Treatment Effectiveness?

A

The probability that a treatment will benefit individual in a defined population for a given problem under AVERAGE conditions

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12
Q

What is Treatment Efficiency?

2

A

Treatment that is effective with a minimum of waste, expense, and necessary effort

High ration of output to input

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13
Q

What are Cochrane Reviews?

A

Summary reports on all kinds of treatment

They usually focus on big studies

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14
Q

How does the average effect on treated recovery compared to the average effect of untreated recovery?

A

Treated recovery has twice as much success

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15
Q

What should be the minimum weekly amount of therapy for aphasia its?

A

2 hours per week

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16
Q

Who treats aphasia patients?

7

A

Neurologists

Physiatrists

Speech-Language Pathologists

Occupational Therapists

Physical Therapists

Therapeutic Recreation Specialists

Neuropsychologists

17
Q

What often dictates the frequency and duration of treatment?

What are clinicians required to do?

When does discharge planning begin?

A

3rd party payers

Criteria for deciding how long a treatment program should last

Onset of treatment

18
Q

What should be the three goals of aphasia treatment?

A

Facilitating effective communication despite residual impairments

Facilitating “communication competence” (the use of language in naturalistic environments)

Generalization

19
Q

What should be the focus and progression of aphasia treatment?

(4)

A

Treat to test approach (identifying deficit areas on tests and construct tasks to mimic these)

Selective treat-to-the-test approach (assign more importance to some tests than others)

Treat underlying processes approach (treat underlying cognitive processes that impact language domains)

Reactivation or restimulating approach (Treating underlying process)

20
Q

What are five metacognitive processes important to treatment outcomes?

A

Self-awareness and Insight

Motivation

Self-monitoring

Self-initiation

Goal-oriented Behavior

21
Q

Does beginning treatment early vs late have an effect on recovery?

A

Yes

22
Q

What five things can effect a patient’s candidacy for treatment?

A

Amount and duration

Location of injury

Medical and Physical condition

Enthusiasm and motivation

Financial Resources

23
Q

What four things should treatment focus on?

A

Individual

Functionality

Patient’s strengths

Patient’s level of breakdown

What a patient can do

24
Q

What sort of improvement is often seen in aphasia patients in a 1+ years after initiating event?

A

Functional improvemetn

25
Q

What is constraint induced therapy?

What is the time committment?

A

Forcing a patient to use areas of weakness

30 hours of treatment over two weeks

26
Q

Do patients make major gains due to intense therapy (5+ hours per week)?

(2)

A

No

2-4 hours per week are equally as effective

27
Q

Are most patients able tolerate more than 2 hours of treatment immediately post-stroke?

A

No

28
Q

What is CATE (Complexity Account of Treatment Efficacy)?

2

A

A program to treat expressive speech

Training sentences that increase in complexity

29
Q

What are often treatment targets in CATE (Complexity Account of Treatment Efficacy)?

A

Atypical categories

30
Q

What is often the focus for SLPs in acute settings?

2

A

Swallowing is taking priority

Communication is taking a back seat