Speech disorders and post stroke rehabilitation

Aim. To assess the dynamics of regression of post-stroke aphasia and dysarthria and their impact on the rehabilitation process in patients in the acute period of stroke. Materials and methods. 718 patients (median age 68.5 (61.0; 76.0)) in the acute phase of stroke were examined. Upon admission and discharge from the hospital, assessments were made using the Wasserman, Barthel, Rankin, and NIHSS scales, the increase in scores from the first day after the onset of stroke to discharge was determined, the duration of inpatient treatment was as sessed. Results. The patients were divided into 3 groups: 246 without speech disorders, 226 with aphasia and 246 with dysar thria. The increase in the Wasserman scale score during the period of hospitalization was higher in cases of dysarthria, while aphasia demonstrated a slower regression (р = 0,0001). The lowest level of NIHSS score increase was observed in patients with aphasia, the highest – with normal speech (p = 0.001). In the group with dysarthria, there were no statistically significant dif ferences when compared with the group without speech pathology (p = 0.241). The increase in the Barthel scale scores in patients with aphasia was significantly lower than the data for the other groups: p = 0.001 when compared with patients without speech disorders and p = 0.007 when compared with the dysarthria group. When comparing the score increase in patients with out speech disorders and with dysarthria, statistically significant differences in the Barthel index were not revealed (p = 0.116). The highest increase in Rankin scores was observed in patients with normal speech, slightly higher in patients with dysarthria, and the lowest increase in patients with aphasia (p = 0.0001). Patients with aphasia had the longest hospitalization periods, while patients without speech pathology spent the shortest time in hospital. In patients with dysarthria, hospitalization periods were al so prolonged, but less significantly than in those with aphasia (p = 0.0001). Conclusion. Speech dysfunction in post-stroke dysarthria regresses faster compared to aphasia. Post-stroke dysarthria and aphasia negatively impact the rehabilitation pro cess, reducing the patient's functional capabilities and prolong ing hospital stays. The presence of aphasia hinders the expan sion of daily activities and delays the recovery of neurological impairments during the acute phase of stroke. Dysarthria does not significantly impact the recovery dynamics as measured by the NIHSS and Barthel scales.

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