Back to Search
Start Over
The longitudinal trajectory of discourse from the hyperacute to the chronic phase in mild to moderate poststroke aphasia recovery: A case series study.
- Source :
- International Journal of Language & Communication Disorders; Jul2023, Vol. 58 Issue 4, p1061-1081, 21p, 2 Diagrams, 5 Charts, 2 Graphs
- Publication Year :
- 2023
-
Abstract
- Background: Discourse analysis has recently received much attention in the aphasia literature. Even if post‐stroke language recovery occurs throughout the longitudinal continuum of recovery, very few studies have documented discourse changes from the hyperacute to the chronic phases of recovery. Aims: To document a multilevel analysis of discourse changes from the hyperacute phase to the chronic phase of post‐stroke recovery using a series of single cases study designs. Methods & Procedures: Four people with mild to moderate post‐stroke aphasia underwent four assessments (hyperacute: 0–24 h; acute: 24–72 h; subacute: 7–14 days; and chronic: 6–12 months post‐onset). Three discourse tasks were performed at each time point: a picture description, a personal narrative and a story retelling. Multilevel changes in terms of macro‐ and microstructural aspects were analysed. The results of each discourse task were combined for each time point. Individual effect sizes were computed to evaluate the relative strength of changes in an early and a late recovery time frame. Outcomes & Results: Macrostructural results revealed improvements throughout the recovery continuum in terms of coherence and thematic efficiency. Also, the microstructural results demonstrated linguistic output improvement for three out of four participants. Namely, lexical diversity and the number of correct information units/min showed a greater gain in the early compared with the late recovery phase. Conclusions & Implications: This study highlights the importance of investigating all discourse processing levels as the longitudinal changes in discourse operate differently at each phase of recovery. Overall results support future longitudinal discourse investigation in people with post‐stroke aphasia. What This Paper Adds: What is already known on the subject: Multi‐level discourse analysis allows for in‐depth analysis of underlying discourse processes. To date, very little is known on the longitudinal discourse changes from aphasia onset through to the chronic stage of recovery. This study documents multi‐level discourse features in four people with mild to moderate aphasia in the hyperacute, acute, subacute and chronic stage of post‐stroke aphasia recovery. What this paper adds to existing knowledge: The study found that most discourse variables demonstrated improvement throughout time. Macrostructural variables of coherence and thematic units improved throughout the continuum whereas microstructural variables demonstrated greater gains in the early compared to the late period of recovery. What are the potential or actual clinical implications of this work?: This study suggests that multilevel discourse analysis will allow a better understanding of post‐stroke aphasia recovery, although more research is needed to determine the clinical utility of these findings. Future research may wish to investigate longitudinal discourse recovery in a larger sample of people with aphasia with heterogenous aphasia profiles and severities. [ABSTRACT FROM AUTHOR]
- Subjects :
- ISCHEMIC stroke
CONVALESCENCE
EFFECT sizes (Statistics)
QUANTITATIVE research
APHASIA
SEVERITY of illness index
COMPARATIVE studies
NEUROPSYCHOLOGICAL tests
INTER-observer reliability
CRONBACH'S alpha
DISCOURSE analysis
SOUND recordings
INTRACLASS correlation
DESCRIPTIVE statistics
DATA analysis software
LONGITUDINAL method
DISEASE complications
Subjects
Details
- Language :
- English
- ISSN :
- 13682822
- Volume :
- 58
- Issue :
- 4
- Database :
- Complementary Index
- Journal :
- International Journal of Language & Communication Disorders
- Publication Type :
- Academic Journal
- Accession number :
- 164960958
- Full Text :
- https://doi.org/10.1111/1460-6984.12844