NeuroRehabilitation - Volume 38, issue 1

Authors: Marin, Sheilla de Medeiros Correia | Bertolucci, Paulo Henrique Ferreira | Marin, Luis Fabiano | de Oliveira, Fabricio Ferreira | Wajman, Jose Roberto | Bahia, Valéria Santoro | Mansur, Letícia Lessa

Article Type: Research Article

Abstract: BACKGROUND: Few studies have described characteristics of swallowing in primary progressive aphasia (PPA) and its variants. OBJECTIVE: To describe and characterize swallowing and eating behaviors of patients with PPA, as well as their correlates with neuropsychiatric symptoms and patterns of communication. METHODS: We studied 16 patients with PPA and 16 their caregivers. PPA was subdivided in agrammatic variant (PPA-G), semantic variant (PPA-S) and logopenic variant (PPA-L). All patients and their caregivers were screened with the following scales: “Assessment of Feeding and Swallowing Difficulties in Dementia”, “Neuropsychiatric Inventory”, and “Functional Outcome Questionnaire for Aphasia”. RESULTS: …Patients with PPA-S had diverse swallowing problems such as drooling of saliva or food, multiple swallows, delayed swallow and choking, all of which correlated with anxiety, apathy and aberrant motor behavior. Patients with PPA-G and PPA-L had choking and delayed swallow, respectively. Disturbances in eating behaviors were more frequent in the group with PPA-L, and they correlated with difficulties in patterns of communication. CONCLUSIONS: All variants showed swallowing difficulties and they were more frequent in PPA-S. Further studies with larger samples of patients are needed to better characterize swallowing problems and their consequences in the different variants of PPA. Show more

Keywords: Aphasia, primary progressive, deglutition disorders/diagnosis, feeding behavior, communication, behavior, questionnaires

DOI: 10.3233/NRE-151299

Citation: NeuroRehabilitation, vol. 38, no. 1, pp. 85-92, 2016

Authors: Palmer, Christina | Kneebone, Ian I. | Strauss, Clara | Jones, Anna-Marie

Article Type: Research Article

Abstract: BACKGROUND: It is important to evaluate change in order to re-assure commissioners, staff and patients of the effectiveness of interventions, but also in order to identify areas for improvement. OBJECTIVE: To consider whether analysis of improvement at the level of the individual, taking into account measurement error, may offer a further valuable way to assess change and inform service development over considering change at the group level in a post-acute neuro-rehabilitation unit. METHOD: Pre and post intervention Scores on the FIM+FAM Full Scale and Cognitive and Motor subscales were considered for eighteen patients aged between 35 …and 81 with mixed diagnoses who attended a post-acute inpatient neuro-rehabilitation unit for treatment. RESULTS: Statistically significant improvements were achieved on the FIM+FAM Full Scale and Cognitive and Motor subscales in a whole group analysis. Reliable change analyses for each patient within each subscale however identified only half of the sample achieved reliable improvement within the Motor domain and just one person within the Cognitive domain (5.6%). CONCLUSIONS: Findings are consistent with the emphasis of the rehabilitation unit on physical/motor function, and unsurprising as many of those assessed had multiple sclerosis, an often deteriorative condition. Use of reliable change analysis allowed a more detailed understanding of intervention impact, potentially identifying what services reliably work for whom, thereby informing future planning. Show more

Keywords: Neurorehabilitation, reliable change analysis, neurodisability, neurological illness

DOI: 10.3233/NRE-151300

Citation: NeuroRehabilitation, vol. 38, no. 1, pp. 93-98, 2016