Rehabilitation of discourse impairments after acquired brain injury

Gindri, Gigiane; Pagliarin, Karina Carlesso; Casarin, Fabíola Schwengber; Ferré, Perrine; Joanette, Yves; Fonseca, Rochele Paz

doi:10.1590/S1980-57642014DN81000009

ABSTRACT

Language impairments in patients with acquired brain injury can have a negative impact on social life as well as on other cognitive domains. Discourse impairments are among the most commonly reported communication deficits among patients with acquired brain damage. Despite advances in the development of diagnostic tools for detecting such impairments, few studies have investigated interventions to rehabilitate patients presenting with these conditions. Objective: The aim of this study was to present a systematic review of the methods used in the rehabilitation of discourse following acquired brain injury. Methods: The PubMed database was searched for articles using the following keywords: "rehabilitation", "neurological injury", "communication" and "discursive abilities". Results: A total of 162 abstracts were found, but only seven of these met criteria for inclusion in the review. Four studies involved samples of individuals with aphasia whereas three studies recruited samples of individuals with traumatic brain injury. Conclusion: All but one article found that patient performance improved following participation in a discourse rehabilitation program.

Key words:
brain injuries; communication; language; rehabilitation

RESUMO

Os prejuízos de linguagem observados em pacientes com lesões cerebrais adquiridas podem ocasionar impacto negativo na vida social do indivíduo assim como em outros domínios cognitivos. Prejuízos em habilidades discursivas estão entre os déficits comunicativos mais comumente reportados em pacientes com lesão cerebral adquirida. Apesar do avanço dos estudos sobre instrumentos para diagnosticar tais déficits, ainda são escassas as investigações que proponham um programa de intervenção para sequelas discursivas. Objetivo: Assim, esta revisão sistemática visou a caracterizar estudos de reabilitação do processamento comunicativo discursivo em casos pós-lesão cerebral adquirida. Métodos: Na base de dados PubMed utilizaram-se palavras-chave dos construtos "reabilitação", "lesão neurológica", "comunicação" e "habilidades discursivas". Resultados: Foram encontrados 162 abstracts, mas apenas sete apresentaram os critérios de inclusão para esta revisão. Quatro estudos envolveram amostras com indivíduos afásicos e três com indivíduos com traumatismo cranioencefálico. Conclusão: Todos, com exceção de um artigo, verificaram evolução dos pacientes após intervenção baseada no discurso.

Palavras-chave:
traumatismos encefálicos; comunicação; linguagem; reabilitação

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REFERENCES

¹
Brookshire RH. Introduction to neurogenic communication disorders. ERIC; 1997.
²
Jørgensen HS, Nakayama H, Raaschou HO, Olsen TS. Recovery of walking function in stroke patients: the Copenhagen Stroke Study. Arch Physic Med Rehab 1995;76:27-32.
³
Murray L, Coppens P. Formal and informal assessment of aphasia. In: Papathanasiou I, Coppens P, Potagas C, editors. Aphasia and related neurogenic communication disorders. Burlington: Jones & Bartlett Learning; 2012.
⁴
Mourik M van, Verschaeve M, Boon P, Paquier P, Harskamp F van. Cognition in global aphasia: Indicators for therapy. Aphasiology 1992;6: 491-499.
⁵
Zaidel E, Kasher A, Soroker N, Batori G. Effects of right and left hemisphere damage on performance of the "Right Hemisphere Communication Battery". Brain lang 2002;80:510-535.
⁶
Herrmann M, Koch U, Johannsen-Horbach H, Wallesch CW. Communicative skills in chronic and severe nonfluent aphasia. Brain Lang 1989; 37:339-352.
⁷
Ortiz KZ, Ferreira CP, Bento ACP. Aplicação do teste Beta 86 (protocolo Mt modificado) em analfabetos. Fono atual 2006;8:65-73.
⁸
Pedersen PM, Vinter K, Olsen TS. Aphasia after stroke: type, severity and prognosis. The Copenhagen aphasia study. Cerebrovasc Dis 2004; 17:35-43.
⁹
Rousseaux M, Daveluy W, Kozlowski O. Communication in conversation in stroke patients. J Neurol 2010;257:1099-1107.
¹⁰
Blake ML. Inferencing processes after right hemisphere brain damage: effects of contextual bias. J Speech Lang Hear Res 2009;52: 373-384.
¹¹
Cote H, Payer M, Giroux F, Joanette Y. Towards a description of clinical communication impairment profiles following right-hemisphere damage. Aphasiology 2007;21:739-749.
¹²
Myers PS. Right hemisphere damage: Disorders of communication and cognition. Singular Pub.; 1999.
¹³
Harley TA. The psychology of language: From data to theory. Taylor & Francis; 2001.
¹⁴
Brandão L. Discurso e cognição em suas variantes da demência frontotemporal e na doença de Alzheimer. Rev Neuropsicol Latinoam 2010; 2:11-24.
¹⁵
Robertson DA, Gernsbacher MA, Guidotti SJ, et al. Functional neuroanatomy of the cognitive process of mapping during discourse comprehension. Psychol Sci 2000;11:255-260.
¹⁶
Van Djik TA. Context and language. Discourse and context: a socio-cognitive approach. New York: Cambridge University Press; 2008.
¹⁷
Tompkins CA, Scharp VL, Fassbinder W, Meigh KM, Armstrong EM. A different story on "theory of mind" deficit in adults with right hemisphere brain damage. Aphasiology 2008;22:42-61.
¹⁸
Lehman Blake M. Clinical relevance of discourse characteristics after right hemisphere brain damage. Am J Speech Lang Pathol 2006; 15:255-267.
¹⁹
Barnes S, Armstrong E. Conversation after right hemisphere brain damage: motivations for applying conversation analysis. Clin Ling Phon 2010;24:55-69.
²⁰
Jorgensen M, Togher L. Narrative after traumatic brain injury: a comparison of monologic and jointly-produced discourse. Brain Inj 2009;23: 727-740.
²¹
Hird K, Kirsner K. The effect of right cerebral hemisphere damage on collaborative planning in conversation: an analysis of intentional structure. Clin Ling Phon 2003;17:309-315.
²²
Angeleri R, Bosco FM, Zettin M, Sacco K, Colle L, Bara BG. Communicative impairment in traumatic brain injury: a complete pragmatic assessment. Brain Lang 2008:229-245.
²³
Ferré P, Ska B, Lajoie C, Bleau A, Joanette Y. Clinical Focus on Prosodic, Discursive and Pragmatic Treatment for Right Hemisphere Damaged Adults: What's Right? Rehab Res Prac 2011;2011:1318-1320.
²⁴
Bryan K. The right hemisphere language battery. Far Communications England; 1989.
²⁵
Joanette Y, Ska B, Cote H. Protocole {MEC}, Protocole Montréal d'évaluation de la communication. Ortho Éd.; 2004.
²⁶
Pimental PA, Kingsbury NA. Mini Inventory of Right Brain Injury. Texas: Pro-Ed.; 1989.
²⁷
Ross-Swain D. Ross information processing assessment. Pro-Ed.; 1986.
²⁸
Ribeiro AF. A utilização de inferências visuais na elaboração do discurso oral de indivíduos normais e indivíduos com lesão de hemisfério direito (Tese). Universidade de São Paulo; 2011.
²⁹
Whitworth A. Using narrative as a bridge: linking language processing models with real-life communication. Semin Speech Lang 2010;31: 64-75.
³⁰
Cicerone KD, Dahlberg C, Kalmar K, et al. Evidence-based cognitive rehabilitation: recommendations for clinical practice. Archives of Physical Medicine and Rehabilitation. WB SAUNDERS CO; 2000;81:1596-1615.
³¹
Cicerone KD, Dahlberg C, Malec JF, et al. Evidence-based cognitive rehabilitation: updated review of the literature from 1998 through 2002. Arch Phys Med Rehabil 2005;86:1681-1692.
³²
Cicerone KD, Langenbahn DM, Braden C, et al. Evidence-based cognitive rehabilitation: updated review of the literature from 2003 through 2008. Arch Phys Med Rehabil 2011;91:519-530.
³³
Tompkins CA. Rehabilitation for cognitive-communication disorders in right hemisphere brain damage. Arch Phys Med Rehabil 2012;93: 61-69.
³⁴
Rispoli MJ, Machalicek W, Lang R. Communication interventions for individuals with acquired brain injury. Dev Neurorehabil 2010;13:141-151.
³⁵
Ardila A. A proposed reinterpretation and reclassification of aphasic syndromes. Aphasiology 2010;24:363-394.
³⁶
Maher LM, Raymer AM. Management of anomia. Top Stroke Rehabil 2004;11:10-21.
³⁷
Foerch C, Misselwitz B, Sitzer M, Berger K, Steinmetz H, Neumann-Haefelin T. Difference in recognition of right and left hemispheric stroke. Lancet 2005;366:392-393.
³⁸
Morris J. Effects of right hemisphere strokes on personality functioning. Top Stroke Rehabil 2009;16:425-430.
³⁹
Sim P, Power E, Togher L. Describing conversations between individuals with traumatic brain injury (TBI) and communication partners following communication partner training: Using exchange structure analysis. Brain Inj 2013;27:717-742.
⁴⁰
Togher L, McDonald S, Tate R, et al. Training communication partners of people with severe traumatic brain injury improves everyday conversations: a multicenter single blind clinical trial. J Rehabil Med 2013;45: 637-645.
⁴¹
Stuss DT, Winocur G, Robertson IH. Cognitive Neurorehabilitation: Evidence and Application. New York: Cambridge University Press; 2008.
⁴²
Cherney LR, Halper AS. Novel technology for treating individuals with aphasia and concomitant cognitive deficits. Top Stroke Rehabil 2008: 542-554.
⁴³
Cherney LR, Halper AS, Holland AL, Cole R. Computerized script training for aphasia: preliminary results. Am J Speech Lang Pathol 2008; 17:19-34.
⁴⁴
Manheim LM, Halper AS, Cherney L. Patient-reported changes in communication after computer-based script training for aphasia. Arch Physic Med Rehabil 2009;90:623-627.
⁴⁵
Simmons-mackie N, Elman RJ, Holland AL, Damico JS. Management of Discourse in Group Therapy for Aphasia. Top Lang Disord 2007; 70420:5-23.
⁴⁶
Carod-Artal J, Egido JA, González JL, Varela De Seijas E. Quality of life among stroke survivors evaluated 1 year after stroke: experience of a stroke unit. Stroke 2000;31:2995-3000.
⁴⁷
Rabelo DF, Neri AL. Recursos psicológicos e ajustamento pessoal frente à incapacidade funcional na velhice. Psicol Est 2005;10:403- 412.
⁴⁸
Cappa SF, Benke T, Clarke S, Rossi B, Stemmer B, Van Heugten CM. EFNS guidelines on cognitive rehabilitation: report of an EFNS task force. Eur J Neurol 2003;10:665-680.
⁴⁹
Rodriguez AD, Rothi LJG. Principles in conducting rehabilitation research. In: Stuss DT, Winocur G, Robertson IH, editors. Cognitive Neurorehabilitation: evidence and application. 2nd ed. New York: Cambridge University Press; 2008:79-90.
⁵⁰
Wilson B. Evidence for the effectiveness of neuropsychological rehabilitation. In: Wilson B, Gracey F, Evans JJ, Bateman A, editors. Neuropsychological rehabilitation: theory, models, therapy and outcome. New York: Cambridge University Press; 2009:22-36.
⁵¹
Mackenzie C, Brady M. Communication difficulties following right hemisphere stroke: applying evidence to clinical management. Evid Based Commun Asses Interv 2008;2:235-247.
⁵²
De Noreña D, Ríos-Lago M, Bombín-González I, Sánchez-Cubillo I, García-Molina A, Tirapu-Ustárroz J. Efectividad de la rehabilitación neuropsicológica en el daño cerebral adquirido (I): atención, velocidad de procesamiento, memoria y lenguaje. Rev Neurol 2010;51:687-698.

Publication Dates

Publication in this collection
Jan-Mar 2014

History

Received
10 Nov 2013
Accepted
15 Jan 2014

This is an open-access article distributed under the terms of the Creative Commons Attribution License

[1] ¹
Brookshire RH. Introduction to neurogenic communication disorders. ERIC; 1997.

[2] ²
Jørgensen HS, Nakayama H, Raaschou HO, Olsen TS. Recovery of walking function in stroke patients: the Copenhagen Stroke Study. Arch Physic Med Rehab 1995;76:27-32.

[3] ³
Murray L, Coppens P. Formal and informal assessment of aphasia. In: Papathanasiou I, Coppens P, Potagas C, editors. Aphasia and related neurogenic communication disorders. Burlington: Jones & Bartlett Learning; 2012.

[4] ⁴
Mourik M van, Verschaeve M, Boon P, Paquier P, Harskamp F van. Cognition in global aphasia: Indicators for therapy. Aphasiology 1992;6: 491-499.

[5] ⁵
Zaidel E, Kasher A, Soroker N, Batori G. Effects of right and left hemisphere damage on performance of the "Right Hemisphere Communication Battery". Brain lang 2002;80:510-535.

[6] ⁶
Herrmann M, Koch U, Johannsen-Horbach H, Wallesch CW. Communicative skills in chronic and severe nonfluent aphasia. Brain Lang 1989; 37:339-352.

[7] ⁷
Ortiz KZ, Ferreira CP, Bento ACP. Aplicação do teste Beta 86 (protocolo Mt modificado) em analfabetos. Fono atual 2006;8:65-73.

[8] ⁸
Pedersen PM, Vinter K, Olsen TS. Aphasia after stroke: type, severity and prognosis. The Copenhagen aphasia study. Cerebrovasc Dis 2004; 17:35-43.

[9] ⁹
Rousseaux M, Daveluy W, Kozlowski O. Communication in conversation in stroke patients. J Neurol 2010;257:1099-1107.

[10] ¹⁰
Blake ML. Inferencing processes after right hemisphere brain damage: effects of contextual bias. J Speech Lang Hear Res 2009;52: 373-384.

[11] ¹¹
Cote H, Payer M, Giroux F, Joanette Y. Towards a description of clinical communication impairment profiles following right-hemisphere damage. Aphasiology 2007;21:739-749.

[12] ¹²
Myers PS. Right hemisphere damage: Disorders of communication and cognition. Singular Pub.; 1999.

[13] ¹³
Harley TA. The psychology of language: From data to theory. Taylor & Francis; 2001.

[14] ¹⁴
Brandão L. Discurso e cognição em suas variantes da demência frontotemporal e na doença de Alzheimer. Rev Neuropsicol Latinoam 2010; 2:11-24.

[15] ¹⁵
Robertson DA, Gernsbacher MA, Guidotti SJ, et al. Functional neuroanatomy of the cognitive process of mapping during discourse comprehension. Psychol Sci 2000;11:255-260.

[16] ¹⁶
Van Djik TA. Context and language. Discourse and context: a socio-cognitive approach. New York: Cambridge University Press; 2008.

[17] ¹⁷
Tompkins CA, Scharp VL, Fassbinder W, Meigh KM, Armstrong EM. A different story on "theory of mind" deficit in adults with right hemisphere brain damage. Aphasiology 2008;22:42-61.

[18] ¹⁸
Lehman Blake M. Clinical relevance of discourse characteristics after right hemisphere brain damage. Am J Speech Lang Pathol 2006; 15:255-267.

[19] ¹⁹
Barnes S, Armstrong E. Conversation after right hemisphere brain damage: motivations for applying conversation analysis. Clin Ling Phon 2010;24:55-69.

[20] ²⁰
Jorgensen M, Togher L. Narrative after traumatic brain injury: a comparison of monologic and jointly-produced discourse. Brain Inj 2009;23: 727-740.

[21] ²¹
Hird K, Kirsner K. The effect of right cerebral hemisphere damage on collaborative planning in conversation: an analysis of intentional structure. Clin Ling Phon 2003;17:309-315.

[22] ²²
Angeleri R, Bosco FM, Zettin M, Sacco K, Colle L, Bara BG. Communicative impairment in traumatic brain injury: a complete pragmatic assessment. Brain Lang 2008:229-245.

[23] ²³
Ferré P, Ska B, Lajoie C, Bleau A, Joanette Y. Clinical Focus on Prosodic, Discursive and Pragmatic Treatment for Right Hemisphere Damaged Adults: What's Right? Rehab Res Prac 2011;2011:1318-1320.

[24] ²⁴
Bryan K. The right hemisphere language battery. Far Communications England; 1989.

[25] ²⁵
Joanette Y, Ska B, Cote H. Protocole {MEC}, Protocole Montréal d'évaluation de la communication. Ortho Éd.; 2004.

[26] ²⁶
Pimental PA, Kingsbury NA. Mini Inventory of Right Brain Injury. Texas: Pro-Ed.; 1989.

[27] ²⁷
Ross-Swain D. Ross information processing assessment. Pro-Ed.; 1986.

[28] ²⁸
Ribeiro AF. A utilização de inferências visuais na elaboração do discurso oral de indivíduos normais e indivíduos com lesão de hemisfério direito (Tese). Universidade de São Paulo; 2011.

[29] ²⁹
Whitworth A. Using narrative as a bridge: linking language processing models with real-life communication. Semin Speech Lang 2010;31: 64-75.

[30] ³⁰
Cicerone KD, Dahlberg C, Kalmar K, et al. Evidence-based cognitive rehabilitation: recommendations for clinical practice. Archives of Physical Medicine and Rehabilitation. WB SAUNDERS CO; 2000;81:1596-1615.

[31] ³¹
Cicerone KD, Dahlberg C, Malec JF, et al. Evidence-based cognitive rehabilitation: updated review of the literature from 1998 through 2002. Arch Phys Med Rehabil 2005;86:1681-1692.

[32] ³²
Cicerone KD, Langenbahn DM, Braden C, et al. Evidence-based cognitive rehabilitation: updated review of the literature from 2003 through 2008. Arch Phys Med Rehabil 2011;91:519-530.

[33] ³³
Tompkins CA. Rehabilitation for cognitive-communication disorders in right hemisphere brain damage. Arch Phys Med Rehabil 2012;93: 61-69.

[34] ³⁴
Rispoli MJ, Machalicek W, Lang R. Communication interventions for individuals with acquired brain injury. Dev Neurorehabil 2010;13:141-151.

[35] ³⁵
Ardila A. A proposed reinterpretation and reclassification of aphasic syndromes. Aphasiology 2010;24:363-394.

[36] ³⁶
Maher LM, Raymer AM. Management of anomia. Top Stroke Rehabil 2004;11:10-21.

[37] ³⁷
Foerch C, Misselwitz B, Sitzer M, Berger K, Steinmetz H, Neumann-Haefelin T. Difference in recognition of right and left hemispheric stroke. Lancet 2005;366:392-393.

[38] ³⁸
Morris J. Effects of right hemisphere strokes on personality functioning. Top Stroke Rehabil 2009;16:425-430.

[39] ³⁹
Sim P, Power E, Togher L. Describing conversations between individuals with traumatic brain injury (TBI) and communication partners following communication partner training: Using exchange structure analysis. Brain Inj 2013;27:717-742.

[40] ⁴⁰
Togher L, McDonald S, Tate R, et al. Training communication partners of people with severe traumatic brain injury improves everyday conversations: a multicenter single blind clinical trial. J Rehabil Med 2013;45: 637-645.

[41] ⁴¹
Stuss DT, Winocur G, Robertson IH. Cognitive Neurorehabilitation: Evidence and Application. New York: Cambridge University Press; 2008.

[42] ⁴²
Cherney LR, Halper AS. Novel technology for treating individuals with aphasia and concomitant cognitive deficits. Top Stroke Rehabil 2008: 542-554.

[43] ⁴³
Cherney LR, Halper AS, Holland AL, Cole R. Computerized script training for aphasia: preliminary results. Am J Speech Lang Pathol 2008; 17:19-34.

[44] ⁴⁴
Manheim LM, Halper AS, Cherney L. Patient-reported changes in communication after computer-based script training for aphasia. Arch Physic Med Rehabil 2009;90:623-627.

[45] ⁴⁵
Simmons-mackie N, Elman RJ, Holland AL, Damico JS. Management of Discourse in Group Therapy for Aphasia. Top Lang Disord 2007; 70420:5-23.

[46] ⁴⁶
Carod-Artal J, Egido JA, González JL, Varela De Seijas E. Quality of life among stroke survivors evaluated 1 year after stroke: experience of a stroke unit. Stroke 2000;31:2995-3000.

[47] ⁴⁷
Rabelo DF, Neri AL. Recursos psicológicos e ajustamento pessoal frente à incapacidade funcional na velhice. Psicol Est 2005;10:403- 412.

[48] ⁴⁸
Cappa SF, Benke T, Clarke S, Rossi B, Stemmer B, Van Heugten CM. EFNS guidelines on cognitive rehabilitation: report of an EFNS task force. Eur J Neurol 2003;10:665-680.

[49] ⁴⁹
Rodriguez AD, Rothi LJG. Principles in conducting rehabilitation research. In: Stuss DT, Winocur G, Robertson IH, editors. Cognitive Neurorehabilitation: evidence and application. 2nd ed. New York: Cambridge University Press; 2008:79-90.

[50] ⁵⁰
Wilson B. Evidence for the effectiveness of neuropsychological rehabilitation. In: Wilson B, Gracey F, Evans JJ, Bateman A, editors. Neuropsychological rehabilitation: theory, models, therapy and outcome. New York: Cambridge University Press; 2009:22-36.

[51] ⁵¹
Mackenzie C, Brady M. Communication difficulties following right hemisphere stroke: applying evidence to clinical management. Evid Based Commun Asses Interv 2008;2:235-247.

[52] ⁵²
De Noreña D, Ríos-Lago M, Bombín-González I, Sánchez-Cubillo I, García-Molina A, Tirapu-Ustárroz J. Efectividad de la rehabilitación neuropsicológica en el daño cerebral adquirido (I): atención, velocidad de procesamiento, memoria y lenguaje. Rev Neurol 2010;51:687-698.

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