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Post-stroke aphasia (PSA) refers to the acquired language impairment caused by the damage of the language function area of the dominant cerebral hemisphere caused by stroke, and the six parts of language functions are spontaneous speech, listening comprehension, repetition, naming, reading and writing.
damaged to varying degrees
.
At present, domestic experience in clinical management of PSA is relatively insufficient
.
In order to promote a more standardized, systematic and comprehensive evaluation of PSA by clinicians and rehabilitation therapists, and to carry out individualized rehabilitation treatment, domestic experts in related fields refer to relevant domestic and foreign studies and guidelines, comprehensively review PSA-related literature, and combine domestic clinical According to the actual situation, an expert consensus on clinical management of PSA in China was compiled
.
Intervention timing PSA can be used for rehabilitation training after stroke is stable
.
It is recommended that neurorehabilitation physicians communicate with speech therapists, physical therapists, occupational therapists and other professionals to determine the appropriate timing of PSA rehabilitation intervention
.
Clinical management process ➤ PSA screening by a neurologist or neurosurgeon within 24 hours of stroke onset; after the condition is stable, a speech therapist will conduct a systematic rehabilitation assessment for PSA patients
.
➤Neurorehabilitation physicians set PSA rehabilitation goals according to the specific situation of the patient; work with speech therapists to determine the intensity and duration of speech and language therapy (SLT); determine compulsory induction training (CIAT), music therapy, computer-assisted One or more combined rehabilitation programs such as speech therapy, transcranial magnetic stimulation (TMS), and transcranial direct current stimulation (tDCS)
.
➤Assess twice a month during the PSA rehabilitation process, execute and record as planned, and finally record the efficacy and summarize the treatment
.
PSA Clinical Management Flowchart Rehabilitation Assessment ➤ Recommendations: ➤ It is recommended that all stroke patients receive PSA screening within 24 hours of onset, and the 9th "best language" item in the National Institutes of Health Stroke Scale can be used
.
Strength of recommendation: Strong recommendation
.
➤ It is recommended that all PSA patients undergo a systematic PSA assessment after their disease is stable, and receive a systematic PSA assessment every half month after the first systematic assessment
.
Strength of recommendation: Strong recommendation
.
Assessment of PSA Type ➤ Stroke and Aphasia Quality of Life Scale (SAQOL-39) is recommended for all patients with PSA to assess their activity and participation
.
Strength of recommendation: Strong recommendation
.
➤It is recommended to predict the prognosis of patients with PSA after systematic evaluation to provide a reference for the formulation of rehabilitation intervention plans
.
Strength of recommendation: Strong recommendation
.
➤ Intravenous thrombolysis or endovascular treatment is recommended within the scope of indications for acute ischemic stroke
.
Strength of recommendation: Strong recommendation
.
➤Drug therapy such as donepezil, piracetam, galantamine, and memantine hydrochloride is recommended as an adjunct to traditional speech therapy
.
Strength of recommendation: Strong recommendation
.
Rehabilitation intervention ➤Recommendation: ➤It is recommended to avoid super-early stroke, and perform PSA rehabilitation training after the condition is stabilized in the acute phase
.
Strength of recommendation: Strong recommendation
.
➤ It is recommended that the cumulative intensity of PSA rehabilitation therapy reaches 50 hours, and centralized training and decentralized training can be selected individually
.
Strength of recommendation: Strong recommendation
.
➤ It is recommended to comprehensively consider factors such as PSA type, severity, and whether it is complicated by other dysfunctions, and select the rehabilitation mode and method individually
.
Strength of recommendation: Strong recommendation
.
➤ It is recommended that a professional speech therapist implement one-to-one SLT-based PSA rehabilitation according to the specific situation of the patient
.
Strength of recommendation: Strong recommendation
.
➤It is recommended that PSA patients undergo CIAT rehabilitation based on SLT
.
Strength of recommendation: Strong recommendation
.
➤ It is recommended to add music therapy on the basis of SLT
.
Strength of recommendation: Strong recommendation
.
➤It is recommended to add computer-assisted speech therapy on the basis of SLT
.
Strength of recommendation: Strong recommendation
.
➤It is recommended that SLT combined with low-frequency repetitive TMS be given to patients with subacute and chronic non-fluent PSA without contraindications
.
Strength of recommendation: Strong recommendation
.
➤ Routine use of tDCS for PSA is not recommended
.
Recommended Strength: Recommended
.
Rehabilitation management ➤ Recommendations: ➤ It is recommended to intervene in personal and environmental factors in the rehabilitation management of PSA
.
Strength of recommendation: Strong recommendation
.
Edited by Yimaitong: Expert consensus on clinical management of aphasia after stroke, Chinese Rehabilitation Theory and Practice, Vol.
28, No.
1, Jan.
2022 Chin J Rehabil Theory Pract,Jan.
,2022,Vol.
28,No.
1
damaged to varying degrees
.
At present, domestic experience in clinical management of PSA is relatively insufficient
.
In order to promote a more standardized, systematic and comprehensive evaluation of PSA by clinicians and rehabilitation therapists, and to carry out individualized rehabilitation treatment, domestic experts in related fields refer to relevant domestic and foreign studies and guidelines, comprehensively review PSA-related literature, and combine domestic clinical According to the actual situation, an expert consensus on clinical management of PSA in China was compiled
.
Intervention timing PSA can be used for rehabilitation training after stroke is stable
.
It is recommended that neurorehabilitation physicians communicate with speech therapists, physical therapists, occupational therapists and other professionals to determine the appropriate timing of PSA rehabilitation intervention
.
Clinical management process ➤ PSA screening by a neurologist or neurosurgeon within 24 hours of stroke onset; after the condition is stable, a speech therapist will conduct a systematic rehabilitation assessment for PSA patients
.
➤Neurorehabilitation physicians set PSA rehabilitation goals according to the specific situation of the patient; work with speech therapists to determine the intensity and duration of speech and language therapy (SLT); determine compulsory induction training (CIAT), music therapy, computer-assisted One or more combined rehabilitation programs such as speech therapy, transcranial magnetic stimulation (TMS), and transcranial direct current stimulation (tDCS)
.
➤Assess twice a month during the PSA rehabilitation process, execute and record as planned, and finally record the efficacy and summarize the treatment
.
PSA Clinical Management Flowchart Rehabilitation Assessment ➤ Recommendations: ➤ It is recommended that all stroke patients receive PSA screening within 24 hours of onset, and the 9th "best language" item in the National Institutes of Health Stroke Scale can be used
.
Strength of recommendation: Strong recommendation
.
➤ It is recommended that all PSA patients undergo a systematic PSA assessment after their disease is stable, and receive a systematic PSA assessment every half month after the first systematic assessment
.
Strength of recommendation: Strong recommendation
.
Assessment of PSA Type ➤ Stroke and Aphasia Quality of Life Scale (SAQOL-39) is recommended for all patients with PSA to assess their activity and participation
.
Strength of recommendation: Strong recommendation
.
➤It is recommended to predict the prognosis of patients with PSA after systematic evaluation to provide a reference for the formulation of rehabilitation intervention plans
.
Strength of recommendation: Strong recommendation
.
➤ Intravenous thrombolysis or endovascular treatment is recommended within the scope of indications for acute ischemic stroke
.
Strength of recommendation: Strong recommendation
.
➤Drug therapy such as donepezil, piracetam, galantamine, and memantine hydrochloride is recommended as an adjunct to traditional speech therapy
.
Strength of recommendation: Strong recommendation
.
Rehabilitation intervention ➤Recommendation: ➤It is recommended to avoid super-early stroke, and perform PSA rehabilitation training after the condition is stabilized in the acute phase
.
Strength of recommendation: Strong recommendation
.
➤ It is recommended that the cumulative intensity of PSA rehabilitation therapy reaches 50 hours, and centralized training and decentralized training can be selected individually
.
Strength of recommendation: Strong recommendation
.
➤ It is recommended to comprehensively consider factors such as PSA type, severity, and whether it is complicated by other dysfunctions, and select the rehabilitation mode and method individually
.
Strength of recommendation: Strong recommendation
.
➤ It is recommended that a professional speech therapist implement one-to-one SLT-based PSA rehabilitation according to the specific situation of the patient
.
Strength of recommendation: Strong recommendation
.
➤It is recommended that PSA patients undergo CIAT rehabilitation based on SLT
.
Strength of recommendation: Strong recommendation
.
➤ It is recommended to add music therapy on the basis of SLT
.
Strength of recommendation: Strong recommendation
.
➤It is recommended to add computer-assisted speech therapy on the basis of SLT
.
Strength of recommendation: Strong recommendation
.
➤It is recommended that SLT combined with low-frequency repetitive TMS be given to patients with subacute and chronic non-fluent PSA without contraindications
.
Strength of recommendation: Strong recommendation
.
➤ Routine use of tDCS for PSA is not recommended
.
Recommended Strength: Recommended
.
Rehabilitation management ➤ Recommendations: ➤ It is recommended to intervene in personal and environmental factors in the rehabilitation management of PSA
.
Strength of recommendation: Strong recommendation
.
Edited by Yimaitong: Expert consensus on clinical management of aphasia after stroke, Chinese Rehabilitation Theory and Practice, Vol.
28, No.
1, Jan.
2022 Chin J Rehabil Theory Pract,Jan.
,2022,Vol.
28,No.
1
