REHABILITATION OF PATIENTS WITH SPEECH DISORDERS OCCURRING FROM POSTERIOR CORTICAL LESIONS

Background: Research data on the compensatory mechanisms in patients with stroke sequelae that have been accumulated within the last years, allows for reconsideration of conventional techniques to restore aphasia. Aim: To increase efficacy of the logopedic rehabilitation of patients with sequelae of the local posterior cortical lesions of the brain. Materials and methods: Two hundred and eighty six patients with aphatic speech disorders during the early and late restorative periods of stroke participated in the study. The presence of aphasia caused by suppressed functioning of the posterior cortical areas was confirmed by the results of neurologic and logopedic assessments using the method of speech assessment in aphasia (L.S. Tsvetkova et al., 1981). Depending on the type of aphasia, the patients were divided in the groups as follows: 1) those with acoustic + gnostic aphasia (middle temporal gyrus); 2) those with acoustic + amnestic aphasia (upper temporal gyrus); 3) those with semantic aphasia (parietal – temporal – occipital areas). All patients underwent a course of logopedic rehabilitation aimed at restoration of the speech thinking. Results: Until now, there was no technique for restoration of acoustic + amnestic and semantic types of aphasia with severe speech impairment. We have developed and implemented modified restoration methods for patients with posterior types of aphasia that increased the efficacy of rehabilitation. An improvement was seen in 61% of patients with severe aphasia, in 68% of those with moderate degree of aphasia and in 90% of patients with mild aphasia. Conclusion: The clue for achievement of very good results of speech thinking restoration was the consideration of the mechanisms of speech impairment and compensatory processes in patients with the stroke sequelae