Article

OBJECTIVE: To explore the perceptions of people with stroke-related dysarthria in
relation to the management and rehabilitation of dysarthria. DESIGN: Qualitative
semi-structured interviews. SETTING: Community setting Subjects: Twenty-four
people with an acquired dysarthria as a result of a stroke in the previous three
years. All were living at home at the time of the interview. None exhibited a
co-existing impairment (for example, aphasia, apraxia or cognitive impairment)
that might have contributed to their communicative experiences. RESULTS:
Participants described the considerable efforts they made to maximize their
communicative effectiveness prior to, and during, communicative interactions.
Activities described included careful articulation and vocal projection as well
as more inconspicuous strategies including pre-planning interactions, focused,
effortful speech and word substitution. Communication was facilitated by a range
of strategies including drafting, rehearsal, manoeuvring and ongoing monitoring
and repair. Self-led speech rehabilitation activities were functionally based and
often undertaken regularly. Some novel reading-aloud and speaking-aloud
activities were described. CONCLUSION: The quantity and nature of inconspicuous,
internalized, cognitive activities people with dysarthria engage in to maximize
their communicative effectiveness should be considered in evaluating the impact
of dysarthria following stroke. Focusing upon externally observable
characteristics alone is insufficient. Challenging, functionally relevant,
patient-focused activities, materials and targets are more likely to be perceived
by the patient as relevant and worthwhile and are thus more likely to ensure
adherence to recommended rehabilitation activities.

Langue : ANGLAIS