Performance Variability as a Predictor of Response to Aphasia Treatment
Performance Variability as a Predictor of Response to Aphasia Treatment
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DOI：
10.1177/1545968316642522
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发表时间：
2016-10-01
影响因子：
4.2
通讯作者：
Small, Steven L.
中科院分区：
文献类型：
--
作者：
Duncan, E. Susan;Schmah, Tanya;Small, Steven L.
背景失语症患者的表现变异性通常被认为是一个令人讨厌的因素，使评估和治疗变得复杂。Objective.我们提出了另一种假设，即个体内变异代表了个体功能的基本特征，也是治疗选择和预后的重要生物标志物。方法.共有19名慢性失语症患者参加了为期6周的基于模仿的言语治疗试验。我们评估了整体语言功能和重复能力的改善。此外，我们确定了哪些预处理变量最能预测重复测试的改善。结果在西方失语症成套测验修订版（WAB）失语商数、皮质商数和2个分测验以及单独的重复测验上取得了显著进步。使用逐步回归，我们发现，治疗前的个体内变异性是唯一的预测性能的提高重复测试，与更大的治疗前变异性预测更大的改善。此外，在治疗过程中，这种变异性的降低程度与改善程度呈正相关。结论.个体内变异性可能表明给定任务的改进潜力，更均匀的表现表明功能处于或接近峰值潜力。
Background. Performance variability in individuals with aphasia is typically regarded as a nuisance factor complicating assessment and treatment. Objective. We present the alternative hypothesis that intraindividual variability represents a fundamental characteristic of an individual's functioning and an important biomarker for therapeutic selection and prognosis. Methods. A total of 19 individuals with chronic aphasia participated in a 6-week trial of imitation-based speech therapy. We assessed improvement both on overall language functioning and repetition ability. Furthermore, we determined which pretreatment variables best predicted improvement on the repetition test. Results. Significant gains were made on the Western Aphasia Battery-Revised (WAB) Aphasia Quotient, Cortical Quotient, and 2 subtests as well as on a separate repetition test. Using stepwise regression, we found that pretreatment intraindividual variability was the only predictor of improvement in performance on the repetition test, with greater pretreatment variability predicting greater improvement. Furthermore, the degree of reduction in this variability over the course of treatment was positively correlated with the degree of improvement. Conclusions. Intraindividual variability may be indicative of potential for improvement on a given task, with more uniform performance suggesting functioning at or near peak potential.