Discourse recovery after severe traumatic brain injury: exploring the first year.

Discourse recovery after severe traumatic brain injury: exploring the first year.
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DOI:
10.1080/02699052.2018.1539246
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发表时间:
2019
期刊:
影响因子:
1.9
通讯作者:
Togher L
Togher L
中科院分区:
医学4区
文献类型:
--
作者:
Elbourn E;Kenny B;Power E;Honan C;McDonald S;Tate R;Holland A;MacWhinney B;Togher L

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虽然对话语障碍了解很多,但对严重创伤性脑损伤(TBI)后的话语恢复知之甚少。本文探讨话语恢复在关键的第一年,控制受伤前,受伤和受伤后的变量。在伤后3、6、9和12个月检查了一个由57名严重TBI参与者组成的初始队列,并与匹配的健康对照参与者的横截面进行了比较。采用主概念分析法对一个叙事语篇任务进行分析。一个混合线性模型的方法被用来跟踪恢复控制受伤前,受伤和受伤后的变量。观察到恢复的上升轨迹,改善的高峰期在3-6个月和9-12个月之间,所有时间点均显著低于对照组。在恢复模型中,受教育年限和PTA持续时间是显著的协变量。失语症的存在也影响了恢复模式。TBI患者通常在第一年有所改善,但许多人在12个月时仍会有话语障碍。在规划服务时,应考虑受教育年限、PTA持续时间和失语症。3-6个月和9-12个月可能是话语恢复的最佳时期,增加支持可能在6-9个月之间有益。
Although much is known about discourse impairment, little is known about discourse recovery after severe traumatic brain injury (TBI). This paper explores discourse recovery across the critical first year, controlling for pre-injury, injury and post-injury variables. An inception cohort comprising 57 participants with severe TBI was examined at 3, 6, 9 and 12 months post-injury and compared to a cross-section of matched healthy control participants. A narrative discourse task was analyzed with main concept analysis (MCA). A mixed linear model approach was used to track recovery controlling for pre-injury, injury and post-injury variables. An upward trajectory of recovery was observed, with peak periods of improvement between 3–6 and 9–12 months and all time points were significantly below controls. Years of education and PTA duration were significant covariates in the recovery model. Presence of aphasia also influenced the recovery model. Individuals with TBI typically improve over the first year, however many will continue to have discourse deficits at 12 months. Years of education, PTA duration and aphasia should be considered when planning services. The 3–6- and 9–12-month periods may offer optimal periods for discourse recovery and increased supports may be beneficial between 6-9 months.
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发表时间: 2002-12-01
影响因子: 2.6
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期刊: BRAIN INJURY
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