Broca’s aphasia is frequently observed following a blockage or clot in the middle cerebral artery, leading to a disruption in blood flow. The left middle cerebral artery serves as a supplier of blood to areas of the brain associated with language processing (Orozco & Manso, 2023). Although Broca’s aphasia affects a person’s ability to communicate, it often coexists with other cognitive issues, such as deficits in memory and attention (Acharya & Wrote, 2023). While it is possible for patients with Broca’s aphasia to have fully preserved intellectual capabilities, they tend to exhibit difficulty with spontaneous speech and normal grammatical structure (Orozco & Manso, 2023). Speech is characterised by a slowed rate and interjections or filler words such as “uh” or “um”. Comprehension is often preserved in individuals with Broca’s aphasia as they frequently experience emotional distress and frustration due to their communication deficits (Bastiaanse & Zonneveld, 2004). According to Whitaker (2007), damage in the Broca region leads to an imbalance between one’s linguistic abilities and thoughts. Hence, patients are often aware of the ideas they want to express but struggle to verbally articulate them. That is, they experience difficulty in converting their mental images into spoken words, which affects their ability to speak fluently. The impairment in language functioning observed in Broca’s aphasia is attributed to the role of the Broca region in organising auditory cues into words and words into sentences, establishing connections between different linguistic elements (Whitaker, 2007). The rate of recovery from post-stroke Broca’s aphasia follows a pattern of initial rapid improvement, followed by a slower rate of progress over time. The maximum improvement in language function typically occurs within the first two to six months of recovery. In the early stages of rehabilitation, individuals may experience more rapid gains in language abilities, but as time progresses, changes become slower and more incremental (Fridrich et al., 2019).
Research has demonstrated the efficacy of treatment methods such as Speech and Language Therapy (SLT) in supporting patients with aphasia (Fridrikkson & Hillis, 2021). The primary goal of SLT is to assist in the practical use of communication skills required in everyday life, such as expressing fundamental needs, understanding, and following instructions (Brady et al., 2016). Therapy is tailored to target specific areas of difficulty. For instance, if a patient presents deficits associated with word retrieval, they may be exposed to activities such as matching words to pictures or sorting words by their meaning (Brady et al., 2020). Yasa et al. (2023) conducted an experiment to explore the benefits of combining SLT with technological approaches such as Transcranial Magnetic Stimulation (TMS). Participants were randomly assigned to four different groups: Treatment I. group underwent SLT. The participants were presented with pictures of objects and were instructed to name them. Treatment II. group underwent TMS. Treatment III. group was exposed to both SLT and TMS consecutively, whereas the control group received no treatment. Participants were expected to complete the Stroke and Aphasia Quality of Life Scale (SAQOL), the Test of Language Assessment in Aphasia (ADD), and the Picture Naming Test (PNT). Participants were assessed at one-month follow-up. The findings demonstrated significant improvements in auditory comprehension, speech fluency and naming for all treatment groups. When comparing changes in language abilities between the groups, participants who received SLT alone demonstrated the greatest improvement. Changes were maintained during the follow-up period. No improvements in language abilities were noted among participants of the TMS group. The findings suggest that solely using TMS is not sufficient, as it is the combined use of both treatments that yields significant benefits in individuals with Broca’s aphasia. While Speech and Language Therapy alone can significantly enhance language abilities, the addition of TMS can aid the overall effectiveness of the treatment (Yasa et al., 2023).
Brady et al. (2016) conducted a review of studies to evaluate the efficacy of SLT in post-stroke aphasia patients. Twenty‐seven studies compared SLT to no SLT. The findings revealed that SLT resulted in significant improvements in functional communication, writing, reading, and expressive language compared to no SLT. However, these improvements were not observed at follow‐up. Furthermore, a separate analysis of thirty‐eight studies assessed two diverse approaches to SLT. The results demonstrated that therapy delivered at a higher intensity, dose, or duration resulted in better outcomes in terms of functional communication compared to low intensity, low dose and shorter periods of therapy. One limitation of the present review is its failure to address the practical implementations of SLT, particularly in terms of cost-effectiveness. This would provide an understanding of the impact of SLT on healthcare costs and further aid clinicians in effectively guiding resource allocation (Brady et al., 2016). An experiment by Koyuncu et al. (2016) further investigated the efficacy of SLT as a rehabilitation method in post-stroke aphasic patients. During the experiment, the researchers provided specific exercises to stimulate different aspects of language such as reading, writing, speaking and comprehension. The findings revealed significant improvements for all participants in auditory and reading comprehension, fluency of speech, repetition and naming. Furthermore, even participants with severe aphasia exhibited significant improvements in language functioning following treatment (Koyuncu et al., 2016).
Summary
Speech and Language Therapy (SLT) has proven effective in enhancing communication skills in patients with Broca's aphasia. Combining SLT with advanced techniques such as Transcranial Magnetic Stimulation (TMS) has shown promise in improving treatment outcomes. Research highlights the importance of therapy intensity and duration in achieving better language recovery. However, further investigation into the cost-effectiveness of these interventions is necessary.
References
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