Combination Treatment in Aphasia: Unilateral Nostril Breathing and Language Therapy

Transcription

1 Combination Treatment in Aphasia: Unilateral Nostril Breathing and Language Therapy Rebecca Shisler Marshall 1, Jacqueline Laures-Gore 2, Micheala DuBay 2, Tiffany Williams 1, Dana Bryant 1 University of Georgia 1 Georgia State University 2 We have no relevant financial or nonfinancial relationships in the products or services described, reviewed, evaluated or compared in this presentation.

2 Aphasia

3 Alternatives? Complementary and Alternative Medicine Integrative Medicine

4 Domains and Examples Goldrosen & Strauss, 2004

5

6 STRESS Decreases immune function, alters DNA Brain Perceives Stress NT, hormones released Changes blood flow, neurons Raises blood pressure, decreases memory

7 Stress Reduction Integrative/CA medicine has been found to reduce stress Naturopathy Lobo et al. (2011) Massage Cady & Jones (2007); Bost & Wallis (2006) Qigong Skoglund & Jansson (2007); Ryu et al. (1996) Mindfulness Meditation Greeson (2009); Larzelere & Jones (2008); Quillian-Wolever (2003) Yoga (postures and breathing) Michalsen et al. (2005)

8 Yogic Breathing

9 Yogic Breathing Unilateral nostril breathing is a type of pranayama Thought to increase prana the vital, life-sustaining force of living beings and vital energy in natural processes of the universe. Breathing is the method of absorbing prana

10 Physiological Change Increase parasympathetic, decrease sympathetic activity Pal et al., (2004)

11 Cognitive Change Increase cognition in contralateral hemispheres Werntz et al. (1987) Increase verbal and spatial skills Jella & Shannahoff-Khalsa (1993)

12 Really? Helpful for individuals with aphasia? Stroke can lead to deficits in: sympathetic and parasympathetic functions (Korpelainen, Sotaniemi, & Myllylä, 1999) Language, Attention, Mood Preliminary results that it can alter language Marshall, Basilakos, Williams, & Love-Myers (in prep)

13 What if yogic breathing could be used in combination with traditional aphasia treatment? Reduce stress and increase language

14 Participants and Methods Three individuals with aphasia Multiple-baseline, single subject All participants were attending speech-language intervention sessions (two 50-minute sessions/week) in a university setting while enrolled in this study.

15 Participants Age Gender Hemisphere of Stroke Months post-onset Handednes s Type of Aphasia A1 49 Female Left 22 months Right Broca s A2 51 Female Left 21 months Right Broca s A3 74 Male Right 12 months Left Global

16 Baseline Pre-Treatment Assessment WAB-R CADL-2 ABA-2* A1 and A2

17 General Probes: Language (content and productivity) Correct information units Word productivity Attention Color Trails Test Methods

18 Methods Individualized Probes A1: orally reading ten single-syllable functional words A2: completing steps 4 and 5 of Rosenbek s 7-step continuum A3: confrontational naming task of trained and untrained visual picture stimuli.

19 Results

20 1. Increase in performance on WAB-R Aphasia Quotient Results

21 60 WAB-R Aphasia Quotient Pre-Test Post-Test A1 A2 A3

22 Results 1. Increase in performance on WAB-R Aphasia Quotient 2. Increase in total number of CIUs

23 Total CIUs

24 Results 1. Increase in performance on WAB-R Aphasia Quotient 2. Increase in total number of CIUs 3. Increases in language measures that correlate with decreased stress Word productivity

25 Productive Words

26 More Results

27 80 CADL Pre-Test Post-Test A1 A2 A3 Percentile

28 Color Trails -1

29 Color Trails-2

30 Individualized Probes

31 A1: Oral Word Reading

32 A2: Rosenbeck s

33 A3: Confrontational Naming

34 Conclusions Combined treatment may benefit overall language production and functional communication May decrease stress to help SLP treatment No change in attention Therapy did not focus on attention Future research could focus on attention in treatment No change in language specific probes Holds promise for augmenting language therapy

35 Aphasia and Aging Research Laboratory University of Georgia Dr. Rebecca Shisler Marshall Aphasia and Motor Speech Disorders Laboratory Georgia State University Dr. Jacqueline Laures-Gore