{"id":147,"date":"2024-04-11T08:44:35","date_gmt":"2024-04-11T06:44:35","guid":{"rendered":"https:\/\/roneuro.ro\/blog\/interventia-logopedica-la-pacientii-cu-traumatism-craniocerebral-sau-avc\/"},"modified":"2024-04-22T12:51:05","modified_gmt":"2024-04-22T10:51:05","slug":"logopedia-in-neurologie","status":"publish","type":"post","link":"https:\/\/roneuro.ro\/blog\/logopedia-in-neurologie\/","title":{"rendered":"Logopedia \u00een neurologie &#8211; recuperarea limbajului pentru pacien\u021bii cu traumatism craniocerebral sau AVC"},"content":{"rendered":"\n<h2>Logopedia \u00een neurologie &#8211; recuperarea limbjului pentru pacien\u021bii cu traumatism craniocerebral sau AVC<\/h2>\n<p>\u00cen urma leziunii cerebrale se poate pierde conexiunea dintre imaginea mental\u0103 a unui cuv\u00e2nt cu semnifica\u021bia acestuia, \u00eentre expresia sonor\u0103 \u0219i semnifica\u021bia cuv\u00e2ntului, sau leg\u0103tura dintre expresia sonor\u0103 a unui cuv\u00e2nt cu schema motorie de articulare a cuv\u00e2ntului.<\/p>\n<p><strong>Un traumatism cerebral sau un accident vascular afecteaz\u0103 emisfera cerebral\u0103 st\u00e2ng\u0103, la cei cu manualitate dreapt\u0103 \u0219i poate produce o afectare a limbajului mai mult sau mai pu\u021bin sever\u0103, \u00een func\u021bie de particularit\u0103\u021bile leziunii.<\/strong><\/p>\n<p><strong>Scopul terapiei logopedice este de a recupera func\u021biile pierdute<\/strong>. Totu\u0219i, este important \u0219i ca pacien\u021bii s\u0103 \u00eenve\u021be s\u0103 func\u021bioneze cu deficitele existente prin tehnici de compensare (ex. vorbitul mai lent), pentru a desf\u0103\u0219ura activit\u0103\u021bile zilnice mai sigur, mai u\u0219or \u0219i mai independent.<\/p>\n<p>Pentru a \u00een\u021belege mai bine cauzele AVC, vizita\u021bi <a href=\"https:\/\/roneuro.ro\/blog\/accidentul-vascular-cerebral\/\">urm\u0103torul link.<\/a><\/p>\n<p>Pentru informa\u021bii despre reabilitarea post-AVC, accesa\u021bi <a href=\"https:\/\/roneuro.ro\/blog\/recuperare-dupa-avc\/\">acest link<\/a>, iar pentru informa\u021bii despre preven\u021bia acestei afec\u021biuni<a href=\"https:\/\/roneuro.ro\/blog\/cum-se-poate-preveni-accidentul-vascular-cerebral\/\"> click aici.<\/a><\/p>\n<p>Pentru \u00een\u021belegerea cauzelor \u0219i mecanismelor TCC, <a href=\"https:\/\/roneuro.ro\/blog\/traumatismele-craniocerebrale\/\">vizita\u021bi acest articol<\/a>.<\/p>\n<h2>Cum func\u021bioneaz\u0103 limbajul?<\/h2>\n<p>Exist\u0103 dou\u0103 arii cerebrale mari care guverneaz\u0103 limbajul (Wernicke \u0219i Broca). Localizarea leziunii, predominant \u00een una dintre arii, determin\u0103 caracteristicile tulbur\u0103rii de limbaj de tip afazic:<\/p>\n<ul>\n<li><strong>Wernicke<\/strong> \u2013 afazia fluent\u0103 cu o comprehensiune (\u00een\u021belegere) a limbajului diminuat\u0103;<\/li>\n<li><strong>Broca <\/strong>\u2013 comprehensiunea p\u0103strat\u0103 \u0219i imposibilitatea exprim\u0103rii verbale.<\/li>\n<\/ul>\n<p>Cele dou\u0103 tipuri de afazie pot coexista, cu diferite grade de predominan\u021b\u0103 \u0219i diferite particularit\u0103\u021bi.<\/p>\n<p><img fetchpriority=\"high\" decoding=\"async\" class=\"wp-image-967 aligncenter\" src=\"https:\/\/roneuro.ro\/blog\/wp-content\/uploads\/2020\/02\/Ariile-limbajului.jpeg\" alt=\"\" width=\"900\" height=\"454\" title=\"\" srcset=\"https:\/\/roneuro.ro\/blog\/wp-content\/uploads\/2020\/02\/Ariile-limbajului.jpeg 1600w, https:\/\/roneuro.ro\/blog\/wp-content\/uploads\/2020\/02\/Ariile-limbajului-300x151.jpeg 300w, https:\/\/roneuro.ro\/blog\/wp-content\/uploads\/2020\/02\/Ariile-limbajului-1024x516.jpeg 1024w, https:\/\/roneuro.ro\/blog\/wp-content\/uploads\/2020\/02\/Ariile-limbajului-768x387.jpeg 768w, https:\/\/roneuro.ro\/blog\/wp-content\/uploads\/2020\/02\/Ariile-limbajului-1536x775.jpeg 1536w, https:\/\/roneuro.ro\/blog\/wp-content\/uploads\/2020\/02\/Ariile-limbajului-750x378.jpeg 750w, https:\/\/roneuro.ro\/blog\/wp-content\/uploads\/2020\/02\/Ariile-limbajului-1140x575.jpeg 1140w\" sizes=\"(max-width: 900px) 100vw, 900px\" \/><\/p>\n<p>Asemeni reconstruc\u021biei unui castel d\u0103r\u00e2mat din piese de lego ce \u00een urma loviturii se \u00eempr\u0103\u0219tie \u00een buc\u0103\u021bele mici individuale sau \u00een buc\u0103\u021bele mai mari, din mai multe piese de lego, recuperarea logopedic\u0103 presupune identificarea p\u0103r\u021bilor mai mari \u0219i reconstruc\u021bia castelului pornind de la acestea.<\/p>\n<h2>Se poate recupera vorbirea?<\/h2>\n<p>Exist\u0103 un proces intern, natural, de preluare a func\u021biilor ariilor cerebrale afectate de c\u0103tre ariile vecine, prin crearea a noi conexiuni neuronale, care reprezint\u0103 un factor facilitator \u00een recuperarea limbajului. <strong>Interven\u021bia logopedic\u0103 prin tehnicile de stimulare concomitent\u0103 pe mai multe canale senzoriale, utilizeaz\u0103 acest factor \u00een reconstruc\u021bia informa\u021biilor.\u00a0<\/strong>Comprehensiunea, \u00een\u021belegerea vorbirii, se recupereaz\u0103 deseori mai rapid dec\u00e2t exprimarea verbal\u0103.<\/p>\n<p><strong>Recuperarea limbajului expresiv presupune, pentru \u00eenceput, efectuarea de exerci\u021bii pentru redob\u00e2ndirea mobilit\u0103\u021bii aparatului fonoarticulator, urmate de stimularea produc\u021biei de sunete simple, apoi de unirea acestora \u00een cuvinte.<\/strong><\/p>\n<p><img decoding=\"async\" class=\"wp-image-968 aligncenter\" src=\"https:\/\/roneuro.ro\/blog\/wp-content\/uploads\/2020\/02\/Terapia-logopedica-post-AVC.jpeg\" alt=\"\" width=\"900\" height=\"412\" title=\"\" srcset=\"https:\/\/roneuro.ro\/blog\/wp-content\/uploads\/2020\/02\/Terapia-logopedica-post-AVC.jpeg 1600w, https:\/\/roneuro.ro\/blog\/wp-content\/uploads\/2020\/02\/Terapia-logopedica-post-AVC-300x137.jpeg 300w, https:\/\/roneuro.ro\/blog\/wp-content\/uploads\/2020\/02\/Terapia-logopedica-post-AVC-1024x469.jpeg 1024w, https:\/\/roneuro.ro\/blog\/wp-content\/uploads\/2020\/02\/Terapia-logopedica-post-AVC-768x352.jpeg 768w, https:\/\/roneuro.ro\/blog\/wp-content\/uploads\/2020\/02\/Terapia-logopedica-post-AVC-1536x704.jpeg 1536w, https:\/\/roneuro.ro\/blog\/wp-content\/uploads\/2020\/02\/Terapia-logopedica-post-AVC-750x344.jpeg 750w, https:\/\/roneuro.ro\/blog\/wp-content\/uploads\/2020\/02\/Terapia-logopedica-post-AVC-1140x522.jpeg 1140w\" sizes=\"(max-width: 900px) 100vw, 900px\" \/><\/p>\n<p style=\"text-align: left;\">Vocabularul specific ariilor de interes ale pacientului, impulsul emo\u021bional \u0219i motiva\u021bia sunt factori ce faciliteaz\u0103 expresia sonor\u0103 a cuvintelor. Terapia logopedic\u0103 dupa un AVC, \u00eembun\u0103t\u0103\u021be\u0219te diverse func\u021bii [1]. Terapia la intensitate mare, \u00een doze mari sau pe o perioad\u0103 mai lung\u0103 de timp poate fi benefic\u0103 [1]. Tocmai de aceea, logopedia \u00een neurologie are un rol vital \u00een recuperarea limbajului.<\/p>\n<p style=\"text-align: center;\"><iframe title=\"YouTube video player\" src=\"https:\/\/www.youtube.com\/embed\/XmtTvgCuiuI?si=ySkSAjnscBL1W5DD\" width=\"560\" height=\"315\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><\/iframe><\/p>\n<h2>Resurse \u0219i suport pentru pacien\u021bi<\/h2>\n<p>Programa\u021bi-v\u0103 acum pentru evaluare la un medic neurolog contact\u00e2nd recep\u021bia Institutului <strong>RoNeuro<\/strong> la num\u0103rul de telefon<strong> <a href=\"tel:+40374462222\">0374 46 2222<\/a><\/strong>, luni \u0219i mar\u021bi \u00eentre orele <strong>08:00 &#8211; 19:00<\/strong>, iar de miercuri p\u00e2n\u0103 vineri \u00eentre orele <strong>08:00 &#8211; 18:00. <\/strong><\/p>\n<p>La momentul program\u0103rii, pute\u021bi opta \u0219i pentru consulta\u021bie neurologic\u0103 gratuit\u0103, decontat\u0103 prin Casa Na\u021bional\u0103 de Asigur\u0103ri de S\u0103n\u0103tate. Mai mult, pot fi efectuate program\u0103ri online.<\/p>\n<p style=\"text-align: center;\"><a style=\"background-color: #6852ed; color: white; text-decoration: none; border: none; padding: 10px 20px; cursor: pointer; display: inline-block;\" href=\"https:\/\/www.roneuro.ro\/progamari.html\">Program\u0103ri online aici!<\/a><\/p>\n<p>Locui\u021bi \u00eentr-o zon\u0103 izolat\u0103 sau nu v\u0103 pute\u021bi deplasa la clinic\u0103? RoNeuro ofer\u0103 \u0219i op\u021biunea de <strong><a href=\"https:\/\/www.roneuro.ro\/telemedicina.html\" target=\"_blank\" rel=\"noopener\">telemedicin\u0103<\/a>.<\/strong><\/p>\n<h2>C\u00e2nd se recomand\u0103 \u00eenceperea interven\u021biei logopedice?<\/h2>\n<p><strong>Cu c\u00e2t interven\u021bia logopedic\u0103 este mai rapid\u0103, cu at\u00e2t \u0219ansele la o bun\u0103 recuperare sunt mai mari. <\/strong>Ideal ar fi s\u0103 se \u00eenceap\u0103 recuperarea<strong> imediat dup\u0103 ce pacientul dep\u0103\u0219e\u0219te starea acut\u0103, cu dou\u0103 \u0219edin\u021be efectuate zilnic, cu o durat\u0103 de circa 20 de minute, diminea\u021ba \u0219i dup\u0103-amiaza, cresc\u00e2nd treptat durata p\u00e2n\u0103 la 60 de minute\/\u0219edin\u021b\u0103.<\/strong><\/p>\n<p>Condi\u021biile financiare sau lipsa de timp restric\u021bioneaz\u0103 deseori accesul la aceast\u0103 interven\u021bie. Se recomand\u0103, pentru a se putea p\u0103stra achizi\u021biile dob\u00e2ndite \u00een timpul \u0219edin\u021belor, ca frecven\u021ba acestora s\u0103 fie de cel pu\u021bin de trei ori pe s\u0103ptam\u00e2n\u0103.<\/p>\n<p>O \u00eent\u00e2rziere \u00een apelarea la serviciile logopedice poate facilita apari\u021bia stereotipiilor (da-da-da, nu \u0219tiu-nu \u0219tiu, \u0219.a.) ceea ce afecteaz\u0103 grav procesul de recuperare, \u00een unele cazuri f\u0103c\u00e2ndu-l chiar imposibil.<\/p>\n<h2>Care sunt pa\u0219ii pentru reabilitarea limbajului?<\/h2>\n<p>\u00cen vederea unei bune recuper\u0103rii se porne\u0219te de la introducerea stimulilor pe mai multe canale concomitent, de la concret spre abstract, de la simplu la complex, prin stimularea \u00eentregului prin parte, a p\u0103r\u021bii prin \u00eentreg, prin ritmare. Facilitarea exprim\u0103rii este deseori m\u0103rit\u0103 prin introducerea unei linii melodice \u00een pronun\u021barea cuv\u00e2ntului, prin interpretarea unor melodii cunoscute, prin activarea\u00a0 automatismelor verbale.<\/p>\n<p>De la a \u00een\u021belege p\u00e2n\u0103 la a exprima ce g\u00e2nde\u0219te sau a interrela\u021biona cu ceilal\u021bi este un \u00eentreg alt demers. \u00cen cazul afaziei Broca (non-fluent\u0103) \u00een care impulsul motor de articulare a cuvintelor este diminuat, de\u0219i cunoa\u0219te semnifica\u021bia lor, tehnicile \u0219i metodele de recuperare sunt diferite de cele utilizate \u00een cazul recuper\u0103rii afaziei Wernicke (afazie fluent\u0103).<\/p>\n<p><a href=\"https:\/\/roneuro.ro\/\"><strong>Institutul Roneuro<\/strong><\/a> permite <strong>\u00eembinarea tehnicilor clasice de recuperare cu cele moderne, de stimulare magnetic\u0103 transcranian\u0103<\/strong>, prin care <strong>corobor\u00e2nd exerci\u021biile logopedice cu stimularea ariilor cerebrale corespunz\u0103toare,<\/strong> progresele \u00een <strong>recuperare sunt mai rapide<\/strong>.\u00a0Pentru mai multe informa\u021bii, viziona\u021bi interviul cu expertul TMS RoNeuro,<strong> medic primar Nicoleta Jemna:<\/strong><\/p>\n<p style=\"text-align: center;\"><iframe title=\"YouTube video player\" src=\"https:\/\/www.youtube.com\/embed\/iEOxikHVWsM?si=v7fkSX8VdaqKcPId\" width=\"560\" height=\"315\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><\/iframe><\/p>\n<h2>C\u00e2t timp dureaz\u0103 recuperarea limbajului?<\/h2>\n<p>Este un proces de lung\u0103 durat\u0103 ce deseori pune la \u00eencercare nu doar pacientul \u00een sine, ci mai ales, apar\u021bin\u0103torii acestuia. Recuperarea depinde de \u00eentinderea \u0219i de profunzimea leziunii suferite, de personalitatea premorbid\u0103 a pacientului, de re\u021beaua de suport de care beneficiaz\u0103 acesta.<\/p>\n<p>Frecvent, \u00een primele luni, se observ\u0103 \u00eencerc\u0103rile de sus\u021binere a pacientului de c\u0103tre apar\u021bin\u0103tori care \u00een timp sau obosesc sau dezvolt\u0103 comportamente hiperprotective \u00een raport cu pacientul, ambele variante fiind deosebit de nocive pentru o bun\u0103 recuperare.<\/p>\n<h2>Importan\u021ba unei abord\u0103ri multidisciplinare \u00een recuperarea limbajului<\/h2>\n<p>Schimb\u0103rile dramatice de rol din familie \u0219i asumarea de noi responsabilit\u0103\u021bi de c\u0103tre apa\u021bin\u0103tori pot consuma, \u00een timp, resursele existente \u0219i conduce efectiv la abandonarea afectiv\u0103 a pacientului, sau la infantilizarea lui \u00een cazul hiperprotec\u021biei, cu efecte nocive asupra recuper\u0103rii mai ales \u00een cazul \u00een care pacientul a recuperat \u00een\u021belegerea vorbirii.<\/p>\n<p>De aici necesitatea unei <strong>consilieri psihologice<\/strong> at\u00e2t pentru pacient c\u00e2t \u0219i pentru apar\u021bin\u0103tori.<\/p>\n<p>Recuperarea limbajului presupune o abordare multidisciplinar\u0103, orice progres ob\u021binut \u00eentr-un domeniu reflect\u00e2ndu-se asupra \u00eentregului proces. Speciali\u0219tii includ:<\/p>\n<ul>\n<li>Neurologi;<\/li>\n<li>Logopezi;<\/li>\n<li>Psihologi;<\/li>\n<\/ul>\n<h2>Concluzii | Logopedia \u00een neurologie<\/h2>\n<p>Interven\u021bia logopedic\u0103 reprezint\u0103 un factor esen\u021bial \u00een procesul de recuperare \u0219i reabilitare a pacien\u021bilor care au suferit un <strong>TCC<\/strong> sau <strong>AVC<\/strong>.<\/p>\n<p>Prin abordarea personalizat\u0103 \u0219i integrat\u0103 a problemelor de vorbire, limbaj \u0219i \u00eenghi\u021bire, logopezii joac\u0103 un rol crucial \u00een \u00eembun\u0103t\u0103\u021birea calit\u0103\u021bii vie\u021bii \u0219i a independen\u021bei acestor pacien\u021bi.<\/p>\n<p>Prin evaluarea atent\u0103 a nevoilor fiec\u0103rui pacient, elaborarea unui plan de tratament adaptat \u0219i folosind tehnici \u0219i instrumente specializate, terapia logopedic\u0103 ajut\u0103 la dep\u0103\u0219irea dificult\u0103\u021bilor asociate TCC \u0219i AVC.<\/p>\n<p>\u00cen plus, logopezii lucreaz\u0103 \u00eendeaproape cu pacien\u021bii \u0219i familiile lor, oferind suport emo\u021bional \u0219i educa\u021bie despre strategiile de gestionare a dificult\u0103\u021bilor \u00een timpul procesului de recuperare. Interven\u021bia logopedic\u0103 nu doar c\u0103 \u00eembun\u0103t\u0103\u021be\u0219te func\u021bia \u0219i autonomia pacien\u021bilor, dar contribuie \u0219i la reintegrarea lor social\u0103 \u0219i profesional\u0103.<\/p>\n<p>Interven\u021bia logopedic\u0103 este esen\u021bial\u0103 post-TCC sau AVC, ajut\u00e2nd la restabilirea abilit\u0103\u021bilor de comunicare \u0219i la \u00eembun\u0103t\u0103\u021birea calit\u0103\u021bii vie\u021bii pacien\u021bilor \u0219i a familiilor lor.<\/p>\n<h2>Referin\u021be<\/h2>\n<ol>\n<li>Brady MC, Kelly H, Godwin J, Enderby P, Campbell P. <a href=\"https:\/\/www.cochranelibrary.com\/cdsr\/doi\/10.1002\/14651858.CD000425.pub4\/full?cookiesEnabled\" target=\"_blank\" rel=\"noopener\">Speech and language therapy for aphasia following stroke<\/a>. Cochrane Database Syst Rev. 2016 Jun 1;2016(6):CD000425. doi: 10.1002\/14651858.CD000425.pub4. PMID: 27245310; PMCID: PMC8078645.<\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"<p>Logopedia \u00een neurologie &#8211; recuperarea limbjului pentru pacien\u021bii cu traumatism craniocerebral sau AVC \u00cen urma leziunii cerebrale se poate pierde conexiunea dintre imaginea mental\u0103 a unui cuv\u00e2nt cu semnifica\u021bia acestuia, \u00eentre expresia sonor\u0103 \u0219i semnifica\u021bia cuv\u00e2ntului, sau leg\u0103tura dintre expresia sonor\u0103 a unui cuv\u00e2nt cu schema motorie de articulare a cuv\u00e2ntului. Un traumatism cerebral sau [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":543,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"jnews-multi-image_gallery":[],"jnews_single_post":{"source_name":"","source_url":"","via_name":"","via_url":"","override_template":"0","override":[{"template":"1","single_blog_custom":"","parallax":"1","fullscreen":"1","layout":"right-sidebar","sidebar":"default-sidebar","second_sidebar":"default-sidebar","sticky_sidebar":"1","share_position":"top","share_float_style":"share-monocrhome","show_share_counter":"1","show_view_counter":"1","show_featured":"1","show_post_meta":"1","show_post_author":"1","show_post_author_image":"1","show_post_date":"1","post_date_format":"default","post_date_format_custom":"Y\/m\/d","show_post_category":"1","show_post_reading_time":"0","post_reading_time_wpm":"300","show_zoom_button":"0","zoom_button_out_step":"2","zoom_button_in_step":"3","show_post_tag":"1","show_prev_next_post":"1","show_popup_post":"1","number_popup_post":"1","show_author_box":"0","show_post_related":"0","show_inline_post_related":"0"}],"override_image_size":"0","image_override":[{"single_post_thumbnail_size":"crop-500","single_post_gallery_size":"crop-500"}],"trending_post":"0","trending_post_position":"meta","trending_post_label":"Trending","sponsored_post":"0","sponsored_post_label":"Sponsored by","sponsored_post_name":"","sponsored_post_url":"","sponsored_post_logo_enable":"0","sponsored_post_logo":"","sponsored_post_desc":"","disable_ad":"0"},"jnews_primary_category":{"id":"","hide":""},"jnews_override_counter":{"override_view_counter":"0","view_counter_number":"0","override_share_counter":"0","share_counter_number":"0","override_like_counter":"0","like_counter_number":"0","override_dislike_counter":"0","dislike_counter_number":"0"},"footnotes":""},"categories":[6],"tags":[],"class_list":["post-147","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-neurologie"],"_links":{"self":[{"href":"https:\/\/roneuro.ro\/blog\/wp-json\/wp\/v2\/posts\/147","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/roneuro.ro\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/roneuro.ro\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/roneuro.ro\/blog\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/roneuro.ro\/blog\/wp-json\/wp\/v2\/comments?post=147"}],"version-history":[{"count":9,"href":"https:\/\/roneuro.ro\/blog\/wp-json\/wp\/v2\/posts\/147\/revisions"}],"predecessor-version":[{"id":990,"href":"https:\/\/roneuro.ro\/blog\/wp-json\/wp\/v2\/posts\/147\/revisions\/990"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/roneuro.ro\/blog\/wp-json\/wp\/v2\/media\/543"}],"wp:attachment":[{"href":"https:\/\/roneuro.ro\/blog\/wp-json\/wp\/v2\/media?parent=147"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/roneuro.ro\/blog\/wp-json\/wp\/v2\/categories?post=147"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/roneuro.ro\/blog\/wp-json\/wp\/v2\/tags?post=147"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}