Laterality and rehabilitation: a comparison of linguistic and motoric function in two aphasic agraphic hemiplegic patients

Abstract

ABSTRACT Traditionally, in clincial practice, speech and language therapists train hemiplegic aphasic patients to write with the non‐dominant left hand. This study examines the side differences of the graphomotor and linguistic aspects of writing in two cases of agraphic aphasic hemiplegic patients. In one case writing was performed with the right hemiplegic hand, facilitated with a writing prosthesis which enabled functional recovery of the arm. In the other case, writing was performed with the left non‐dominant, non‐paralysed hand. The two moderate aphasic clients received four weeks of training to learn to use the prosthesis, followed by 12 weeks of treatment. Assessment took place before the training and at the end of the treatment period. Initially, writing performance was examined only with the left hand due to the lack of graphomotor skills and by both hands at the end of the trial. The results demonstrated that writing performance with the right hemiplegic hand, in conjunction with the prosthesis, was superior to the left hand in both cases. However, improvement in the other aspects of language, generalisation of language function as well as functional use of the hemiplegic hand in non‐clinical settings were observed only in the patient who used his right paralysed hand, facilitated with the prosthesis during the treatment period. The results suggest that this group of clients will benefit from the use of a writing prosthesis during the treatment period. This raises questions about the clinical strategies which speech and language therapists are using during the rehabilitation of writing.