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Gallée J, Tilton-Bolowsky VE, Stark BC. The Communication Success Screener: A Preliminary Investigation of Perceived Communicative Success Across Modalities, Environments, and Demands. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2024; 67:149-169. [PMID: 37956866 PMCID: PMC11000814 DOI: 10.1044/2023_jslhr-23-00171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 06/10/2023] [Accepted: 09/18/2023] [Indexed: 11/15/2023]
Abstract
PURPOSE Behavioral intervention targeting speech, language, and communication concerns is an established therapeutic approach for patients with communication concerns across a range of acquired neurogenic disorders. The multidimensional factors that contribute to a person's self-identified communication challenges and strengths in their daily communication needs must be considered to provide functional and person-centered care. While assessments grounded in clinician observation or client self-report exist, there is a direct need for a screening tool that comprehensively evaluates the roles of modality (verbal, text, gesture) and environment (in-person, virtual) on self-reported success across communicative demands. In this study, we describe a preliminary approach to monitoring the progression of receptive and expressive communication skills in people with chronic poststroke aphasia in the context of communication practices of the 21st century, culminating in the development and exploratory implementation of a novel clinical instrument: the Communication Success Screener (COMSS). METHOD Thirty-three participants with aphasia due to stroke were recruited to complete and evaluate the COMSS via an online survey. Quantitative responses and open-ended participant feedback were collected to validate and propose adaptations to the COMSS. Group-level analyses and case presentations were used to highlight COMSS features and outcomes. RESULTS Participant responses to the COMSS questionnaire suggest that this screening tool creates differentiated communicative success profiles based on self-report. Participant feedback also indicated that the COMSS appropriately evaluates self-reported success across modalities of verbal, text, and gesture in the context of in-person and virtual environments. CONCLUSIONS The communication concerns experienced by people with aphasia are often heterogeneous and vary as a function of their daily activities of living, preferred language modalities, and environmental supports. We present preliminary feasibility analyses of the COMSS as a potential tool to support the monitoring of functional change by evaluating self-reported communicative success across form, modality, environment, and task demand. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.24521044.
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Affiliation(s)
- Jeanne Gallée
- Department of Psychology, Institute for Learning and Brain Sciences, University of Washington, Seattle
- Department of Communication Sciences and Disorders, MGH Institute of Health Professions, Charlestown, MA
| | | | - Brielle C. Stark
- Department of Speech, Language and Hearing Sciences, Indiana University, Bloomington
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Georgiou AM, Kambanaros M. Therapies and Challenges in the Post-Stroke Aphasia Rehabilitation Arena: Current and Future Prospects. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1674. [PMID: 37763793 PMCID: PMC10537631 DOI: 10.3390/medicina59091674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 09/11/2023] [Accepted: 09/14/2023] [Indexed: 09/29/2023]
Abstract
Aphasia is a serious consequence of stroke that results in a breakdown in communication. The course of aphasia recovery differs between afflicted individuals, and responsiveness to treatment cannot be predicted. Aphasiologists continue to investigate numerous behavioral treatment protocols that have shifted their focus to complimentary rehabilitation strategies. The aim of this study is threefold. First, to summarize the different categories of aphasia interventions post-stroke, considering their respective protocols, and present available evidence on the effectiveness of those protocols. Second, to document the challenges regarding the prediction of aphasia treatment response post-stroke in individual patients. Third, to report the challenges faced by researchers in recruiting people with aphasia (PWA) for treatment studies, and provide recommendations on how to increase participant recruitment and retention. This study provides up-to-date information on (i) effective therapies and aphasia recovery processes, and (ii) research recruitment hurdles together with potential strategies for overcoming them.
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Affiliation(s)
- Anastasios M. Georgiou
- The Brain and Neurorehabilitation Lab, Department of Rehabilitation Sciences, Cyprus University of Technology, 3041 Limassol, Cyprus;
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Rose ML, Nickels L, Copland D, Togher L, Godecke E, Meinzer M, Rai T, Cadilhac DA, Kim J, Hurley M, Foster A, Carragher M, Wilcox C, Pierce JE, Steel G. Results of the COMPARE trial of Constraint-induced or Multimodality Aphasia Therapy compared with usual care in chronic post-stroke aphasia. J Neurol Neurosurg Psychiatry 2022; 93:573-581. [PMID: 35396340 PMCID: PMC9148985 DOI: 10.1136/jnnp-2021-328422] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 03/09/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND While meta-analyses confirm treatment for chronic post-stroke aphasia is effective, a lack of comparative evidence for different interventions limits prescription accuracy. We investigated whether Constraint-Induced Aphasia Therapy Plus (CIAT-plus) and/or Multimodality Aphasia Therapy (M-MAT) provided greater therapeutic benefit compared with usual community care and were differentially effective according to baseline aphasia severity. METHODS We conducted a three-arm, multicentre, parallel group, open-label, blinded endpoint, phase III, randomised-controlled trial. We stratified eligible participants by baseline aphasia on the Western Aphasia Battery-Revised Aphasia Quotient (WAB-R-AQ). Groups of three participants were randomly assigned (1:1:1) to 30 hours of CIAT-Plus or M-MAT or to usual care (UC). Primary outcome was change in aphasia severity (WAB-R-AQ) from baseline to therapy completion analysed in the intention-to-treat population. Secondary outcomes included word retrieval, connected speech, functional communication, multimodal communication, quality of life and costs. RESULTS We analysed 201 participants (70 in CIAT-Plus, 70 in M-MAT and 61 in UC). Aphasia severity was not significantly different between groups at postintervention: 1.05 points (95% CI -0.78 to 2.88; p=0.36) UC group vs CIAT-Plus; 1.06 points (95% CI -0.78 to 2.89; p=0.36) UC group vs M-MAT; 0.004 points (95% CI -1.76 to 1.77; p=1.00) CIAT-Plus vs M-MAT. Word retrieval, functional communication and communication-related quality of life were significantly improved following CIAT-Plus and M-MAT. Word retrieval benefits were maintained at 12-week follow-up. CONCLUSIONS CIAT-Plus and M-MAT were effective for word retrieval, functional communication, and quality of life, while UC was not. Future studies should explore predictive characteristics of responders and impacts of maintenance doses. TRIAL REGISTRATION NUMBER ACTRN 2615000618550.
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Affiliation(s)
- Miranda L Rose
- Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia .,Centre of Research Excellence in Aphasia Recovery and Rehabilitation, La Trobe University, Melbourne, Victoria, Australia
| | - Lyndsey Nickels
- School of Psychological Sciences, Macquarie University, Sydney, New South Wales, Australia
| | - David Copland
- Health and Rehabilitation Sciences, University of Queensland, Brisbane, Queensland, Australia.,Queensland Aphasia Rehabilitation Centre, University of Queensland, Brisbane, Queensland, Australia
| | - Leanne Togher
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Erin Godecke
- Edith Cowan University, Joondalup, Western Australia, Australia
| | - Marcus Meinzer
- Department of Neurology, University Medicine Greifswald, Greifswald, Germany
| | - Tapan Rai
- University of Technology Sydney, Sydney, New South Wales, Australia
| | - Dominique A Cadilhac
- Stroke and Ageing Research, Monash University Faculty of Medicine Nursing and Health Sciences, Clayton, Victoria, Australia
| | - Joosup Kim
- Stroke and Ageing Research, Monash University Faculty of Medicine Nursing and Health Sciences, Clayton, Victoria, Australia
| | - Melanie Hurley
- Centre of Research Excellence in Aphasia Recovery and Rehabilitation, La Trobe University, Melbourne, Victoria, Australia
| | - Abby Foster
- Centre of Research Excellence in Aphasia Recovery and Rehabilitation, La Trobe University, Melbourne, Victoria, Australia.,Monash Health, Clayton, Victoria, Australia
| | - Marcella Carragher
- Centre of Research Excellence in Aphasia Recovery and Rehabilitation, La Trobe University, Melbourne, Victoria, Australia
| | - Cassie Wilcox
- Centre of Research Excellence in Aphasia Recovery and Rehabilitation, La Trobe University, Melbourne, Victoria, Australia
| | - John E Pierce
- Centre of Research Excellence in Aphasia Recovery and Rehabilitation, La Trobe University, Melbourne, Victoria, Australia
| | - Gillian Steel
- Centre of Research Excellence in Aphasia Recovery and Rehabilitation, La Trobe University, Melbourne, Victoria, Australia
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Zettin M, Bondesan C, Nada G, Varini M, Dimitri D. Transcranial Direct-Current Stimulation and Behavioral Training, a Promising Tool for a Tailor-Made Post-stroke Aphasia Rehabilitation: A Review. Front Hum Neurosci 2021; 15:742136. [PMID: 34987366 PMCID: PMC8722401 DOI: 10.3389/fnhum.2021.742136] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 11/22/2021] [Indexed: 12/14/2022] Open
Abstract
Aphasia is an acquired language disorder resulting from damage to portions of the brain which are responsible for language comprehension and formulation. This disorder can involve different levels of language processing with impairments in both oral and written comprehension and production. Over the last years, different rehabilitation and therapeutic interventions have been developed, especially non-invasive brain stimulation (NIBS) techniques. One of the most used NIBS techniques in aphasia rehabilitation is the Transcranial Direct-Current Stimulation (tDCS). It has been proven to be effective in promoting a successful recovery both in the short and the long term after a brain injury. The main strength of tDCS is its feasibility associated with relatively minor side effects, if safely and properly administered. TDCS requires two electrodes, an anode and a cathode, which are generally placed on the scalp. The electrode montage can be either unipolar or bipolar. The main aim of this review is to give an overview of the state of the art of tDCS for the treatment of aphasia. The studies described included patients with different types of language impairments, especially with non-fluent aphasia and in several cases anomia. The effects of tDCS are variable and depend on several factors, such as electrode size and montage, duration of the stimulation, current density and characteristics of the brain tissue underneath the electrodes. Generally, tDCS has led to promising results in rehabilitating patients with acquired aphasia, especially if combined with different language and communication therapies. The selection of the appropriate approach depends on the patients treated and their impaired language function. When used in combination with treatments such as Speech and Language Therapy, Constraint Induced Aphasia Therapy or Intensive Action Treatment, tDCS has generally promoted a better recovery of the impaired functions. In addition to these rehabilitation protocols, Action Observation Therapy, such as IMITAF, appeared to contribute to the reduction of post-stroke anomia. The potential of combining such techniques with tDCS would would therefore be a possibility for further improvement, also providing the clinician with a new action and intervention tool. The association of a tDCS protocol with a dedicated rehabilitation training would favor a generalized long-term improvement of the different components of language.
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Affiliation(s)
- Marina Zettin
- Centro Puzzle, Turin, Italy
- Department of Psychology, University of Turin, Turin, Italy
| | | | - Giulia Nada
- Department of Psychology, University of Turin, Turin, Italy
| | - Matteo Varini
- Department of Psychology, University of Turin, Turin, Italy
| | - Danilo Dimitri
- Centro Puzzle, Turin, Italy
- Department of Psychology, University of Turin, Turin, Italy
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Armour M, Del Toro CM. The Effectiveness of Verbal-Gestural Treatment on Verb Naming in Acute Inpatient Rehabilitation. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2021; 30:713-721. [PMID: 33734899 DOI: 10.1044/2020_ajslp-20-00365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Purpose The purpose of this study was to investigate the effectiveness of verbal-gestural treatment on verb production in patients with acute aphasia. Method Treatment was delivered during inpatient stay to four participants using a single-subject design. Results All patients demonstrated improvements in verbal expression. Some patients' improvements generalized to untrained verbs and nouns. Conclusions This study indicates verbal-gestural treatment can be an effective treatment model for acute aphasia in a hospital environment. Concurrent deficits resulting from stroke may impact the success with verbal-gestural treatment at this acute phase of recovery.
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Affiliation(s)
- Michelle Armour
- Northwestern Medicine Aphasia Center at Marianjoy, Marianjoy Rehabilitation Hospital, Wheaton, IL
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Clough S, Duff MC. The Role of Gesture in Communication and Cognition: Implications for Understanding and Treating Neurogenic Communication Disorders. Front Hum Neurosci 2020; 14:323. [PMID: 32903691 PMCID: PMC7438760 DOI: 10.3389/fnhum.2020.00323] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 07/21/2020] [Indexed: 01/20/2023] Open
Abstract
When people talk, they gesture. Gesture is a fundamental component of language that contributes meaningful and unique information to a spoken message and reflects the speaker's underlying knowledge and experiences. Theoretical perspectives of speech and gesture propose that they share a common conceptual origin and have a tightly integrated relationship, overlapping in time, meaning, and function to enrich the communicative context. We review a robust literature from the field of psychology documenting the benefits of gesture for communication for both speakers and listeners, as well as its important cognitive functions for organizing spoken language, and facilitating problem-solving, learning, and memory. Despite this evidence, gesture has been relatively understudied in populations with neurogenic communication disorders. While few studies have examined the rehabilitative potential of gesture in these populations, others have ignored gesture entirely or even discouraged its use. We review the literature characterizing gesture production and its role in intervention for people with aphasia, as well as describe the much sparser literature on gesture in cognitive communication disorders including right hemisphere damage, traumatic brain injury, and Alzheimer's disease. The neuroanatomical and behavioral profiles of these patient populations provide a unique opportunity to test theories of the relationship of speech and gesture and advance our understanding of their neural correlates. This review highlights several gaps in the field of communication disorders which may serve as a bridge for applying the psychological literature of gesture to the study of language disorders. Such future work would benefit from considering theoretical perspectives of gesture and using more rigorous and quantitative empirical methods in its approaches. We discuss implications for leveraging gesture to explore its untapped potential in understanding and rehabilitating neurogenic communication disorders.
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Affiliation(s)
- Sharice Clough
- Communication and Memory Lab, Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN, United States
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Riedl L, Nagels A, Sammer G, Straube B. A Multimodal Speech-Gesture Training Intervention for Patients With Schizophrenia and Its Neural Underpinnings - the Study Protocol of a Randomized Controlled Pilot Trial. Front Psychiatry 2020; 11:110. [PMID: 32210849 PMCID: PMC7068208 DOI: 10.3389/fpsyt.2020.00110] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Accepted: 02/07/2020] [Indexed: 01/02/2023] Open
Abstract
UNLABELLED Dysfunctional social communication is one of the most stable characteristics in patients with schizophrenia that also affects quality of life. Interpreting abstract speech and integrating nonverbal modalities is particularly affected. Considering the impact of communication on social life but failure to treat communication dysfunctions with usual treatment, we will investigate the possibility to improve verbal and non-verbal communication in schizophrenia by applying a multimodal speech-gesture training (MSG training). Here we describe the newly developed MSG training program and the study design for the first clinical investigation. The intervention contains perceptive rating (match/mismatch of sentence and gesture) and memory tasks (n-back tasks), imitation and productive tasks (e.g., SG fluency-similar to verbal fluency where words are accompanied by gesture). In addition, we offer information about gesture as meta-learning element as well as homework for reasons of transfer to everyday life as part of every session. In the MSG training intervention, we offer eight sessions (60 min each) of training. The first pilot study is currently conducted as a single-center, randomized controlled trial of speech-gesture intervention versus wait-list control with a follow-up. Outcomes are measured through pre-post-fMRI and standardized psychological questionnaires comparing two subject groups (30 patients with schizophrenia and 30 healthy controls). Patients and healthy controls are randomized in two intervention groups (with 20 being in the wait-training group and 10 in the training-follow-up group). With our study design we will be able to demonstrate the beneficial effect of the MSG training intervention on behavioral and neural levels. CLINICAL TRIAL REGISTRATION DRKS.de, identifier DRKS00015118.
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Affiliation(s)
- Lydia Riedl
- Translational Neuroimaging Lab, Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Marburg, Germany
| | - Arne Nagels
- Department of English and Linguistics, Johannes-Gutenberg-University, Mainz, Germany
| | - Gebhard Sammer
- Department of Psychiatry and Psychotherapy, Justus-Liebig-University, Gießen, Germany
| | - Benjamin Straube
- Translational Neuroimaging Lab, Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Marburg, Germany
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Wortman-Jutt S, Edwards D. Poststroke Aphasia Rehabilitation: Why All Talk and No Action? Neurorehabil Neural Repair 2019; 33:235-244. [PMID: 30900528 DOI: 10.1177/1545968319834901] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
There is ample agreement in the scientific literature, across diverse areas of study, that suggests that language and movement are interrelated. In particular, it is widely held that the upper limb and hand play a key role in language use. Aphasia, a common, disabling language disorder frequently associated with stroke, requires new restorative methods. A combinatorial hand-arm-language paradigm that capitalizes on shared neural networks may therefore prove beneficial for aphasia recovery in stroke patients and requires further exploration.
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Affiliation(s)
- Susan Wortman-Jutt
- 1 Burke Rehabilitation Hospital, White Plains, NY, USA
- 2 Burke Neurological Institute, White Plains, NY, USA
| | - Dylan Edwards
- 3 Moss Rehabilitation Research Institute, Elkins Park, PA, USA
- 4 Edith Cowan University, Joondalup, Western Australia, Australia
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Macedonia M, Hammer F, Weichselbaum O. Guided Embodiment and Potential Applications of Tutor Systems in Language Instruction and Rehabilitation. Front Psychol 2018; 9:927. [PMID: 29951017 PMCID: PMC6008518 DOI: 10.3389/fpsyg.2018.00927] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Accepted: 05/22/2018] [Indexed: 11/13/2022] Open
Abstract
Intelligent tutor systems (ITSs) in mobile devices take us through learning tasks and make learning ubiquitous, autonomous, and at low cost (Nye, 2015). In this paper, we describe guided embodiment as an ITS essential feature for second language learning (L2) and aphasia rehabilitation (ARe) that enhances efficiency in the learning process. In embodiment, cognitive processes, here specifically language (re)learning are grounded in actions and gestures (Pecher and Zwaan, 2005; Fischer and Zwaan, 2008; Dijkstra and Post, 2015). In order to guide users through embodiment, ITSs must track action and gesture, and give corrective feed-back to achieve the users' goals. Therefore, sensor systems are essential to guided embodiment. In the next sections, we describe sensor systems that can be implemented in ITS for guided embodiment.
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Affiliation(s)
- Manuela Macedonia
- Information Engineering, Johannes Kepler Universität Linz, Linz, Austria.,Neural Mechanisms of Human Communication, Max-Planck-Institut für Kognitions- und Neurowissenschaften, Leipzig, Germany
| | | | - Otto Weichselbaum
- Information Engineering, Johannes Kepler Universität Linz, Linz, Austria.,Sew Systems Gmbh, Linz, Austria
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Dietz A, Vannest J, Maloney T, Altaye M, Holland S, Szaflarski JP. The feasibility of improving discourse in people with aphasia through AAC: Clinical and functional MRI correlates. APHASIOLOGY 2018; 32:693-719. [PMID: 32999522 PMCID: PMC7523709 DOI: 10.1080/02687038.2018.1447641] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
AIMS The purpose of this study is twofold: (1) to examine the feasibility of providing high-tech augmentative and alternative communication (AAC) treatment to people with chronic aphasia, with the goal of evoking changes in spoken language; and (2) to identify evidence of AAC-induced changes in brain activation. METHOD & PROCEDURES We employed a pre- post-treatment design with a control (usual care) group to observe the impact of an AAC treatment on aphasia severity and spoken discourse. Further, we used functional magnetic resonance imaging (fMRI) to examine associated neural reorganization. OUTCOMES & RESULTS Compared to the usual care group, the AAC intervention trended toward larger treatment effects and resulted in a higher number of responders on behavioral outcomes. Both groups demonstrated a trend toward greater leftward lateralization of language functions via fMRI. Secondary analyses of responders to treatment revealed increased activation in visual processing regions, primarily for the AAC group. CONCLUSIONS This study provides preliminary guidance regarding how to implement AAC treatment in a manner that simultaneously facilitates language recovery across a variety of aphasia types and severity levels while compensating for residual deficits in people with chronic aphasia. Further, this work motivates continued efforts to unveil the role of AAC-based interventions in the aphasia recovery process and provides insight regarding the neurobiological mechanisms supporting AAC-induced language changes.
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Pierce JE, Menahemi-Falkov M, O’Halloran R, Togher L, Rose ML. Constraint and multimodal approaches to therapy for chronic aphasia: A systematic review and meta-analysis. Neuropsychol Rehabil 2017; 29:1005-1041. [DOI: 10.1080/09602011.2017.1365730] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- John E. Pierce
- School of Allied Health, La Trobe University, Melbourne, Australia
- Speech Pathology, Cabrini Health, Melbourne, Australia
| | | | - Robyn O’Halloran
- School of Allied Health, La Trobe University, Melbourne, Australia
| | - Leanne Togher
- Speech Pathology, Faculty of Health Sciences, University of Sydney, Lidcombe, Australia
| | - Miranda L. Rose
- School of Allied Health, La Trobe University, Melbourne, Australia
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Zhang J, Yu J, Bao Y, Xie Q, Xu Y, Zhang J, Wang P. Constraint-induced aphasia therapy in post-stroke aphasia rehabilitation: A systematic review and meta-analysis of randomized controlled trials. PLoS One 2017; 12:e0183349. [PMID: 28846724 PMCID: PMC5573268 DOI: 10.1371/journal.pone.0183349] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2017] [Accepted: 08/02/2017] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Constraint-induced aphasia therapy (CIAT) has been widely used in post-stroke aphasia rehabilitation. An increasing number of clinical controlled trials have investigated the efficacy of the CIAT for the post-stroke aphasia. PURPOSE To systematically review the randomized controlled trials (RCTs) concerning the effect of the CIAT in post-stroke patients with aphasia, and to identify the useful components of CIAT in post-stroke aphasia rehabilitation. METHODS A computerized database search was performed through five databases (Pubmed, EMbase, Medline, ScienceDirect and Cochrane library). Cochrane handbook domains were used to evaluate the methodological quality of the included RCTs. RESULTS Eight RCTs qualified in the inclusion criteria. Inconsistent results were found in comparing the CIAT with conventional therapies without any component from the CIAT based on the results of three RCTs. Five RCTs showed that the CIAT performed equally well as other intensive aphasia therapies, in terms of improving language performance. One RCT showed that therapies embedded with social interaction were likely to enhance the efficacy of the CIAT. CONCLUSION CIAT may be useful for improving chronic post-stroke aphasia, however, limited evidence to support its superiority to other aphasia therapies. Massed practice is likely to be a useful component of CIAT, while the role of "constraint" is needed to be further explored. CIAT embedded with social interaction may gain more benefits.
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Affiliation(s)
- Jiaqi Zhang
- Master of Science in Neurological Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Jiadan Yu
- School of Rehabilitation Sciences, West China School of Medicine, Sichuan University, Sichuan, China
| | - Yong Bao
- Ruijin Rehabilitation Hospital of Shanghai Jiao Tong University, Shanghai, China
| | - Qing Xie
- Department of Rehabilitation Medicine, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yang Xu
- School of Rehabilitation Sciences, West China School of Medicine, Sichuan University, Sichuan, China
| | - Junmei Zhang
- Department of Physical Education, Wuhan University of Technology, Wuhan, China
| | - Pu Wang
- Department of Rehabilitation Medicine, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- * E-mail:
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de Ruiter J. Chapter 4. The asymmetric redundancy of gesture and speech. GESTURE STUDIES 2017. [DOI: 10.1075/gs.7.04der] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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Nouwens F, Visch-Brink EG, Van de Sandt-Koenderman MME, Dippel DWJ, Koudstaal PJ, de Lau LML. Optimal timing of speech and language therapy for aphasia after stroke: more evidence needed. Expert Rev Neurother 2015; 15:885-93. [DOI: 10.1586/14737175.2015.1058161] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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Neuroscience of Aphasia Recovery: the Concept of Neural Multifunctionality. Curr Neurol Neurosci Rep 2015; 15:41. [DOI: 10.1007/s11910-015-0568-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Harnish SM, Morgan J, Lundine JP, Bauer A, Singletary F, Benjamin ML, Gonzalez Rothi LJ, Crosson B. Dosing of a cued picture-naming treatment for anomia. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2014; 23:S285-S299. [PMID: 24686830 DOI: 10.1044/2014_ajslp-13-0081] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
PURPOSE Recent investigations into effects of intensity or distribution of aphasia therapy have provided moderate evidence supporting intensive therapy schedules on aphasia treatment response. The purpose of the present study was to investigate the feasibility of creating an intensive therapy session without extending the amount of daily time a person spends in treatment. METHOD Individuals who presented with chronic anomia poststroke (N = 8) participated in 2 weeks of a computerized, therapist-delivered, cued, picture-naming treatment. Dosing parameters for each session were 8 presentations of 50 pictures, totaling 400 teaching episodes per session. RESULTS Of the 8 participants, 6 achieved significant increases from baseline on trained items after 400 teaching episodes (i.e., 1 treatment hr), and the remaining 2 participants achieved significant increases from baseline after 1200 teaching episodes (i.e., 3 treatment hr). Maintenance data from 7 of the participants indicated that 6 participants maintained significant improvement from baseline on trained items. CONCLUSIONS Given an intensive and saturated context, anomic individuals were surprisingly quick at relearning to produce problematic words successfully. Most participants demonstrated retention of the gains 2 months after treatment ended. The high density of teaching episodes within the treatment session (i.e., the intensive treatment schedule) may have contributed to the behavioral gains.
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Marangolo P, Caltagirone C. Options to enhance recovery from aphasia by means of non-invasive brain stimulation and action observation therapy. Expert Rev Neurother 2013; 14:75-91. [PMID: 24308276 DOI: 10.1586/14737175.2014.864555] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Aphasia is a highly disabling language disorder usually caused by a left-lateralized brain damage. Even if traditional linguistic-based therapies have been proved to induce an adequate clinical improvement, a large percentage of patients are left with some degree of language impairments. Therefore, new approaches to common speech therapies are urgently needed in order to maximize the recovery from aphasia. The recent application of non-invasive neurostimulation techniques to language rehabilitation has already provided promising results particularly for the recovery of word-retrieval deficits in chronic stroke aphasic patients. Positive outcomes also come from action observation therapy. Indeed, some very recent studies have shown that the observation and/or execution of gestures positively influences language recovery especially for words related to human actions. This article gives an overview of the most important results achieved using these two approaches and discusses how the application of these treatments might potentiate aphasia recovery.
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Affiliation(s)
- Paola Marangolo
- Dipartimento di Medicina Sperimentale e Clinica, Facoltà di Medicina, Ancona, Italy
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