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Pierce JE, OHalloran R, Togher L, Nickels L, Copland D, Godecke E, Meinzer M, Rai T, Cadilhac DA, Kim J, Hurley M, Foster A, Carragher M, Wilcox C, Steel G, Rose ML. Acceptability, feasibility and preliminary efficacy of low-moderate intensity Constraint Induced Aphasia Therapy and Multi-Modality Aphasia Therapy in chronic aphasia after stroke. Top Stroke Rehabil 2024; 31:44-56. [PMID: 37036031 DOI: 10.1080/10749357.2023.2196765] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 03/24/2023] [Indexed: 04/11/2023]
Abstract
BACKGROUND High-intensity Constraint-Induced Aphasia Therapy Plus (CIAT-Plus) and Multi-Modality Aphasia Therapy (M-MAT) are effective interventions for chronic post-stroke aphasia but challenging to provide in clinical practice. Providing these interventions may be more feasible at lower intensities, but comparative evidence is lacking. We therefore explored feasibility, acceptability, and preliminary efficacy of the treatments at a lower intensity. METHODS A multisite, single-blinded, randomized Phase II trial was conducted within the Phase III COMPARE trial. Groups of participants with chronic aphasia from the usual care arm of the COMPARE trial were randomized to M-MAT or CIAT-Plus, delivered at the same dose as the COMPARE trial but at lower intensity (6 hours/week × 5 weeks rather than 15 hours/week × 2 weeks). Blinded assessors measured aphasia severity (Western Aphasia Battery-Revised Aphasia Quotient), word retrieval, connected speech, multimodal communication, functional communication, and quality of life immediately post interventions and after 12 weeks. Feasibility and acceptability were explored. RESULTS Of 70 eligible participants, 77% consented to the trial; 78% of randomized participants completed intervention and 98% of assessment visits were conducted. Fatigue and distress ratings were low with no related withdrawals. Adverse events related to the trial (n = 4) were mild in severity. Statistically significant treatment effects were demonstrated on word retrieval and functional communication and both interventions were equally effective. CONCLUSIONS Low-moderateintensity CIAT-Plus and M-MAT were feasible and acceptable. Both interventions show preliminary efficacy at a low-moderate intensity. These results support a powered trial investigating these interventions at a low-moderate intensity.
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Affiliation(s)
- John E Pierce
- Centre of Research Excellence in Aphasia Recovery and Rehabilitation, La Trobe University, Melbourne, Victoria, Australia
| | - Robyn OHalloran
- Centre of Research Excellence in Aphasia Recovery and Rehabilitation, La Trobe University, Melbourne, Victoria, Australia
| | - Leanne Togher
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Lyndsey Nickels
- School of Psychological Sciences, Macquarie University, Sydney, New South Wales, Australia
| | - David Copland
- Queensland Aphasia Research Centre, The University of Queensland, Herston, Queensland, Australia
- Surgical Treatment and Rehabilitation Service Education and Research Allience, Metro North Health, Herston, Queensland, Australia
| | - Erin Godecke
- School of Medical and Health Sciences, Edith Cowan University, Western, Australia
| | - Marcus Meinzer
- Department of Neurology, University Medicine Greifswald, Greifswald, Germany
| | - Tapan Rai
- Graduate Research School, University of Technology Sydney, New South Wales, Australia
| | - Dominique A Cadilhac
- Stroke and Ageing Research, Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Victoria, Australia
- Speech Pathology, Monash Health, Clayton, Victoria, Australia
| | - Joosup Kim
- Stroke and Ageing Research, Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Victoria, Australia
- Speech Pathology, Monash Health, Clayton, Victoria, Australia
| | - Melanie Hurley
- CRE Aphasia Recovery and Rehabilitation, La Trobe University, Bundoora, Australia
| | - Abby Foster
- Speech Pathology, Monash Health, Clayton, Victoria, Australia
- School of Allied Health, Human Service & Sport, La Trobe University, Victoria, Australia
- School of Primary & Allied Health Care, Monash University, Victoria, Australia
| | - Marcella Carragher
- CRE Aphasia Recovery and Rehabilitation, La Trobe University, Bundoora, Australia
| | - Cassie Wilcox
- CRE Aphasia Recovery and Rehabilitation, La Trobe University, Bundoora, Australia
| | - Gillian Steel
- CRE Aphasia Recovery and Rehabilitation, La Trobe University, Bundoora, Australia
| | - Miranda L Rose
- CRE Aphasia Recovery and Rehabilitation, La Trobe University, Bundoora, Australia
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