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Rehabilitation of aphasia: application of melodic-rhythmic therapy to Italian language.

Cortese MD, Riganello F, Arcuri F, Pignataro LM, Buglione I - Front Hum Neurosci (2015)

Bottom Line: The patients were treated 4 days a week for 16 weeks, with sessions of 30-40 min.The patients showed a significant improvement at the Aachener Aphasie Test (AAT) in different fields of spontaneous speech, with superimposable results at the follow-up.Specifically, MRT seems to benefit from its stronger structure than the available stimulation-facilitation procedures and allows a better quantification of the rehabilitation efficacy.

View Article: PubMed Central - PubMed

Affiliation: Intensive Care Unit, S. Anna Institute and Research in Advanced Neurorehabilitation Crotone, Italy.

ABSTRACT
Aphasia is a complex disorder, frequent after stroke (with an incidence of 38%), with a detailed pathophysiological characterization. Effective approaches are crucial for devising an efficient rehabilitative strategy, in order to address the everyday life and professional disability. Several rehabilitative procedures are based on psycholinguistic, cognitive, psychosocial or pragmatic approaches, including amongst those with a neurobehavioral approach the Melodic Intonation Therapy (MIT). Van Eeckhout's adaptation of MIT to French language (Melodic-Rhythmic Therapy: MRT) has implemented the training strategy by adding a rhythmic structure reproducing French prosody. The purpose of this study was to adapt MRT rehabilitation procedures to Italian language and to verify its efficacy in a group of six chronic patients (five males) with severe non-fluent aphasia and without specific aphasic treatments during the previous 9 months. The patients were treated 4 days a week for 16 weeks, with sessions of 30-40 min. They were assessed 6 months after the end of the treatment (follow-up). The patients showed a significant improvement at the Aachener Aphasie Test (AAT) in different fields of spontaneous speech, with superimposable results at the follow-up. Albeit preliminary, these findings support the use of MRT in the rehabilitation after stroke. Specifically, MRT seems to benefit from its stronger structure than the available stimulation-facilitation procedures and allows a better quantification of the rehabilitation efficacy.

No MeSH data available.


Related in: MedlinePlus

Score of the spontaneous speech in baseline, end of the protocol and follow-up. Green line: mean of the scores; red lines: standard deviation; black dashed line: raw data.
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Figure 3: Score of the spontaneous speech in baseline, end of the protocol and follow-up. Green line: mean of the scores; red lines: standard deviation; black dashed line: raw data.

Mentions: At baseline, the patients’ speech was restricted to few, fragmentary and scarcely understandable sentences. Anomies, agramatisms, phonemic paraphasias, neologisms and perseverations were observed as indicative of partial efficacy of conventional rehabilitation on spontaneous speech. Spontaneous speech (as measured by the AAT test; Figure 3; Table 6) was improved at the end of MRT specifically, in the semantic-lexical structure (Wilcoxon exact test: z = −2.220, p = 0.031, r = 0.640), phonemic structure (Wilcoxon exact test: z = −2.226, p = 0.031, r = 0.642), speech automatism (Wilcoxon exact test: z = −2.332, p = 0.031, r = 0.673), prosody (Wilcoxon exact test: z = −2.333, p = 0.031, r = 0.673) and communication (Wilcoxon exact test: z = −2.264, p = 0.031, r = 0.653). Moreover improvements were found in the correct repetition (Wilcoxon exact test: z = −2.207, p = 0.031, r = 0.637), naming (Wilcoxon exact test: z = −2.201, p = 0.031, r = 0.635), and comprehension (Wilcoxon exact test: z = −2.201, p = 0.031, r = 0.635) subtests (Figure 3; Table 7). The number of pronounced words per interval time increased, phonemic structure and syntax improved too. At follow-up, the AAT ratings in all subtests were superimposable to those recorded at the end of rehabilitation in the spontaneous speech as well as in the subtest (z ≤ −1.633, p ≥ 0.125).


Rehabilitation of aphasia: application of melodic-rhythmic therapy to Italian language.

Cortese MD, Riganello F, Arcuri F, Pignataro LM, Buglione I - Front Hum Neurosci (2015)

Score of the spontaneous speech in baseline, end of the protocol and follow-up. Green line: mean of the scores; red lines: standard deviation; black dashed line: raw data.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4585219&req=5

Figure 3: Score of the spontaneous speech in baseline, end of the protocol and follow-up. Green line: mean of the scores; red lines: standard deviation; black dashed line: raw data.
Mentions: At baseline, the patients’ speech was restricted to few, fragmentary and scarcely understandable sentences. Anomies, agramatisms, phonemic paraphasias, neologisms and perseverations were observed as indicative of partial efficacy of conventional rehabilitation on spontaneous speech. Spontaneous speech (as measured by the AAT test; Figure 3; Table 6) was improved at the end of MRT specifically, in the semantic-lexical structure (Wilcoxon exact test: z = −2.220, p = 0.031, r = 0.640), phonemic structure (Wilcoxon exact test: z = −2.226, p = 0.031, r = 0.642), speech automatism (Wilcoxon exact test: z = −2.332, p = 0.031, r = 0.673), prosody (Wilcoxon exact test: z = −2.333, p = 0.031, r = 0.673) and communication (Wilcoxon exact test: z = −2.264, p = 0.031, r = 0.653). Moreover improvements were found in the correct repetition (Wilcoxon exact test: z = −2.207, p = 0.031, r = 0.637), naming (Wilcoxon exact test: z = −2.201, p = 0.031, r = 0.635), and comprehension (Wilcoxon exact test: z = −2.201, p = 0.031, r = 0.635) subtests (Figure 3; Table 7). The number of pronounced words per interval time increased, phonemic structure and syntax improved too. At follow-up, the AAT ratings in all subtests were superimposable to those recorded at the end of rehabilitation in the spontaneous speech as well as in the subtest (z ≤ −1.633, p ≥ 0.125).

Bottom Line: The patients were treated 4 days a week for 16 weeks, with sessions of 30-40 min.The patients showed a significant improvement at the Aachener Aphasie Test (AAT) in different fields of spontaneous speech, with superimposable results at the follow-up.Specifically, MRT seems to benefit from its stronger structure than the available stimulation-facilitation procedures and allows a better quantification of the rehabilitation efficacy.

View Article: PubMed Central - PubMed

Affiliation: Intensive Care Unit, S. Anna Institute and Research in Advanced Neurorehabilitation Crotone, Italy.

ABSTRACT
Aphasia is a complex disorder, frequent after stroke (with an incidence of 38%), with a detailed pathophysiological characterization. Effective approaches are crucial for devising an efficient rehabilitative strategy, in order to address the everyday life and professional disability. Several rehabilitative procedures are based on psycholinguistic, cognitive, psychosocial or pragmatic approaches, including amongst those with a neurobehavioral approach the Melodic Intonation Therapy (MIT). Van Eeckhout's adaptation of MIT to French language (Melodic-Rhythmic Therapy: MRT) has implemented the training strategy by adding a rhythmic structure reproducing French prosody. The purpose of this study was to adapt MRT rehabilitation procedures to Italian language and to verify its efficacy in a group of six chronic patients (five males) with severe non-fluent aphasia and without specific aphasic treatments during the previous 9 months. The patients were treated 4 days a week for 16 weeks, with sessions of 30-40 min. They were assessed 6 months after the end of the treatment (follow-up). The patients showed a significant improvement at the Aachener Aphasie Test (AAT) in different fields of spontaneous speech, with superimposable results at the follow-up. Albeit preliminary, these findings support the use of MRT in the rehabilitation after stroke. Specifically, MRT seems to benefit from its stronger structure than the available stimulation-facilitation procedures and allows a better quantification of the rehabilitation efficacy.

No MeSH data available.


Related in: MedlinePlus