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Constraint-Induced Aphasia Therapy for Treatment of Chronic Post-Stroke Aphasia: A Randomized, Blinded, Controlled Pilot Trial.

Szaflarski JP, Ball AL, Vannest J, Dietz AR, Allendorfer JB, Martin AN, Hart K, Lindsell CJ - Med. Sci. Monit. (2015)

Bottom Line: Clinicians treating patients (CIAT group) did not communicate with other team members to maintain blinding and the testing team members were blinded to treatment group assignment.Other measures trended towards better performance in the CIAT group.In this pilot RCT intensive language therapy led to an improvement in subjective language abilities.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, USA.

ABSTRACT

Background: To provide a preliminary estimate of efficacy of constraint-induced aphasia therapy (CIAT) when compared to no-intervention in patients with chronic (>1 year) post-stroke aphasia in order to plan an appropriately powered randomized controlled trial (RCT).

Material and methods: We conducted a pilot single-blinded RCT. 24 patients were randomized: 14 to CIAT and 10 to no-intervention. CIAT groups received up to 4 hours/day of intervention for 10 consecutive business days (40 hours or therapy). Outcomes were assessed within 1 week of intervention and at 1 and 12 weeks after intervention and included several linguistic measures and a measure of overall subjective communication abilities (mini-Communicative Abilities Log (mini-CAL)). Clinicians treating patients (CIAT group) did not communicate with other team members to maintain blinding and the testing team members were blinded to treatment group assignment.

Results: Overall, the results of this pilot RCT support the results of previous observational studies that CIAT may lead to improvements in linguistic abilities. At 12 weeks, the treatment group reported better subjective communication abilities (mini-CAL) than the no-intervention group (p=0.019). Other measures trended towards better performance in the CIAT group.

Conclusions: In this pilot RCT intensive language therapy led to an improvement in subjective language abilities. The effects demonstrated allow the design of a definitive trial of CIAT in patients with a variety of post-stroke aphasia types. In addition, our experiences have identified important considerations for designing subsequent trial(s) of CIAT or other interventions for post-stroke aphasia.

No MeSH data available.


Related in: MedlinePlus

Stick plots for each aphasia test at each time point split by treatment group. Each line represents a single case.
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f3-medscimonit-21-2861: Stick plots for each aphasia test at each time point split by treatment group. Each line represents a single case.

Mentions: There were few statistically significant differences in NAT scores between the intervention and control groups (Table 2). Specifically, differences were observed in subjective communication abilities assessed with the mini-CAL. Patients who received CIAT scored higher on the mini-CAL at 12 weeks after intervention compared to the control group (Mean 31 vs. 23; difference=8, 95% CI 1.3 to 13.5, p=0.019). The SFT was marginally higher 2 weeks after intervention in CIAT patients than controls (Mean 21 vs. 12; difference 9, 95% CI −0.3 to 17.8, p=0.058). This difference was not sustained at twelve weeks after intervention. Scores for all NATs are presented in Table 2 and Figure 3.


Constraint-Induced Aphasia Therapy for Treatment of Chronic Post-Stroke Aphasia: A Randomized, Blinded, Controlled Pilot Trial.

Szaflarski JP, Ball AL, Vannest J, Dietz AR, Allendorfer JB, Martin AN, Hart K, Lindsell CJ - Med. Sci. Monit. (2015)

Stick plots for each aphasia test at each time point split by treatment group. Each line represents a single case.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4588672&req=5

f3-medscimonit-21-2861: Stick plots for each aphasia test at each time point split by treatment group. Each line represents a single case.
Mentions: There were few statistically significant differences in NAT scores between the intervention and control groups (Table 2). Specifically, differences were observed in subjective communication abilities assessed with the mini-CAL. Patients who received CIAT scored higher on the mini-CAL at 12 weeks after intervention compared to the control group (Mean 31 vs. 23; difference=8, 95% CI 1.3 to 13.5, p=0.019). The SFT was marginally higher 2 weeks after intervention in CIAT patients than controls (Mean 21 vs. 12; difference 9, 95% CI −0.3 to 17.8, p=0.058). This difference was not sustained at twelve weeks after intervention. Scores for all NATs are presented in Table 2 and Figure 3.

Bottom Line: Clinicians treating patients (CIAT group) did not communicate with other team members to maintain blinding and the testing team members were blinded to treatment group assignment.Other measures trended towards better performance in the CIAT group.In this pilot RCT intensive language therapy led to an improvement in subjective language abilities.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, USA.

ABSTRACT

Background: To provide a preliminary estimate of efficacy of constraint-induced aphasia therapy (CIAT) when compared to no-intervention in patients with chronic (>1 year) post-stroke aphasia in order to plan an appropriately powered randomized controlled trial (RCT).

Material and methods: We conducted a pilot single-blinded RCT. 24 patients were randomized: 14 to CIAT and 10 to no-intervention. CIAT groups received up to 4 hours/day of intervention for 10 consecutive business days (40 hours or therapy). Outcomes were assessed within 1 week of intervention and at 1 and 12 weeks after intervention and included several linguistic measures and a measure of overall subjective communication abilities (mini-Communicative Abilities Log (mini-CAL)). Clinicians treating patients (CIAT group) did not communicate with other team members to maintain blinding and the testing team members were blinded to treatment group assignment.

Results: Overall, the results of this pilot RCT support the results of previous observational studies that CIAT may lead to improvements in linguistic abilities. At 12 weeks, the treatment group reported better subjective communication abilities (mini-CAL) than the no-intervention group (p=0.019). Other measures trended towards better performance in the CIAT group.

Conclusions: In this pilot RCT intensive language therapy led to an improvement in subjective language abilities. The effects demonstrated allow the design of a definitive trial of CIAT in patients with a variety of post-stroke aphasia types. In addition, our experiences have identified important considerations for designing subsequent trial(s) of CIAT or other interventions for post-stroke aphasia.

No MeSH data available.


Related in: MedlinePlus