Event Abstract

Back to Event

Combining Aerobic Exercise and Speech Language Treatment for Aphasia Rehabilitation: A Case Study

Elizabeth E. Galletta1* and Mira Goral2
  • 1 NYU Langone Health’s Child Study Center, United States
  • 2 Lehman College, United States

Introduction Although recent research has demonstrated that neuroplasticity – neuronal reorganization in the brain – continues into adulthood (e.g. Blake, 2017), recovery of language skills in adults with aphasia is typically modest and rarely complete. In the literature on typical and atypical aging, accumulating evidence suggests that aerobic exercise (AE) promotes neuroplasticity and the maintenance of cognitive skills over time (e.g., Zlatar et al., 2015). AE is linked to increased production of BDNF (brain derived neurotrophic factor) (e.g., Erickson et al., 2011), which promotes synaptic plasticity. In post-stroke rehabilitation, AE has been linked to improved cardiac health (MacKay-Lyons, 2012) and there are some promising results for cognitive benefit from AE post-stroke (Hasan et al., 2016). The potential benefit of AE combined with speech-language rehabilitation post stroke has not been studied. We hypothesized that the administration of AE in conjunction with speech-language treatment (SLT) will improve treatment efficacy by promoting restitution of language abilities in post-stroke adults with aphasia. Method A 41year-old right-handed gentleman, 13-months post stroke, served as the participant. Aphasia was characterized by relatively short grammatically correct utterances, reduced initiation of speech production, anomia, and good comprehension (WAB-R AQ=57). A single-subject crossover design combining AE and SLT was implemented. The AE program comprised two weekly 30-minute sessions. The SLT incorporated Constraint Induced Language Therapy (CILT) principles (i.e. treatment focused only on oral verbal production; based on Pulvermüller et al. 2001). SLT included a Semantic Feature Analysis (SFA) approach (i.e. targeted specific sematic features such as category, location, etc. based on Boyle and Coelho, 1995) and Verb Network Strengthening Treatment (VNeST) (training verbs and their semantically related agents and objects; Edmonds, Mammino, and Ojeda, 2014). The participant received SLT in two treatment blocks within an A-B-A (Washout) A-B-A design. The AE was administered during Treatment Block 1. Five assessments pre- and post- each treatment block were administered and included measures of single word and sentence production and comprehension, picture sequence description, and answering wh-questions (Goral and Borodkin, unpublished). Results Linguistic analysis of the pre- and post-treatment testing battery demonstrated that following Treatment Block 1, the participant increased the proportion of complete, grammatical and relevant sentences produced during picture sequence description (from 60% to 88%) and answering wh-questions (from 88% to 100%), suggesting generalization of the skills practiced during treatment to untreated connected language production (See Figure 1). There was minimal change at the word level production and in his (near-ceiling) comprehension abilities. Discussion These preliminary results point to the potential of maximizing the role of neuroplasticity in stroke rehabilitation. Because we enrolled only one individual to date, it is difficult to determine whether the greater improvement in selected linguistic abilities observed following the combined SLT + AE was due to the contribution of the AE to the treatment efficacy or, in part, due to it being the first treatment block, a dissociation that can be established with the administration of a similar intervention design with additional participants, counter-balancing the order of the treatment with and without AE.

Figure 1
Image

References

Blake, D.T. (2017). Network supervision of adult experience and learning dependent sensory cortical pasticity. Comprehensive Physiology, 7(3), 977-1008.

Boyle, M. & Coelho, C.A. (1995). Application of semantic feature analysis as a treatment for aphasic dysnomia. American Journal of Speech-Language Pathology, 4, 94-98.

Edmonds, L.A., Mammino, K., & Ojeda, J. (2014). Effect of Verb Network Strengthening Treatment (VNeST) in persons with aphasia: Extension and replication of previous findings. American Journal of Speech-Language Pathology, 23, S312-S329.

Erickson, K.I., Voss, M.W., Prakash, R.S., Basak,C., Szabo, A.N., Chaddock, L., et al. (2011). Exercise training increases size of hippocampus and improves memory. Proceeding of the National Academy of Science USA, 108, 3017-3022.

Hasan, S.M.M., Rancourt, S.N., Austin, M.W. & Ploughman, M. (2016). Defining optimal aerobic exercise parameters to affect complex motor and cognitive outcomes after stroke: A systematic review and synthesis. Hindawi Publishing Corporation Neural Plasticity, Article ID 2961573, 12 pages

Kertesz, A. (2007). Western Aphasia Battery – Revised (WAB-R). San Antonio, TX: PsychCorp.

MacKay-Lyons, M. (2012). Aerobic treadmill training effectively enhances cardiovascular fitness and gait function for older persons with chronic stroke. Journal of Physiotherapy, 58(4), 271.

Pulvermüller, F. Neininger, B., Elbert, T., Mohr, B., Rockstroh, B., Koebbel, P., & Taub, E. (2001). Constraint-induced therapy of chronic aphasia after stroke. Stroke, 32(7):1621-6.

Zlatar, Z.Z., McGregor, K.M., Towler, S., Nocera, J.R., Dzierzewski, J.M., & Crosson, B. (2015). Self-reported physical activity and objective aerobic fitness: Differential associations with gray matter density in healthy aging. Frontiers in Aging Neuroscience, 7 (5), 1-8.

Keywords: Aphasia, aerobic exercise, neuroplasticity, Rehabilitation, Treatment

Conference: Academy of Aphasia 56th Annual Meeting, Montreal, Canada, 21 Oct - 23 Oct, 2018.

Presentation Type: poster presentation

Topic: not eligible for a student prize

Citation: Galletta EE and Goral M (2019). Combining Aerobic Exercise and Speech Language Treatment for Aphasia Rehabilitation: A Case Study. Conference Abstract: Academy of Aphasia 56th Annual Meeting. doi: 10.3389/conf.fnhum.2018.228.00015

Copyright: The abstracts in this collection have not been subject to any Frontiers peer review or checks, and are not endorsed by Frontiers. They are made available through the Frontiers publishing platform as a service to conference organizers and presenters.

The copyright in the individual abstracts is owned by the author of each abstract or his/her employer unless otherwise stated.

Each abstract, as well as the collection of abstracts, are published under a Creative Commons CC-BY 4.0 (attribution) licence (https://creativecommons.org/licenses/by/4.0/) and may thus be reproduced, translated, adapted and be the subject of derivative works provided the authors and Frontiers are attributed.

For Frontiers’ terms and conditions please see https://www.frontiersin.org/legal/terms-and-conditions.

Received: 28 Apr 2018; Published Online: 22 Jan 2019.

* Correspondence: Dr. Elizabeth E Galletta, NYU Langone Health’s Child Study Center, New York, NEW YORK, 10016, United States, elizabeth.galletta@gmail.com