Optimal Intensity of Anomia Treatment in Post-stroke Aphasic Patients
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1
Centre de recherche CERVO, Centre Intégré Universitaire de Santé et de Services Sociaux de la Capitale-Nationale (CIUSSSCN), Canada
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2
Laval University, Département de réadaptation, Canada
Statement of the problem: Determining the optimal intensity of an effective treatment for adults with aphasia is a challenge for researchers and clinicians who want to optimize speech therapy. In the last few years, a considerable amount of research was conducted to identify the optimal treatment intensity for aphasia rehabilitation (ex. Bhogal, Teasell, & Speechley, 2003; Woldag, Voigt, Bley, & Hummelsheim, 2017). In most of the studies, researchers had their own definition of the intensity of treatment, thus making it difficult to establish a clear portrait of the issue. Thus, confusion is still present considering the overall dose and intensity of treatment required for meaningful change in people with post-stroke aphasia (Worrall & Foster, 2017). The aim of this study was to verify whether intensive vs. non-intensive treatment of post-stroke anomia led to outcome differences, using a very rigorous method for the control of intensity parameters.
Procedures and analyses conducted: Two aphasic patients with post-stroke anomia resulting from lexical impairment participated in this multiple case study. They received a phonological treatment at two different frequencies: intensive (I= four times a week) and non-intensive (NI= once a week). All parameters others than frequency were controlled among treatments: number of therapies (n=12); total time of treatment (360 minutes) and type of therapy (phonological). The order of treatment was counterbalanced among individuals (NI-I; I-NI). Three lists of items (A= treated items; B: exposed but not treated items and C= non-exposed items) were created to compare the effectiveness of the phonological treatment in each condition (I and NI). Moreover, the effectiveness of the intensive and non-intensive treatments was measured immediately post-treatment and at maintenance (four weeks after the end of treatment).
Results obtained: Both treatments were effective for the two participants. For each type of treatment, the lists were comparable at baselines and significantly different at the post treatment (p<0.001) and maintenance (p<0.001) measures, with participants performing better with the treated items (list A) than with the non-treated one (lists B and C). When comparing both treatments effectiveness, no significant differences were found between NI and I treatments at post treatment and maintenance.
Final conclusion(s): These results suggest that when all intensity parameters other than frequency are controlled, intensive and non-intensive treatments are equally effective. This same research protocol is currently conducted with more participants to confirm these results and determine which individual’s characteristics may influence treatment outcomes.
References
1. Bhogal, S. K., Teasell, R., & Speechley, M. (2003). Intensity of aphasia therapy, impact on recovery. Stroke, 34(4), 987-993.
2. Woldag, H., Voigt, N., Bley, M., & Hummelsheim, H. (2017). Constraint-Induced Aphasia Therapy in the Acute Stage: What Is the Key Factor for Efficacy? A Randomized Controlled Study. Neurorehabilitation and Neural Repair, 31(1), 72–80. https://doi.org/10.1177/1545968316662707
3. Worrall, L., & Foster, A. (2017). Does intensity matter in aphasia rehabilitation? The Lancet, 389(10078), 1494–1495. https://doi.org/10.1016/S0140-6736(17)30546-9
Keywords:
Aphasia treatment,
Intensity,
anomia treatment,
effectiveness,
phonological therapy
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:
Monetta
L,
Lavoie
M and
Macoir
J
(2019). Optimal Intensity of Anomia Treatment in Post-stroke Aphasic Patients.
Conference Abstract:
Academy of Aphasia 56th Annual Meeting.
doi: 10.3389/conf.fnhum.2018.228.00047
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Received:
23 Apr 2018;
Published Online:
22 Jan 2019.
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Correspondence:
Dr. Laura Monetta, Centre de recherche CERVO, Centre Intégré Universitaire de Santé et de Services Sociaux de la Capitale-Nationale (CIUSSSCN), Laval, Canada, laura.monetta@rea.ulaval.ca