Aphasia - Authors

NOTE: When reviewing the findings of randomized clinical trials (RCTs), repeated measures studies, crossover studies, cohort studies and quasi-experimental studies in the results table, it is important to note that a ‘+’ is indicated only if there was a significant post treatment difference between the treatment group and the control group. For pre-post study designs, a ‘+’ indicates a significant difference from pre to post intervention assessment.

Author, year, PEDro score

Sample size

Intervention

Outcome and significance:
(+) significant (-) not significant

Akabogu et al., 2019
PEDro score: 6
Country: Nigeria

86 patients with stroke (recovery period not specified)

Cognitive behavior language therapy
(CBLT, n=43)

vs.

No treatment
(n=43)

Treatment details:
2-hour sessions, 2 sessions/week for 10 weeks and 4 weeks of follow-up sessions 2 months after completion of treatment.

CBLT:  individual and group sessions where patients were encouraged to challenge their language-related negative beliefs, trained to identify and systematically modify any irrational thoughts related to speech making, language, and communication; included activities in which the therapies directly targeted specific listening, speaking, reading or writing skills; patients learned to identify and dispute their unhelpful thoughts and beliefs through psycho-education, cognitive restructuring, exposure techniques. It also involved directed training of caregivers focused on education about aphasia and its impacts.

At 10 weeks (post-treatment):
(+) Porch Index of Communicative Ability (PICA)
(+) Speech-Language Unhelpful Thoughts and Beliefs Scale (SLUBS)

At 3 months (follow-up):
(+) PICA
(+) SLUBS

Altmann et al., 2014
PEDro:  4
ountry: USA

14 patients with chronic stroke

Intentional gestures + intensive anomia treatment
(n=7)

vs.

No gestures + intensive anomia treatment
(n=7)

Treatment details:
1 hour/session, 2 sessions/day, 5 times/week for 3 weeks.

Intentional gestures: participants initiated treatment trials with the left hand by opening and reaching into a box and pushing a red button; during each correction procedure participants were required to make nonmeaningful circular gestures with the left hand.

Intensive anomia treatment: 3 phases of treatment that focused on naming pictures and verbally generating exemplars of different picture categories.

At 3 weeks (post-treatment):
(-) Picture Naming probes %
(-) Category-Generation probes %
(-) Boston Naming Test (BNT)
(-) Western Aphasia Battery – Aphasia Quotient (WAB-AQ)
(-) Discourse Quantity – Utterances
(-) Discourse Quantity – Words
(-) Discourse Quantity – Verbs
(-) Discourse Quantity – Nouns
(-) Discourse Quality – grammatical
(-) Discourse Quality – Correct information units
(-) Discourse Quality – Propositions
(-) Discourse Quality – Utterances with new information

At 3 months (follow-up):
(-) Picture Naming probes %
(-) Category-Generation probes %
(-) BNT
(-) WAB-AQ
(-) Discourse Quantity – Utterances
(+) Discourse Quantity – Words
(-) Discourse Quantity – Verbs
(-) Discourse Quantity – Nouns
(-) Discourse Quality – Grammatical
(-) Discourse Quality – Correct information units
(-) Discourse Quality – Propositions
(-) Discourse Quality – Utterances with new information

Benjamin et al., 2014
PEDro: 4
Country: USA

14 patients with chronic stroke

Intention treatment + picture naming and category-member generation training
(n=7)

vs.

Picture naming and category-member generation training
(n=7)

Treatment details:
10-45-minutes/session, 5 times/week for 6 weeks.

Intention treatment: participants used their left hand to lift a box lid and push a red button, which initiated trials by triggering the presentation of the treatment stimuli.

Picture naming and category-member generation training: training picture naming and categories with gradual increase in difficulty.

At 6 weeks (post-treatment):
(-) Picture Naming probes %
(-) Category-Generation probes %

At 3 months (follow-up):
(-) Picture Naming probes %
(-) Category-Generation probes %

Bowen et al., 2012
PEDro: 7
Country: United Kingdom

170 patients with acute stroke at time of admission to study

Speech language therapy
(SLT, n=85)

vs.

Social contact intervention
(n=85)

Treatment details:
Up to 3 times/week for 16 weeks (variable duration and frequency).

SLT: enhanced, agreed best practice, communication therapy specific to aphasia or dysarthria offered by speech and language therapists according to participants needs, with continuity from hospital to community.

Social contact intervention: excluded communication therapy where participants benefited spending time with with an untrained conversation partner.

At 6 months post-stroke (follow-up):
(-) Therapy Outcome Measure: Communication Activity Scale
(-) Communication Outcome After Stroke Scale (COAST)
(-) Carer COAST
(-) Carers of Older People in Europe (COPE) Index – Negative impact
(-) COPE Index – Positive impact
(-) COPE Index – Quality of support
(-) Serious adverse events

Breitenstein et al., 2017
PEDro: 8
Country: Germany

158 patients with chronic stroke

Intensive speech and language therapy
(n=79)

vs.

Deferred intensive SLP
(n = 79)

Treatment details:
10 hours or more/week (one-to-one and/or group rehabilitation with a speech language pathologist) + 5 hours or more/week (self-managed training) for 3 or more weeks.

Intensive speech and language therapy: linguistic and communicative-pragmatic approaches individualized to the baseline profile of each patient.

Participants in the deferred intensive SLP received the treatment following 3 weeks of no treatment.

At 3 weeks (post-treatment):
(+) Amsterdam-Nijmegen Everyday Language Test (ANELT) A-scale
(-) ANELT B-scale
(-) Modified Rankin Scale (mRS)
(+) Sprachsystematisches APhasieScreening (SAPS) – Total
(-) SAPS – Phonology
(+) SAPS – Lexicon
(+) SAPS – Syntax
(+) SAPS – Language comprehension
(+) SAPS – Language production
(+) Stroke and Aphasia Quality of Life Scale-39 (SAQoL-39) – Total
(-) SAQoL-39 – Physical
(-) SAQoL-39 – Communication
(-) SAQoL-39 – Psychosocial
(-) SAQoL-39 – Energy
(-) Nonverbal Learning Test (NVLT)
(-) Trail Making Test – A
(-) Trail Making Test – B

At 6 months (follow-up):
(-) Communicative Effectiveness Index
(-) ANELT A-scale
(-) ANELT B-scale
(-) mRS
(-) SAPS – Total
(+) SAPS – Phonology
(-) SAPS – Lexicon
(-) SAPS – Syntax
(-) SAPS – Language comprehension
(-) SAPS – Language production
(-) SAQoL-39 – Total
(-) SAQoL-39 – Physical
(-) SAQoL-39 – Communication
(-) SAQoL-39 – Psychosocial
(-) SAQoL-39 – Energy
(-) NVLT
(-) Trail Making Test – A
(-) Trail Making Test – B

Ciccone et al., 2016
PEDro: 8
Country: Australia

20 patients with acute stroke

Constraint-induced aphasia therapy
(CIAT, n=12)

vs.

Individual therapy
(n=8)

Treatment details:
45-60-minutes/session, 5 times/week for 4-5 weeks.

CIAT: participants were constrained to interact through verbal production only during a request and response language activity in which they aimed to collect the highest number of paired picture cards; conducted in groups.

Individual therapy: semantic feature therapy, cued naming therapy, lexical semantic, mapping therapy, phonological feature mapping.

At 4-5 weeks (post-treatment):
(-) Western Aphasia Battery – Aphasia Quotient (WAB-AQ)
(-) Discourse Analysis (DA)
(-) Stroke and Aphasia Quality of Life Scale (SAQoL)

At 12 weeks (follow-up):
(-) WAB-AQ
(-) DA
(-) SAQoL

At 26 weeks (follow-up):
(-) WAB-AQ
(-) DA
(-) SAQoL

David et al., 1982 
PEDro score: 5
Country: United Kingdom

155 patients with subacute/chronic stroke

Speech language therapy by speech pathologists
(n=65)

vs.

Language stimulation and support by untrained volunteers
(n=68)

Treatment details:
30 hours over 15- 20 weeks.

Details on the format and consistency of interventions were not provided.

At week 1/2/3/4 of treatment and at 15-20 weeks (post-treatment):
(-) Functional Communication Profile
Note: results referred to changes in scores from baseline to post-treatment.

de Jong-Hagelstein et al., 2011
PEDro score: 8

Country: The Netherlands

85 patients with acute/subacute stroke

Cognitive-linguistic treatment comprising semantic and/or phonological training
(n=41)

vs.

Communicative treatment comprising compensatory strategies and use of residual language skills
(n=44)

Treatment details:
2 – 5 hours/week for 6 months.

CLT: speech language pathologists provided BOX, a semantic treatment programme, and/or

FIKS, a phonological treatment programme (paper and computer versions), as suitable for the individual.

Communicative treatment: aimed at improving communicative ability using all verbal and non-verbal strategies available to the patient (e.g. written choice communication, communication books, role playing and conversational coaching). Techniques included PACE, role play and conversational coaching.

At 3 months (mid-treatment):
(-) Amsterdam-Nijmegen Everyday Language Test – Scale A Understandability (ANELT-A) – Final score
(-) ANELT-A – Mean improvement
(-) ANELT-A – Severity category
(-) Semantic Association Test (SAT)
(+) Semantic Word Fluency (SWF)
(-) Psycholinguistic Assessment of Language Processing in Aphasia (PALPA) – Semantic association with low imageability words
(-) PALPA – Nonword repetition
(-) PALPA – Auditory lexical decision
(-) Letter Fluency Task

At 6 months (post-treatment):
(-) ANELT-A – Final score
(-) ANELTA-A – Mean improvement
(-) ANELT-A – Severity category
(-) SAT
(-) SWF
(-) PALPA: semantic association with low imageability words
(-) PALPA: nonword repetition
(-) PALPA: auditory lexical decision
(+) Letter Fluency Task

Doesborgh et al., 2004a 
PEDro score: 8
Country: the Netherlands

58 patients with subacute stroke

Semantic treatment
(n=29)

vs.

Phonological treatment
(n=29)

Treatment details:
1.5 hours/session, 1-2 sessions/week for 40-60 hours of treatment over 10-12 months.

Semantic treatment: BOX intervention focused on the interpretation of

written words, sentences, and texts, containing a variety of semantic decision tasks aimed at enhancing semantic processing. Exercises are in multiple choice or right/wrong format and have several levels of difficulty.

Phonological treatment: FIKS treatment that is focused on sound structure. As in BOX, written exercises on the word, sentence, and text level are presented, directed at the phonological input and output routes.

At 10-12 months (post-treatment):
(-) Amsterdam Nijmegen Everyday Language Test (ANELT-A) – Final score
(-) ANELT-A – Mean improvement
(-) Semantic Association Test
(-) Psycholinguistic Assessment of Language Processing in Aphasia (PALPA) – Synonym judgment subtest
(-) PALPA – Nonword repetition subtest
(+) PALPA – Auditory lexical decision subtest*

* in favour of phonological vs. semantic treatment

Doesborgh et al., 2004b 
PEDro score: 6
Country: The Netherlands

19 patients with chronic stroke

Multicue computer program
(n=9)

vs.

No treatment
(n=10)

Treatment details:
30-45-minutes/session, 2-3 sessions/week for 2 months for a total of 10-11 hours of treatment.

Multicue computer program: participants were offered a variety of cues for improving word finding; the computer program assisted participants to find which cues were the most helpful.

At 2 months (post-treatment):
(-) Amsterdam Nijmegen Everyday Language Test – Scale A  
(-) Boston Naming Test

Drummond, & Rentschler, 1981
PEDro: 5
Country: USA

8 patients with chronic stroke

Visual-gestural cueing 
(n=4)

vs.

No gestural cueing
(n=4)

Treatment details:
15-30-minutes/session, 1 session/day for 2 weeks.

Gestural cueing: the “AMERIND Gestural Code” visual-gestural system was used, which incorporates manual gestures/signs to assist with word retrieval.

Both groups received conventional auditory-verbal cueing consisting of initial-syllable and sentence-completion cues.

At 2 weeks (post-treatment):
(-) Response time to 10 AMERIND nouns and 10 non-AMERIND nouns

Elman & Burnstein-Ellis, 1999 
PEDro score: 8
Country: USA

28 patients with chronic stroke

Group communication treatment
(n=14)

vs.

Deferred treatment
(n=14)

Treatment details:
2.5-hours/session, 2 sessions/week for 4 months (total of 32 sessions).

Group communication treatment: increasing initiation of conversation and exchanging information using all conversation means possible (e.g. communicative notes, books, gestures, mimes, role play, etc.), delivered by a speech language pathologist in a group format. 

Participants in the deferred group received 3 or more hours/week of social group activities of their choice (e.g. movement lessons, creative performance arts group, church activities, support groups, etc.).

Participants in the deferred treatment received the Group Communication Treatment at 4 months (i.e. after the treatment group completed their allocated intervention).

At 4 months (post-treatment):
(+) Western Aphasia Battery-Aphasia Quotient (WAB-AQ)
(+) Communicative Abilities in Daily Living Test (CADL)
(-) Shortened Porch Index of Communicative Ability (SPICA)

At 5 months (follow-up):
(-) WAB-AQ
(-) CADL
(-) SPICA

Godecke et al., 2014
PEDro: N/A (quasi-experimental study design)
Country: Australia

47 patients with acute stroke

Very early rehabilitation
(n=20)

vs.

Usual care – cohort sample from Godecke et al., 2012
(n=27)

Treatment details:
20 x 1-hour sessions, 5 times/week for 4 weeks.

Very early rehabilitation:  group (constraint-induced aphasia therapy) or individual therapy (Semantic Feature Therapy, Cued Naming therapy, Lexical-semantic (BOX) therapy, Mapping therapy and/or Phonological Feature Therapy).

Usual care: 85% of participants received no therapy; 15% of participants received cognitive-neuropsychological and neurolinguistically-based therapy including BOX therapy, Mapping therapy and/or Semantic Feature Therapy. Participants received usual care on average for 11 minutes/week for 3 weeks.

At 4-5 weeks (post-treatment):
(+) Western Aphasia Battery – Aphasia Quotient (WAB-AQ) % maximum potential recovery
(+) Discourse Analysis

At 26 weeks post-stroke (follow-up):
(+) WAB-AQ % maximum potential recovery
(-) Discourse Analysis

Hartman and Laundau, 1987 
PEDro score: 6
Country: USA

60 patients with subacute stroke

Task-oriented aphasia therapy
(n=30)

vs.

Nondirective counseling and conversation
(n=30)

Treatment details:
2 sessions/week for 6 months (session duration unspecified).

Task-oriented aphasia therapy: individualised language ‘drills’ using auditory stimulation at single-word and phrase level, following spoken commands, reading, sentence repetition/completion and cueing strategies.

Nondirective counseling and conversation: speech language pathologists provided unstructured, conversational sessions with no conventional therapeutic informal

instruction or specific suggestions for language practice.

At 6 months (post-treatment):
(-) Porch Index of Communicative Ability (PICA)

At 10 months (follow-up):
(-) PICA

Kagan et al., 2001 
PEDro score: 6
Country: Canada

40 patients with chronic stroke

Supported Conversation for Adults with Aphasia (SCA) training workshop
(n=20)

vs.

Social interactions with an untrained volunteer (n=20)

Treatment details:
1-day workshop session.

SCA: didactic and experiential training that included a conceptual/motivational module (1.25 hours), technical module (2 hours), integrative role-play (1.5 hours) and an evaluation exercise (0.5) hours; and was performed in dyads (i.e.  patient with stroke and a volunteer).

Untrained volunteers: time-matched social interactions with volunteers who were not trained; volunteers had to be proficient in English (i.e. English as a mother-tongue or the language that is used primarily).

At post-treatment (1 workshop):
Patients:
(+) Measure of Participation in Conversation for Adults with Aphasia (MPCA) – interaction
(+) MPCA – transaction

Katz & Wertz, 1997
PEDro: 5
Country: USA

63 patients with chronic stroke

Computer reading
(n=21)

vs.

Non-language computer stimulation
(n=21)

vs.

No treatment
(control, n=21)

Treatment details:
3 hours/week for 6 months.

Computer reading: computer-facilitated activities of different difficulty levels that targeted perceptual-visual matching and reading comprehension.

Computer stimulation: non-verbal cognitive rehabilitation software and computerized arcade-style games that did not include language stimuli.

At 6 months (post-treatment):
Computer reading vs. Computer stimulation:
(+) Porch Index of Communicative Ability (PICA) – Overall
(-) PICA – Auditory
(+) PICA – Verbal
(-) PICA – Pantomime
(-) PICA – Visual
(-) PICA – Reading
(-) PICA – Copying
(-) PICA – Writing
(+) Western Aphasia Battery (WAB) – Aphasia Quotient
(-) WAB – Spontaneous speech
(-) WAB – Comprehension
(+) WAB – Repetition
(-) WAB – Naming

Computer reading vs. No treatment:
(+) PICA – Overall
(-) PICA – Auditory
(+) PICA – Verbal
(+) PICA – Pantomime
(-) PICA – Visual
(-) PICA – Reading
(-) PICA – Copying
(-) PICA – Writing
(+) WAB – Aphasia Quotient
(-) WAB – Spontaneous speech
(-) WAB – Comprehension
(+) WAB – Repetition
(-) WAB – Naming

Computer stimulation vs. No treatment:
(-) PICA – Overall
(-) PICA – Auditory
(-) PICA – Verbal
(+) PICA – Pantomime
(-) PICA – Visual
(-) PICA – Reading
(-) PICA – Copying
(-) PICA – Writing
(-) WAB – Aphasia Quotient
(-) WAB – Spontaneous speech
(-) WAB – Comprehension
(+) WAB – Repetition
(-) WAB – Naming
Note: participants were also tested at ~mid-treatment (3 months) however results are not reported.

Katz & Wertz, 1992
PEDro: 5
Country: USA

43 patients with chronic stroke

Computer reading
(n=13)

vs.

Non-language computer stimulation
(n=15)

vs.

No treatment
(n=15)

Treatment details:
3 hours/week for 6 months.

Computer reading: 29 activities of different difficulty levels to facilitate perceptual-visual matching and reading comprehension.

Computer stimulation: non-language cognitive rehabilitation software and computerized arcade-style games that did not include language stimuli.

At 6 months (post-treatment):
Computer reading vs. Non-language computer stimulation:
(+) PICA – Overall
(-) PICA – Reading
(+) PICA – Writing
(+) PICA – Verbal
(-) WAB-AQ
(-) C-CAT (non-standardized assessment comprised of 232 items from the computer reading program)

Computer reading vs. No treatment:
(+) PICA – Overall
(-) PICA – Reading
(-) PICA – Writing
(+) PICA – Verbal
(-) WAB-AQ
(-) C-CAT

Non-language computer reading vs. No treatment:
(-) PICA – Overall
(-) PICA – Reading
(-) PICA – Writing
(-) PICA – Verbal
(-) WAB-AQ
(-) C-CAT

Kesav et al., 2017
PEDro: 6
Country: India

24 patients with acute/subacute stroke

Computer-based language rehabilitation therapy + conventional speech language therapy (SLT)
(n=12)

vs.

Conventional SLT alone
(n=12)

Treatment details:
1-hour/session, 3 sessions/week for 4 weeks.

Computer-based language rehabilitation therapy: MOZHI software was used that comprised hexarchial language hierarchy modules to address auditory verbal comprehension, expression of language assessment, naming, writing, reading, and calculation.

Conventional SLT consisted of deblocking for improving comprehension, supported communication, promoting aphasics communicative effectiveness (PACE) therapy, melodic intonation therapy, multiple input phoneme therapy, prolongation techniques, word fluency exercises, picture description, narration tasks, alphabetical identification and naming, phone-grapheme correlation, unison reading, letter by letter reading. It was delivered in 12 x 1-hour sessions, 3 sessions/week for 4 weeks.

At 4 weeks (post-treatment):
(+) Western Aphasia Battery – Aphasia Quotient (WAB-AQ)

At 3 months (follow-up):
(+) WAB-AQ
Note: results were in favor of conventional SLT alone vs. computer-based language rehabilitation therapy + conventional SLT.

Kurland et al., 2016
PEDro: 6
Country: USA

24 patients with chronic stroke

Interactive language action therapy – constrained
(ILAT – constrained)
(n=12)

vs.

Modified version of Promoting Aphasic Communicative Effectiveness – unconstrained
(mPACE – unconstrained)
(n=12)

Treatment details:
3-hrs/session (morning or afternoon), over 10 consecutive workdays.

ILAT: therapeutic language games using picture cards representing trained sets of actions such as requesting, accepting, and denying. Patients were guided by constraint to respond verbally. 

mPACE: same therapeutic games, but patients were guided towards multiple response modalities and were free to choose any one or more approaches (e.g. gestures, spoken words).

At 2 weeks (post-treatment):
(-) Boston Diagnostic Aphasia Examination 3rd Edition (BDAE-3) – Aphasia severity
(-) BDAE-3 – Auditory comprehension
(-) BDAE-3 – Sentence repetition
(-) BDAE-3 – Cookie Theft Description task – changes in content unit
(-) Boston Naming Test 2nd Edition (BNT-2)
(-) Porch Index of Communicative Ability
(-) Object and Action Naming Battery – trained pictures
(-) Object and Action Naming Battery – untrained pictures

Laska et al., 2011 
PEDro score: 7
Country: Sweden

123 patients with acute stroke

Early speech language therapy
(n=62)

vs.

No treatment
(n=61)

Treatment details:
45-minutes/session, 5 days/week for 3 weeks.

Speech language therapy: Language Enrichment Therapy.

Note: Following the 21-day intervention period, all patients could receive speech language therapy at the discretion of the responsible physician.

At 21 days (post-treatment):
(-) Amsterdam-Nijmegen Everyday Language Test (ANELT)
(-) Norsk Grunntest for Afasi (NGA) aphasia coefficient

At 6 months (follow-up):
(-) ANELT
(-) NGA aphasia coefficient

Lincoln et al., 1984 
PEDro score: 6
Country : United Kingdom

327 patients with subacute stroke

Speech therapy (n=163)
vs.

No treatment
(n=164)

Treatment details:
1 hour/session, 2 times/week for 24 weeks.

Speech therapy: delivered by therapists who determined the appropriate intervention according to the needs of the patient.

All participants received conventional rehabilitation (e.g. occupational therapy); the no treatment group was offered speech therapy at 24 weeks.

At 12 weeks (mid-treatment):
(-) Porch Index of Communicative Ability (PICA)
(-) Functional Communication Profile
(-) Speech Questionnaire

At 24 weeks (post-treatment):
(-) PICA
(-) Functional Communication Profile
(-) Speech Questionnaire

Lincoln et al., 1982 
PEDro score: 4
(two cross-over comparisons design study)
Country: United Kingdom

24 patients with subacute/chronic stroke

Speech language therapy (n=12)

vs.

Operant conditioning (n=6)

Or

Attention placebo (n=6)

Treatment details:
30 minutes/session, 12 sessions over 4 weeks. Participants then crossed over to receive the other intervention for a further 4 weeks, whereby each participant received two interventions: (i) speech language pathology, and (ii) operant conditioning or attention placebo.

Speech language therapy: the speech language pathologist selected tasks to improve various aspects

of communication ability. Early stages facilitated use of automatic and serial speech, and matching tasks (e.g. matching pictures with spoken and written words, phrases and sentences), and tasks to improve auditory memory and discrimination. Verbal expressive ability was facilitated in stages using

imitation, sentence completion, word games, sequencing tasks, grammar

exercises and stylised conversation. Reading and writing were also practiced in a progression from simple to more complex tasks.

Operant conditioning: participants were provided with immediate contingent verbal praise, such as “yes”, “good”, “that’s right, it’s a chair” and, in addition, tokens were given for correct responses, to provide visual feedback. Whether words, words and phrases or sentences were to be reinforced was decided from a single baseline session.

Attention placebo: the therapist conversed with the patient about a series of predetermined topics in a conversational manner, with the participant using explanatory gestures as necessary. Therapists selected 1 topic/session and obtained 10 items of information/topic. The initiation of conversation was left, as far as possible, to the patient.

At 4 weeks (post-treatment T1 or post-treatment T2):
Speech language therapy vs. Operant conditioning
(-) Porch Index of Communicative Ability
(-) Token Test – short version
(-) Object Naming Test
(-) Fluency (naming – Food, Countries)
(-) Picture Description
(-) Raven’s Progressive Matrices
(-) Speech Questionnaire

Speech language therapy vs. Attention placebo
(-) Porch Index of Communicative Ability
(-) Token Test – short version
(-) Object Naming Test
(-) Fluency (naming)
(-) Picture Description
(+) Raven’s Progressive Matrices
(-) Speech Questionnaire*
* favouring attention placebo vs. speech language pathology

Lyon et al., 1997 
PEDro score: N/A (quasi-experimental design study)
Country: USA

10 patients with chronic stroke

Communication partner training program

Treatment details:
Phase I: communication practice 1-1.5 hours/session, 2 sessions/week for 6 weeks; 

Phase II: activity participation for 1-4 hours, 2 times/week for 14 weeks.

Communication partner training program: patient, caregiver and communication partner triads worked together to learn and practice how to interact freely and effectively. The communication partner (community volunteer) served to bridge clinical and real-life pursuits.

Note: 3 triads were randomly assigned to a deferred treatment group, although between-group comparisons were not made.

At 20 weeks (post-treatment):
(-) Boston Diagnostic Aphasia Examination – overall mean percentile
(-) Communication Abilities in Daily Living
(-) Affect Balance Scale
 (+) Communication Readiness and Use Index (non-standardized) – patient, carer, communication partner
 (+) Psychosocial Wellbeing Index (non-standardized) – patient, carer, communication partner
Note: results reflect within-group differences from pre- to post-treatment.

Maher et al., 2006
PEDro score: 4
Country : USA

9 patients with chronic stroke

Constraint-induced language therapy (CILT)
(n=4)

vs.

Modified version of Promoting Aphasic Communicative Effectiveness (mPACE)
(n=5)

Treatment details:
3 hours/session, 4 days/week for 2 weeks.

CILT: participants’ communication was restricted to spoken output; alternative communication modes (e.g. writing, gesturing, pointing) were not permitted.

mPACE: participants were allowed to communicate in any and all modalities (e.g.  gesturing, pointing, writing, etc.) during therapy sessions.

At 2 weeks (post-treatment): 
(-) Western Aphasia Battery – Aphasia Quotient
(-) Boston Naming Test (raw score)
(-) Action Naming Test (raw score)
Note: measures were also collected at 1-month follow-up; however, no statistical analyses were performed due to a high dropout rate from the PACE group.

Mattioli et al., 2014
PEDro: 5
Country: Italy

12 patients with acute stroke

Aphasia treatment
(n=6)

vs.

No treatment
(n=6)

Treatment details:
1 hour/session, 5 days/week for 2 weeks.

Aphasia treatment: verbal comprehension and lexical retrieval in form of naming task, facilitators, and stimulation of deficits.

At 2 weeks post-stroke (post-treatment):
(-) Aachen Aphasia Test (AAT) – Repetition
(+) AAT – Naming
(+) AAT – Written language
(-) AAT – Oral comprehension
(-) AAT – Written comprehension
(-) AAT – Token Test (50-item)
(-) AAT – Spontaneous language

At 6 months post-stroke (follow-up):
(-) AAT – Repetition
(+) AAT – Naming
(+) AAT – Written language
(-) AAT – Oral comprehension
(-) AAT – Written
comprehension
(-) AAT – Token Test (50-item)
(-) AAT – Spontaneous language

Nenert et al., 2017
PEDro: 5
Country: USA

19 patients with chronic stroke

Constraint-induced aphasia therapy (CIAT, n=11)

vs.

No treatment (n=8)

Treatment details:
4 hours/session for 10 consecutive days.

CIAT: tailored intervention to promote spoken language and to limit compensatory non-spoken language strategies, where in a therapeutic game context, participants request picture cards from each other by using descriptions of the depicted objects.

At 10 days (post-treatment):
(-) Functional magnetic resonance imaging (fMRI) – Semantic Decision
(-) fMRI – Tone Decision

(-) fMRI – Covert Verb Generation
(-) Peabody Picture Vocabulary Test
(-) Boston Naming Test
(-) Controlled Oral Word Association Test (raw score)
(-) Semantic Fluency Test
(-) Mini-Communicative Activities Log
(-) Noun recall

At 3 months (follow-up):
(-) fMRI – Semantic Decision
(-) fMRI – Tone Decision
(-) fMRI – Covert Verb Generation

Nobis-Bosch et al., 2011
PEDro: 6 (cross-over design)
Country: Germany

18 patients with chronic stroke

Intensive language training by an electronic learning device B.A.Bar
(n=9)

vs.

Nonlinguistic cognitive training

(n=9)

Treatment details:
1 hour/session, 2 times/day, 4 days/week for 4 weeks; participants were also supervised by their SLP for 1 hour/week. Participants then crossed over to receive the alternative intervention for a following 4 weeks.

Intensive language training by a B.A.Bar electronic learning device: stimulation of a conversation-like setting and daily living situations to practice verbal skills, using an electronic device. Training involved adjacency pairs, a unit of natural conversation that contains an exchange of information between two speakers who take turns in conversation. The turns are functionally related to each other in such a fashion that the first turn requires from the second turn a certain type of response.

Nonlinguistic cognitive training: on basic functions of visual exploration and attention. It involved visual–cognitive exercises such as visual matching of a part to the whole, maze games, comparing two

pictures to find differences, or searching for target objects in complex pictures.

At 4 weeks:
(-) Dialogue test (DT) linguistic scoring – trained items
(-) DT linguistic scoring – untrained items
(-) DT communicative scoring – trained items
(-) DT communicative scoring -untrained items
(-) Word Fluency Test – Food
(-) Word Fluency Test – Animals
(-) German adaptation of Thurstone’s Primary Mental Ability Test – Pattern recognition from subtest 10
(-) Test for Attentional Performance – Visual scanning from subtest 9
(-) Wechsler Memory Scale – Auditory digit span
(-) Corsi Block Tapping Test – Visual memory
(-) Spontaneous speech – semi-standardized interview
(-) Amsterdam Nijmegen Everyday Language Test

At 8 weeks:
(-) DT linguistic scoring – trained items
(-) DT linguistic scoring – untrained items
(-) DT communicative scoring – trained items
(-) DT communicative scoring -untrained items
(-) Word Fluency Test – Food
(-) Word Fluency Test – Animals
(-) German adaptation of Thurstone’s Primary Mental Ability Test – Pattern recognition from subtest 10
(-) Test for Attentional Performance – Visual scanning from subtest 9
(-) Wechsler Memory Scale – Auditory digit span
(-) Corsi Block Tapping Test – Visual memory
(-) Spontaneous speech – semi-standardized interview
(-) Amsterdam Nijmegen Everyday Language Test

At 3 months (follow-up):
(-) DT linguistic scoring – trained items
(-) DT linguistic scoring – untrained items
(+) DT communicative scoring – trained items*
(+) DT communicative scoring – untrained items*
(-) Word Fluency Test – Food
(-) Word Fluency Test – Animals
(-) German adaptation of Thurstone’s Primary Mental Ability Test – Pattern recognition from subtest 10
(-) Test for Attentional Performance – Visual scanning from subtest 9
(-) Wechsler Memory Scale – Auditory digit span
(-) Corsi Block Tapping Test – Visual memory
(-) Spontaneous speech – semi-standardized interview
(-) Amsterdam Nijmegen Everyday Language Test
* In favor of Group B.

Palmer et al., 2012
PEDro: 7
Country: United Kingdom

34 patients with chronic stroke

Computer treatment
(n=17)

vs.

No treatment
(n=17)

Treatment details:
20-minutes/session, 3 times/week for 5 months (approximately 1500 minutes of practice time in total).

Computer treatment: participants used the StepbyStep computer program, which contains a library of more than 13,000 language exercises; participants followed steps progressing from listening to target words, producing words with visual, semnatic, phonemic, or written letter/word cues through to saying the words in sentences. This program was developed a speech language pathologist and supported by a volunteer.

All patients received usual care that included participation in activities to provide general language stimulation, attendance at communication support groups, and conversation, reading, and writing activities that are part of everyday life.

At 5 months (post-treatment):
(+) Object and Action Naming Battery

At 8 months (follow-up):
(-) Object and Action Naming Battery

Sickert et al., 2014
PEDro: 6
Country: Germany

100 patients with subacute stroke

Modified Constraint Induced Aphasia Therapy
(mCIAT, n=50)

vs.

Conventional aphasia therapy
(n=50)

Treatment details:
2 hours/session for 3 weeks, total 15 hours.

mCIAT: therapeutic language games performed in groups where shaping and constraint of non-verbal strategies were used (encouraging patients to use only verbal communication to describe cards with objects, drawings, photographs of everyday situations and a module of written language). 

Conventional aphasia therapy: training specific deficits including exercises of sentence completion, improving patients’ retrieval of words, learning sentences patterns, conversation on current topics, listening to words, and repeating and following instructions, where participants were permitted to use any communication mode, including non-verbal communication.

At 3 weeks (post-treatment):
(-) Aachener Aphasia Test (AAT) – Spontaneous speech
(-) AAT – Token test
(-) AAT – Repetition
(-) AAT – Written language
(-) AAT – Naming
(-) AAT – Comprehension
(-) Communicative Activity Log (CAL) – Amount of communication (patient)
(-) CAL – Quality of communication (patient)
(-) CAL – Amount of communication (relative)
(-) CAL – Quality of communication (relative)

At 8 weeks and 1 year (follow-up):
(-) AAT – Spontaneous speech
(-) AAT – Token test
(-) AAT – Repetition
(-) AAT – Written language
(-) AAT – Naming
(-) AAT – Comprehension
(-) CAL – Amount of communication (patient)
(-) CAL – Quality of communication (patient)
(-) CAL – Amount of communication (relative)
(-) CAL – Quality of communication (relative)

Stahl et al., 2016
PEDro: 7 (crossover design)
Country: Germany

18 patients with chronic stroke

Intensive language-action therapy
(ILAT, n=9)

vs.

Naming therapy
(n=9)

Treatment details:
3.5-hours/session, 1 session/day for 6 consecutive days. Participants then received 6 days of no therapy, before crossing over to the other intervention group for a further 6 days.

ILAT: participants played a card game in groups of 3 with 1 therapist who facilitated communicative-pragmatic action-imbedded therapy focusing on verbal requests.

Naming therapy: participants played the same card game as the ILAT group; participants were required to describe or name objects shown on picture cards, with no verbal utterances for communication and social interaction.

At 6 days (post 1st treatment):
(+) Aachen Aphasia Test (AAT) – mean score
(+) AAT – production score

At 18 days (post 2nd treatment):
(+) AAT – mean score
(+) AAT – production score
Note: Results were in favour of ILAT vs. Naming therapy at both time points.

Szaflarski et al., 2015
PEDro: 8
Country: USA

24 patients with chronic stroke

Constraint-induced aphasia therapy
(CIAT, n=14)

vs.

No treatment
(n=10)

 

Treatment details:
45-minutes/session, 4 sessions/day for 10 consecutive days (10-15-minute break between sessions)

CIAT: participants engaged in group therapeutic language card games using verbal communication to describe line drawings of nouns and photos of action verbs.

At 3 weeks (1-week post end of treatment):
(-) Boston Naming Test (BNT)
(-) Controlled Oral Word Association Test
(-) Semantic Fluency Test
(-) Boston Diagnostic Aphasia Examination (BDAE) – Complex ideation
(-) Peabody Picture Vocabulary Test III
(-) Mini-Communicative Activities Log (mini-CAL)

At 3 months (follow-up):
(-) BNT
(-) Controlled Oral Word Association Test
(-) Semantic Fluency Test
(-) BDAE – Complex ideation
(-) Peabody Picture Vocabulary Test III
(+) mini-CAL

Thompson et al., 2010
PEDro: 4
Country: USA

20 patients with chronic stroke

Computer-automated Treatment of Underlying Forms (Computer TUF)
(n=6)

vs.

Clinician-administered TUF
(n=8)

vs.

No treatment
(n=6)

Treatment details:
1 hour/session, 4 sessions/week for 5 weeks (maximum 20 sessions) or until 80% correct performance on the daily production prove was noted for 4 consecutive days. 

TUF: a linguistically-based treatment for improving agrammatic sentence deficits.

Computer-automated TUF: Sentactics® interactive computer system was used to deliver TUF by a virtual clinician.

Clinician-trained TUF: administered by clinicians and did not involve the use of a computer.

At ~ 5 weeks (post-treatment):
Computer TUF vs. Clinician TUF
(-) Comprehension Probe (CP) – Object relatives
(-) CP – Object clefts
(-) CP – Object wh-questions
(-) Production Probe (PP) – Object relatives
(-) PP – Object clefts
(-) PP – Object wh-questions
(-) Northwestern Assessment of Verbs and Sentences (NAVS) – Sentence Production Priming Test (SPPT) – Object relatives
(-) NAVS-SPPT – Object wh-questions
(-) NAVS-SPPT – Subject relatives
(-) NAVS-SPPT – Subject wh-questions
(-) NAVS – Sentence Comprehension Test (SCT) – Object relatives
(-) NAVS-SCT – Object wh-questions
(-) NAVS-SC – Subject relatives

(-) NAVS-SCT – Subject wh-questions

Computer TUF vs. No treatment
(+) CP – Object relatives
(-) CP – Object clefts
(-) CP – Object wh-questions
(+) PP – Object relatives
(+) PP – Object clefts
(-) PP – Object wh-questions
(+) NAVS-SPPT – Object relatives
(-) NAVS-SPP – Object wh-questions
(-) NAVS-SPPT – Subject relatives
(-) NAVS-SPPT – Subject wh-questions
(+) NAVS-SCT – Object relatives
(-) NAVS-SCT – Object wh-questions
(-) NAVS-SCT – Subject relatives
(-) NAVS-SCT – Subject wh-questions
(-) Cinderella Naratives (CN) – Mean length of utterance
(-) CN – Words per minute
(-) CN – Complex to simple sentence ratio
(-) CN – Noun to verb ratio
(-) CN – Open to closed class ratio
(-) CN – % grammatical sentences
(-) CN – % verbs with correct arguments

Whitworth et al., 2014
PEDro: 6
Country: Australia

14 patients with subacute/chronic stroke

Novel Approach to Real-life Communication: Narrative Intervention in Aphasia
(NARNIA, n=8)

vs.

Conventional speech language therapy
(n=6)

Treatment details:
4 sessions/week for 5 weeks (session duration is unspecified).

NARNIA: word retrieval, sentence production, and discourse macrostructure across a range of everyday discourse genres.

Speech language therapy: interventions routinely used in clinical practice, and individually tailored to meet the assessed needs of the participant.

At 5 weeks (post-treatment):
(-) Pyramid and Palmtrees Test
(-) Kissing and Dancing Test
(-) Object and Action Naming Battery – Verb Retrieval
(-) Object and Action Naming Battery – Noun Retrieval
(-) Northwester Assessment of Verbs and Sentences (NAVS) – Verb Comprehension
(-) NAVS – Verb Naming
(-) NAVS – Sentence Comprehension Test
(-) NAVS – Argument Structure Production Test
(-) Sentence Generation Test
(-) Everyday discourse – Overall output – Number of utterances
(-) Everyday discourse – Single Word Level – Heavy verbs
(-) Everyday discourse – Single Word Level – Light verbs
(-) Everyday discourse – Single Word Level – Mental verbs
(-) Everyday discourse – Sentence Level – Two arguments
(-) Everyday discourse – Sentence Level – Three arguments
(-) Everyday discourse – Sentence Level – Thematic embedding
(+) Everyday discourse – Discourse – Orientation
(-) Everyday discourse – Discourse – Body
(-) Everyday discourse – Discourse – Conclusion

Woldag et al., 2017
PEDro: 7
Country: Germany

62 patients with acute stroke

Constraint-induced aphasia therapy
(CIAT, n=21)

vs.

Conventional communication group language therapy
(n=21)

vs.

Low-intensity individual/group speech language therapy
(n=20)

Treatment details:
3 hours/session, 1 time/day over 10 working days (30 hours).

CIAT: group-based therapeutic language games using spoken communication only; groups comprised 2-3 patients and 2 therapists.

Conventional communication group language therapy: group interactions to facilitate all types of communication; groups comprised 3-4 patients and 1 therapist.

Low-intensity speech language therapy: individual (30 minutes/session, 2 times/day for 10 days) + group (4x 1-hour sessions) therapy sessions to address all communication modalities; provided for a total of 14 hours of treatment.

At 2 weeks (post-treatment):
CIAT vs. High-intensity conventional communication group:
(-) Aachen Aphasia Test (AAT) – Token test
(-) AAT – Repetition
(-) AAT – Written language
(-) AAT – Naming
(-) AAT – Comprehension
(-) AAT – Profile level
(+) Communicative Activity Log (CAL) – Qualitative
(-) CAL – Quantitative

CIAT vs. Low-intensity individual/group speech language therapy:
(-) AAT – Token test
(-) AAT – Repetition
(-) AAT – Written language
(-) AAT – Naming
(-) AAT – Comprehension
(-) AAT – Profile level
(-) CAL – Qualitative
(-) CAL – Quantitative

Conventional communication group language therapy vs. Low-intensity individual/group speech language therapy:
(-) AAT – Token test
(-) AAT – Repetition
(-) AAT – Written language
(-) AAT – Naming
(-) AAT – Comprehension
(-) AAT – Profile level
(-) CAL – Qualitative
(-) CAL – Quantitative

 

Was this text useful?

"Aphasia – Authors"
Answer Now Answer Later