Constraint-induced Aphasia Therapy Improves the Use of Spoken Language and Word-finding Ability in Chronic Subcortical Aphasia: A Case Report

Abstract

Background: Constraint-induced aphasia therapy (CIAT) has been reported as a short-term, intensive language training program for improving language function in patients with chronic aphasia. We report the recovery of language function in a patient with chronic aphasia who was evaluated in the baseline assessment as having reached a plateau. Case: The patient with subcortical aphasia was a 62-year-old, right-handed man. At 192 days after left putamen hemorrhage, he visited our hospital to begin CIAT. The patient's language and speech abilities were evaluated 1 month before and immediately before the start of CIAT. To evaluate the training effect, language function was assessed immediately after, 1 month after, 3 months after, and 6 months after the end of CIAT. The Western Aphasia Battery (WAB), the single-word-naming task in the Test of Lexical Processing in Aphasia (TLPA), and the Verbal Activity Log (VAL) were used to assess his language function and the amount of spoken language. From 1 month before CIAT to 6 months after CIAT, the WAB Aphasia Quotient increased by 6.1 points. Compared with before therapy, the errors of apraxia of speech in the TLPA disappeared from immediately after to 6 months after CIAT. Although the VAL score at 3 months after CIAT was higher than that before the start of CIAT, the score decreased after 6 months because of reduced opportunities for communication with friends. Discussion: CIAT improved the word-naming ability and amount of spontaneous, real-world spoken language in a patient with chronic aphasia.

Speech Therapy for Poststroke Aphasia: A Systematic Review and Network Meta-Analysis of Randomized Controlled Trials

“…37 In CIAT, participants are required to use spoken language, rather than alternative forms of communication, such as gestures, writing, or communicative aids; 21,39 that is, the use of speech is encouraged by constraining the use of nonverbal strategies and providing situations in which patients must speak. 40,41 Our analyses revealed that CIAT effectively improves speech and motor aphasia performance in patients with poststroke aphasia; it is also effective for treating patients in the chronic phase of aphasia. Therefore, we recommend CIAT as the treatment of choice in poststroke aphasia.…”