Constraint-Induced Therapy of Chronic Aphasia After Stroke

Abstract

Abstract-Patients with chronic aphasia were assigned randomly to a group to receive either conventional aphasia therapy or constraint-induced (CI) aphasia therapy, a new therapeutic technique requiring intense practice over a relatively short period of consecutive days. CI aphasia therapy is realized in a communicative therapeutic environment constraining patients to practice systematically speech acts with which they have difficulty. Patients in both groups received the same amount of treatment (30 to 35 hours) as 10 days of massed-practice language exercises for the CI aphasia therapy group (3 hours per day minimum; 10 patients) or over a longer period of Ϸ4 weeks for the conventional therapy group (7 patients). CI aphasia therapy led to significant and pronounced improvements on several standard clinical tests, on self-ratings, and on blinded-observer ratings of the patients' communicative effectiveness in everyday life. Patients who received the control intervention failed to achieve comparable improvements. Data suggest that the language skills of patients with chronic aphasia can be improved in a short period by use of an appropriate massed-practice technique that focuses on the patients' communicative needs. (Stroke. 2001;32:1621-1626.)

Intensive language training in the rehabilitation of chronic aphasia: Efficient training by laypersons

“…However, no further improvement during a 6-month follow-up period during which patients received approximately 2 hr0week outpatient language therapy. Similarly, Pulvermueller et al (2001) demonstrated more improvement of language functions after 2 weeks of intensive treatment (3 hr0day) than after the same number of treatment hours extended across several weeks.…”

“…All patients received the same standardized intensive training, Constraint-Induced Aphasia Therapy (CIAT, Meinzer et al, 2005;Pulvermueller et al, 2001). CIAT is an adaption of Constraint-Induced Movement Therapy (CIMT), a well-evaluated therapeutic tool for the treatment of poststroke paresis (Taub et al, 1999).…”

“…CIAT is based on the core principles of CI movement therapy (Pulvermueller et al, 2001). Similar to the observed non-use of the affected limb in hemiparesis, patients with aphasia often use nonvocal communication channels as a compensatory mechanism for spoken language (e.g., gesturing).…”

“…In the present study, we selected CIAT as the treatment of choice because substantial and stable improvement of language function in chronic aphasia has been demonstrated (Maher et al, 2006;Meinzer et al, 2005;Pulvermueller et al, 2001). The short-term nature of the treatment controls for confounds related to extended treatment intervals (e.g., dropouts, influence of unspecific factors).…”

D-Amphetamine Boosts Language Learning Independent of its Cardiovascular and Motor Arousing Effects

“…Owing to its incidental (associative) learning principle, the model is suitable for high-frequency training programs in brain-damaged populations. Recent experimental (Basso and Caporali, 2001;Pulvermuller et al, 2001) and review work (Bhogal et al, 2003a;Bhogal et al, 2003b;Robey, 1994) on aphasia therapy has suggested that training intensity may in fact play the most important role in predicting treatment success in aphasia. Furthermore, in a still-ongoing study, we collected the first evidence that some patients with aphasia may benefit from our word-learning model.…”