The comparative effects of Multi-Modality Aphasia Therapy and Constraint-Induced Aphasia Therapy-Plus for severe chronic Broca's aphasia: An in-depth pilot study

Abstract

Background: Anomia is a debilitating symptom of aphasia, which impacts significantly on patient quality of life. There is strong evidence in the literature to indicate that treatments for anomia are successful for individuals with aphasia, including those in the chronic stage. However, numerous limitations exist within the methodologies of relevant studies. It remains unclear which treatments provide optimal benefits for varying types and severities of aphasia.

Aims: The primary aim of this study was to compare the effectiveness of two treatments, Constraint-Induced Aphasia Therapy-Plus (CIATplus) and Multi-modality Aphasia Therapy (M-MAT) for noun retrieval in individuals with severe chronic Broca's aphasia. The secondary aim was to investigate whether the use of verbal constraint is an essential element of therapy. We hypothesised that M-MAT and CIATplus would lead to equally improved naming scores for treated stimuli.

Methods & Procedures: Two females with chronic Broca's aphasia (CH and MT) participated in the study. We utilised two single-participant, alternating treatment designs with multiple probes. For each treatment participants received 3.25-hour treatment sessions along with 45 minutes social interaction 4 days a week, for 2 weeks (32 hours total). Treatment involved naming items in the context of turn-taking card games and home transfer request tasks. Naming probes and assessments were conducted at baseline, following each treatment, and at 6 weeks and 3 months post treatment.

Outcomes & Results: Both participants differed in their responses to the treatments. However, M-MAT proved equally efficacious as CIATplus for naming of treated items. Overall, generalisation was not observed for any of the measures. CH reported enjoying both treatments, while MT preferred M-MAT.

Conclusions: As expected, a number of variables are likely to have contributed to differences in participant responses to treatment. Replication with larger, well-stratified samples is required to better ascertain the effects of CIATplus and M-MAT on anomia in different types and severities of aphasia. This information would contribute to the more effective application of client-tailored treatment practices.

Keywords:

• Anomia
• Broca's aphasia
• Constraint-Induced Aphasia Therapy-Plus
• CIATplus
• Multi-modality Aphasia Therapy
• M-MAT
• Nouns
• Naming

Notes

This research was primarily funded by the Australian NHMRC funded Centre for Clinical Research Excellence in Aphasia Rehabilitation. The first author was the recipient of a La Trobe University, Faculty of Health Sciences Honours Grant. The authors would like to thank the participants and their spouses for their ongoing patience, enthusiasm, and commitment. They also recognise the Australian Aphasia Association and The Stroke Association of Victoria for publishing a recruitment advertisement in their member newsletter.

¹As CH's conversation was of reduced length, her conversations generally pertained to questions 1–3.