Constraint-induced aphasia therapy in subacute neurorehabilitation

Abstract

Background: Constraint-induced aphasia therapy (CIAT) is an intensive, short-term speech and language therapy. Previous research indicates that CIAT can lead to lasting improvements in chronic aphasia. CIAT in the subacute phase of recovery has only been sparsely investigated and only in modified versions compared to the original protocol.

Aims: The aim of the current pilot study was to investigate unmodified CIAT in stroke patients in the subacute phase of recovery in the frame of an inpatient multidisciplinary neurorehabilitation program.

Methods & Procedures: Eleven stroke patients with subacute aphasia completed 30 hr of CIAT in 10 weekdays. Language functions as well as the amount and quality of communication were assessed four times, before the control period, pre- and post-CIAT, and at follow-up. The primary outcome measure was Western Aphasia Battery. Secondary measures were the Danish adaptions of Communication Effectiveness Index and of Communication Effectiveness Profile. Issues of applicability were observed currently.

Outcomes & Results: The improvement of neither language nor communication was statistically significant; however, all completing participants presented an improved or at least stable language function. CIAT was applied without modification of intensity and as group therapy to a subgroup of patients with aphasia in the first months after stroke in an inpatient multidisciplinary setting. Only one participant dropped out. Logistics, prioritisation of rehabilitation needs, and prioritisation of the resources of the patients and of the speech and language pathologists turned out to be issues of applicability.

Conclusions: The improvement of language and of real-life communication was not statistically significant. The original protocol was followed demonstrating that CIAT can be applied without modifications in a subacute, inpatient multidisciplinary setting. Issues of applicability were identified.

Keywords:

• constraint-induced aphasia therapy
• stroke
• aphasia
• subacute
• applicability

Acknowledgement

We thank all the participating patients and staff at Hammel Neurorehabilitation Centre and University Research Clinic.