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This study explores the effectiveness of Constraint-Induced Aphasia Therapy (CIAT) in assisting language production in patients with aphasia post-stroke. The therapy involves intensive sessions of language tasks embedded in communicative language games. The study aims to compare CIAT with conventional functional therapy approaches.
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CATIn patients with aphasia post stroke, does constraint induced aphasia therapy assist language production? NSW Adult Communication and Dysphagia Group
CIAT • Application in Speech Pathology; • Intensity: 30hr over 2weeks • Shaping; language tasks of increasing complexity embedded in communicative language games within a group setting (max 2-3 people) • Constraint: constraint of non-verbal or compensatory strategies. (Taub, et al 2002 cited in Meinzer et al 2006)
CAP#1:Pulvermueller et al (2001) Constraint induced therapy of chronic aphasia after stroke. Stroke. 32: 1621-1626 CAP#2: Meinzer et al(2005). Long term stability of improved language functions in chronic aphasia after constrain inducedaphasia therapy. Stroke. 37(6):1464 –1466. CATSearch produced two articles for appraisal.
Massed-practice CIAT performed intensely over a short period of time with chronic aphasics resulted in improved language performance. It is difficult to determine whether CIAT was more effective than other conventional therapies. Clinical Bottom LineCAP#1 & #2
Conventional Therapies • Chronic aphasics usually receive the option of gp or individual therapy. • Individual therapy 1hr/wk • Offered in blocks –particularly if students placements available and if caseload permitting. • Goal oriented therapy • Gp therapy: 2hr a week/fortnight for a period of 10-12 weeks. Total communication approach. • Transport and staffing
Conventional Therapy • Therapies used in individual and gp sessions include: • Strategies • Impairment • Family Education • Functional Therapy
Is CIAT an alternative model to service delivery for aphasia?
Participants • Recruit 30 participants • Confirmed diagnosis of stroke and aphasia • Have functional comprehension at a single sentence level • 12 mth post onset • Outpatients
Methodology • Blinding assessors • Concealed and quasi-randomised • Control gp • 2 participants in the control or both treatment gps • Therapy conducted 2hr/day for 2 weeks with carer education
Treatment Gp 1- CIAT • Therapy tasks could include go-fish game, other barrier task games plus general conversation on current affairs topics.
Treatment Gp 2 – Functional Therapy • Social communication tasks • Total communication approach utilised • Education to carers provided
Control • Wait list gp • Treatment not withheld
How? • Big exercise • At a smaller level • Utilise clients as their own control while they are on the waiting list • Compare CIAT with current functional therapy approach that focuses on total communication • Increase intensity at sub acute level of rehab (inpatients)