Acceptability, feasibility and preliminary efficacy of low-moderate intensity Constraint Induced Aphasia Therapy and Multi-Modality Aphasia Therapy in chronic aphasia after stroke.

Autor: Pierce JE; Centre of Research Excellence in Aphasia Recovery and Rehabilitation, La Trobe University, Melbourne, Victoria, Australia., OHalloran R; Centre of Research Excellence in Aphasia Recovery and Rehabilitation, La Trobe University, Melbourne, Victoria, Australia., Togher L; Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia., Nickels L; School of Psychological Sciences, Macquarie University, Sydney, New South Wales, Australia., Copland D; Queensland Aphasia Research Centre, The University of Queensland, Herston, Queensland, Australia.; Surgical Treatment and Rehabilitation Service Education and Research Allience, Metro North Health, Herston, Queensland, Australia., Godecke E; School of Medical and Health Sciences, Edith Cowan University, Western, Australia., Meinzer M; Department of Neurology, University Medicine Greifswald, Greifswald, Germany., Rai T; Graduate Research School, University of Technology Sydney, New South Wales, Australia., Cadilhac DA; Stroke and Ageing Research, Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Victoria, Australia.; Speech Pathology, Monash Health, Clayton, Victoria, Australia., Kim J; Stroke and Ageing Research, Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Victoria, Australia.; Speech Pathology, Monash Health, Clayton, Victoria, Australia., Hurley M; CRE Aphasia Recovery and Rehabilitation, La Trobe University, Bundoora, Australia., Foster A; Speech Pathology, Monash Health, Clayton, Victoria, Australia.; School of Allied Health, Human Service & Sport, La Trobe University, Victoria, Australia.; School of Primary & Allied Health Care, Monash University, Victoria, Australia., Carragher M; CRE Aphasia Recovery and Rehabilitation, La Trobe University, Bundoora, Australia., Wilcox C; CRE Aphasia Recovery and Rehabilitation, La Trobe University, Bundoora, Australia., Steel G; CRE Aphasia Recovery and Rehabilitation, La Trobe University, Bundoora, Australia., Rose ML; CRE Aphasia Recovery and Rehabilitation, La Trobe University, Bundoora, Australia.
Jazyk: angličtina
Zdroj: Topics in stroke rehabilitation [Top Stroke Rehabil] 2024 Jan; Vol. 31 (1), pp. 44-56. Date of Electronic Publication: 2023 Apr 10.
DOI: 10.1080/10749357.2023.2196765
Abstrakt: Background: High-intensity Constraint-Induced Aphasia Therapy Plus (CIAT-Plus) and Multi-Modality Aphasia Therapy (M-MAT) are effective interventions for chronic post-stroke aphasia but challenging to provide in clinical practice. Providing these interventions may be more feasible at lower intensities, but comparative evidence is lacking. We therefore explored feasibility, acceptability, and preliminary efficacy of the treatments at a lower intensity.
Methods: A multisite, single-blinded, randomized Phase II trial was conducted within the Phase III COMPARE trial. Groups of participants with chronic aphasia from the usual care arm of the COMPARE trial were randomized to M-MAT or CIAT-Plus, delivered at the same dose as the COMPARE trial but at lower intensity (6 hours/week × 5 weeks rather than 15 hours/week × 2 weeks). Blinded assessors measured aphasia severity (Western Aphasia Battery-Revised Aphasia Quotient), word retrieval, connected speech, multimodal communication, functional communication, and quality of life immediately post interventions and after 12 weeks. Feasibility and acceptability were explored.
Results: Of 70 eligible participants, 77% consented to the trial; 78% of randomized participants completed intervention and 98% of assessment visits were conducted. Fatigue and distress ratings were low with no related withdrawals. Adverse events related to the trial ( n  = 4) were mild in severity. Statistically significant treatment effects were demonstrated on word retrieval and functional communication and both interventions were equally effective.
Conclusions: Low-moderateintensity CIAT-Plus and M-MAT were feasible and acceptable. Both interventions show preliminary efficacy at a low-moderate intensity. These results support a powered trial investigating these interventions at a low-moderate intensity.
Databáze: MEDLINE
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