Stroke Patients Regain Language Skills After Intense Therapy
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Short term, intense language therapy has improved communication skills in stroke patients left with chronic aphasia, researchers here reported.
The intense, 30-hour language training program improved measurable communication skills by 85%, according to Marcus Meinzer, Ph.D., of the Unversita"t Konstanz here.
The finding suggested that the brain is capable of recruiting undamaged regions to take over language function, he and colleagues reported in the June issue of Stroke, Journal of the American Heart Association.
Dr. Meinzer said the results achieved with this short term approach—30 hours over 10 days—were durable for more than six months in the 27 stroke patients recruited for the study.
Results were even better, he said, for a subset of 15 patients who had the communication training reinforced by family and friends at home.
Standard communication therapy for chronic aphasia after a stroke is given about two hours a week over the course of a year, Dr. Meinzer said. “We found that it is basically better to give therapy within a two-week period.” Moreover, he said that any well-designed communication therapy regimen that is compressed into a two-week period is likely to be as effective as the program used in the German study. “Training intensity appears to be the crucial factor.”
About 38% of stroke patients experience aphasia after suffering left-hemispheric stroke. Many of those patients have a spontaneous improvement in language skills during the first six months after stroke, but as many as 60% will develop chronic aphasia.
The language therapy used by Dr. Meinzer’s group involved a technique called constraint-induced aphasia therapy, or CIAT, that relies on language games aimed at rapidly progressing from simple communication to more complex language skills.
The language games use decks of cards that have images and words that can be paired (each deck contains 15 pairs). The cards are distributed to the patients and therapists who are instructed to ask for matching cards by spoken language—so the game is similar to the popular children’s card game, “Go Fish.”
Twelve patients were assigned to a basic CIAT program that relied on only the 30 hours of training and 15 were assigned to CIAT plus in which training was reinforced by family members at home.
The mean age of the patients was 51.5, and 11 were women. On average the patients had chronic aphasia for almost four years. At baseline, 15 patients were classified as moderate aphasia, 10 with mild aphasia and two were categorized as severe aphasia.
Language functions were assessed at baseline, immediately after the two-week CIAT training and again at six months with the Aachener Aphasic Test (AAT) a standardized measure of aphasia.
After training 17 of the 27 patients across groups showed significant improvement on at least one AAT subtest (CIAT N = 8/12, CIATplus N = 9/15), 6 patients improved at least one subscale (CIAT N = 2/12, CIATplus N = 4/15), the authors wrote. A total of 85% of the patients improved after therapy.
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