CAT In patients with aphasia post stroke, does constraint induced aphasia therapy assist language pr

1
CATIn patients with aphasia post stroke, does
constraint induced aphasia therapy assist
language production?

• NSW Adult Communication and Dysphagia Group

2
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)

3
CATSearch produced two articles for appraisal.

• CAP1Pulvermueller et al (2001) Constraint
  induced therapy of chronic aphasia after stroke.
  Stroke. 32 1621-1626

• CAP2 Meinzer et al(2005). Long term stability
  of improved language functions in chronic aphasia
  after constrain induced aphasia therapy. Stroke.
  37(6)1464 1466.

4
CAPS
5
CAP Contd
6
Clinical Bottom LineCAP1 2

• 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.

7
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

8
Conventional Therapy

• Therapies used in individual and gp sessions
  include
• Strategies
• Impairment
• Family Education
• Functional Therapy

9
Is CIAT an alternative model to service delivery
for aphasia?
10
Participants

• Recruit 30 participants
• Confirmed diagnosis of stroke and aphasia
• Have functional comprehension at a single
  sentence level
• 12 mth post onset
• Outpatients

11
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

12
Treatment Gp 1- CIAT

• Therapy tasks could include go-fish game, other
  barrier task games plus general conversation on
  current affairs topics.

13
Treatment Gp 2 Functional Therapy

• Social communication tasks
• Total communication approach utilised
• Education to carers provided

14
Control

• Wait list gp
• Treatment not withheld

15
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)

16
(No Transcript)