Constraint-Induced Therapy of Chronic Aphasia After Stroke

TLDR

CI aphasia therapy uses a communicative environment that forces patients to practice speech acts they find difficult. Patients were randomized to receive either conventional therapy (≈4 weeks, 30–35 hours) or CI therapy (10 days, 30–35 hours of massed practice). CI therapy produced significant improvements on clinical, self‑rated, and observer‑rated measures of communicative effectiveness, whereas conventional therapy did not yield comparable gains, indicating that massed‑practice can enhance language skills in chronic aphasia within a short period.

Abstract

Abstract —Patients with chronic aphasia were assigned randomly to a group to receive either conventional aphasia therapy or constraint-induced (CI) aphasia therapy, a new therapeutic technique requiring intense practice over a relatively short period of consecutive days. CI aphasia therapy is realized in a communicative therapeutic environment constraining patients to practice systematically speech acts with which they have difficulty. Patients in both groups received the same amount of treatment (30 to 35 hours) as 10 days of massed-practice language exercises for the CI aphasia therapy group (3 hours per day minimum; 10 patients) or over a longer period of ≈4 weeks for the conventional therapy group (7 patients). CI aphasia therapy led to significant and pronounced improvements on several standard clinical tests, on self-ratings, and on blinded-observer ratings of the patients’ communicative effectiveness in everyday life. Patients who received the control intervention failed to achieve comparable improvements. Data suggest that the language skills of patients with chronic aphasia can be improved in a short period by use of an appropriate massed-practice technique that focuses on the patients’ communicative needs.