科研之友
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摘要
Background: There is an urgent need for treatment comparison studies for chronic aphasia. Two different treatments, Constraint-Induced Aphasia Therapy Plus (CIAT Plus) and Multi-Modality Aphasia Therapy (M-MAT) aim to improve spoken language production through intensive shaping of responses, and social-mediated repetitive practice. CIAT Plus constrains responses to the verbal modality, while M-MAT includes gesture, drawing, writing and reading-based cues to assist production. Aims: This Phase 1 study compared the efficacy of CIAT Plus and M-MAT. The study also aimed to investigate the relationship between treatment responsiveness and participant%26apos;s aphasia severity and cognitive variables. Methods %26 Procedures: We utilised 11 single-subject multiple baseline designs with a cross-over for treatment type. Participants had chronic aphasia (17-88 months post onset) and a range of aphasia severities (WAB AQ 36.2-92.8). Participants named 180 noun and verb probes three times at pre-, mid-, post-treatments and at 1- and 3-month follow-ups. Both CIAT Plus and M-MAT were delivered for 32 hours over 2 weeks. Six participants received M-MAT first while five received CIAT Plus first. Standard case charts were developed for visual analysis of each participant%26apos;s probe results. Within-subject effect sizes (ESs) were calculated on naming the probe scores. Discourse measures were analysed with descriptive statistics. Participant%26apos;s satisfaction with each treatment type was probed. Results %26 Conclusions: A total of 32 (of 44 total) immediate post-treatment ESs reached small (3), medium (7) or large (22) levels, and ranged from -0.96 to 30.6. Higher ESs were found for nouns as compared to verbs, and for items treated during the first treatment phase. The mean ES was comparable for items treated with M-MAT (M=8.00) and CIAT Plus (M=8.58) and was well maintained at the 1-month follow-up. As a group, aphasia severity was significantly reduced at the 1-month and 3-month follow-up time points. WAB AQ change scores immediately post-treatment favoured M-MAT for four participants and CIAT Plus for five; however, order effects are likely to have played a significant role. Treatment potency was demonstrated with generalisation to noun (8 participants) and verb production (1 participant) in discourse. Overall, CIAT Plus and M-MAT were equally efficacious for these 11 individuals, although six participants expressed preference for M-MAT and three for CIAT Plus. Delayed treatment effects were present in some participants. Future large-scale studies are required to deal with order effects and a participant%26apos;s variability.
- 出版日期2013-8-1
