Rehabilitation of Post-stroke Aphasia by Targeting Phonological, and Lexico-semantic Deficits With Speech Output Tasks

Not Applicable

Completed

Brief Summary: Aphasia in brain-damaged adult patients refers "to the more or less complete loss of the ability to use language" resulting from acquired brain damage, typically of the left hemisphere. The defective spoken output of persons with aphasia (PWA) has anomia as a main clinical manifestation. Improving anomia is a main goal of any language treatment.

The present randomized controlled study assessed the effectiveness of a novel, two-week, rehabilitation protocol (PHOLEXSEM), focused on PHonological, SEmantic, and LExical deficits, aiming at improving lexical retrieval, and, generally, spoken output.

The effects of the PHOLEXSEM treatment were compared to those of a control treatment, i.e., a Promoting Aphasics Communicative Effectiveness (PACE) protocol.

Finally, we studied the effects of age, education, disease duration, brain lesion volume, and functional independence (Functional Idependence Measure, FIM) on the treatment-induced linguistic improvements.

Recruitment & Eligibility

Inclusion Criteria

Exclusion Criteria

Arm && Interventions

Group	Intervention	Description
PHOLEXSEM	PHOLEXSEM	Each session lasted 30 minutes, and comprised three sections, each lasting 10 minutes: Repetition, Semantic Feature Analysis (SFA), and Lexical retrieval. Repetition: 50 items for different kind of stimuli including: syllables, 2-syllable words and non-words; 2-syllable words and non-words with one consonant cluster; 3-syllable words and non-words; 3-syllable words and non-words with one consonant cluster, nuclear phrases. SFA: stimuli were 46 pictures of nouns, including living and non-living objects, controlled for frequency of use. Lexical retrieval phase: the patient was given three fluency tasks: a) 4 min of phonemic recall, b) 4 min of semantic recall, and c) 2 min of verb recall.
PACE	PACE	Three decks of cards - diversified by frequency of use - depicting nouns, were presented in sets of 4 cards each. In an exchange modality, the task consisted in understanding the noun chosen by the patient and, in turn, by the rehabilitator. Any communicative modality (oral, gestural, verbal, graphic) was allowed. Word difficulty was graded based on the frequency of use and semantic proximity or distance between target and distractors.

Primary Outcome Measures

Name	Time	Method
Change from baseline in the auditory digit span	At baseline and immediately after the intervention.	To assess auditory verbal short-term memory
Change from baseline in the Neuropsychological Examination of Language (ENPA)	At baseline and immediately after the intervention.	A test for aphasia assessment in the Italian population
Change from baseline in phonemic fluency	At baseline and immediately after the intervention.	To assess lexical retrieval based on a letter
Change from baseline in semantic fluency	At baseline and immediately after the intervention.	To assess lexical retrieval based on a semantic category
Change from baseline in syntagma repetition	At baseline and immediately after the intervention.	The syntagma repetition test from the Aachner Aphasie Test (AAT)
Change from baseline in the word repetition span	At baseline and immediately after the intervention.	To assess auditory verbal short-term memory, with words stimuli
Change from baseline in the Token Test	At baseline and immediately after the intervention.	To assess auditory language comprehension

Secondary Outcome Measures

Name	Time	Method

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