Randomized Controlled Trial Of Constraint-Induced Aphasia Therapy In Patients With Chronic Stroke (S21.001)

Objective: To investigate the effects of constraint-induced aphasia therapy (CIAT) on language function in patients with chronic post-stroke aphasia. Background: Aphasia is one of the most devastating sequelae of left middle cerebral artery (LMCA) stroke. The currently available rehabilitative therapies provide only partial improvement of language function and many patients are left with significant disability despite undergoing extensive rehabilitation. New therapies are needed and CIAT has been recently proposed to be one of them. Design/Methods: 32 subjects with history of LMCA stroke and residual moderate aphasia were screened; 24 were randomized to receive CIAT (N=14) or observation (N=10). CIAT included 10 daily sessions, each 4 hours long, of tailored intervention designed to promote verbal communication and to limit compensatory non-verbal strategies. Sessions were supervised concurrently by at least 2 trained speech language pathologists. The observation group did not receive any treatment. The data collection team was blinded to group assignment until after all subjects completed all assessments. Primary outcomes were the Boston Naming Test, Semantic Fluency Test, Controlled Oral Word Association Test, Complex Ideational subtest of the Boston Diagnostic Aphasia Examination, and the Peabody Picture Vocabulary Test. Evaluations were performed 1 week prior to, within 1 week of, and 3 months after intervention or observation. Groups were compared using the chi-square test, Mann-Whitney U test or Fisher’s exact test as appropriate. Results: The groups were well matched on demographic and pre-intervention (observation) variables including age, time from stroke, sex, and comorbidities (all p>0.195). We observed small improvements in Semantic Fluency Test and Controlled Oral Word Association Test in the CIAT group, but these did not reach statistical significance (all p>0.112). Conclusions: Overall, this randomized controlled trial did not show improvement in language abilities in this small group of subjects with chronic post-stroke aphasia receiving CIAT when compared to observation. Disclosure: Dr. Szaflarski has received personal compensation for activities with UCB Pharma. Dr. Szaflarski has received research support from the National Institutes of Health, the American Academy of Neurology, the Shor Foundation for Epilepsy Research, Neuren, and Eisai Inc. Dr. Allendorfer has received research support from the Shor Foundation for Epilepsy Research. Dr. Ball has nothing to disclose. Dr. Banks has nothing to disclose. Dr. Dietz has nothing to disclose. Dr. Hart has nothing to disclose. Dr. Lindsell has received research support from Abbott POC. Dr. Martin has nothing to disclose. Dr. Vannest has nothing to disclose.