Intense Training Improves Language After Stroke

NEW YORK (Reuters Health) - A short-term, intense language training program leads to stable, long-term improvement in communication skills in stroke survivors whose speech has been affected, German researchers report in the medical journal Stroke: Journal of the American Heart Association.

The program, called "constraint-induced aphasia therapy (CAIT)," includes 30 hours of training within 2 weeks with strategies to constrain nononverbal communication attempts by the patient.

According to lead author Dr. Marcus Meinzer and associates, the program involves "shaping," in which "language tasks of increasing level of difficulty are embedded in communicative language games realized within a group setting including 2 to 3 patients."

Meinzer, from Konstanz University in Reichenau, and his team followed 27 stroke patients who speech loss (aphasia) for about 46 months. Twelve patients were included in the CIAT program and 15 to "CIATplus," in which family members were instructed to practice verbal communication with the patient as often as possible.

The results of a standardized language test showed significant improvement in both groups immediately after training, the researchers report. They found that the improvements, documented in 85 percent of patients, remained over the following 6 months.

The patients' progress was dependent on age, time since stroke, or degree of aphasia, the team notes.

Relatives' ratings of the effectiveness of patients' communication also showed significant improvements after training. Relatives of patients in the CIATplus group reported further improvement in the quality and quantity of everyday communication after the 6-month follow-up.

"Intensity seems to be a crucial factor for the successful rehabilitation of chronic aphasia (or, as we believe, in neurorehabilitation in general)," Meinzer's group writes. The current practice of spreading rehabilitation treatment sessions over a long period "should be questioned, especially in the chronic stage of stroke-related disorders."

They add that including patients' relatives or support networks may enhance treatment while reducing costs.

SOURCE: Stroke, July 2005.