Rehabilitation of post-stroke aphasia by a single protocol targeting phonological, lexical, and semantic deficits with speech output tasks: a randomized controlled trial.

BACKGROUND

The defective spoken output of persons with aphasia has anomia as a main clinical manifestation. Improving anomia is therefore a main goal of any language treatment.

AIM: This study assessed the effectiveness of a novel, 2-week, rehabilitation protocol (PHOLEXSEM), focused on PHonological, SEmantic, and LExical deficits, aiming at improving lexical retrieval, and, generally, spoken output.

DESIGN

A prospective, randomized controlled trial.

SETTING

In-patient and out-patient population of the Neurorehabilitation Unit of the Istituto Auxologico Italiano IRCCS, Milan, Italy.

POPULATION: The sample comprised 44 adults with aphasia due to left brain damage; 22 of them were assigned to the experimental (PHOLEXSEM) group, whereas 22 were assigned to the control group that received the Promoting Aphasics Communicative Effectiveness (PACE) protocol.

METHODS

All participants were treated 30-min daily for two weeks. The PHOLEXSEM training included 3 sets of exercises: 1) non-word, word, and phrase repetition; 2) semantic feature analysis by naming; 3) phonemic, semantic, and verb recall. Treatment effects were evaluated with tasks and items different from those used for training, to assess generalization effects.

RESULTS

After the PHOLEXSEM treatment, repetition, naming, lexical retrieval and sentence comprehension improved more than in the control - PACE - group, with gains generalizing to non-trained items. These improvements were independent of aphasia chronicity and only marginally influenced by demographic factors.

CONCLUSIONS

The 2-week PHOLEXSEM training, by targeting spoken output, ameliorates different aspects of aphasia, ranging from speech production (i.e., phonology and lexical retrieval) to comprehension.

CLINICAL REHABILITATION IMPACT: The PHOLEXSEM training is a useful and easy-to-administer intervention to improve post-stroke language deficits in adults of different ages, levels of education, duration, type, and severity of aphasia.