Szaflarski Jerzy P, Ball Angel, Grether Sandra, Al-Fwaress Firas, Griffith Nathan M, Neils-Strunjas Jean, Newmeyer Amy, Reichhardt Robert
Department of Neurology, University of Cincinnati Academic Health Center, Cincinnati, OH, U.S.A. and The Neuroscience Institute, Cincinnati, OH 45267-0525, USA.
Med Sci Monit. 2008 May;14(5):CR243-250.
Constraint-induced aphasia therapy (CIAT) offers potential benefits to individuals with history of aphasia-producing ischemic stroke. The goals of this pilot study were to implement the original German CIAT protocol, refine the treatment program, and confirm its efficacy in patients with chronic aphasia.
MATERIAL/METHODS: We translated and modified the original CIAT protocol to include a hierarchy of individual skill levels for semantic, syntactic, and phonological language production, while constraining non-use behaviors. Three male participants with moderate to severe post-stroke aphasia received CIAT 3-4 hours/day for 5 consecutive days. Pre and post-testing included formal language evaluation, linguistic analysis of story retell, and mini-Communication Activity Log (mini-CAL).
Substantial improvements in comprehension and verbal skills were noted in 2 patients with an increase in the total number of words (31% and 95%) and in number of utterances for story-retell task (57% and 75%). All participants demonstrated an improvement on at least one linguistic measure. No subjective improvements on mini-CAL were noted by any of the participants.
Given that the duration of treatment was only 1 week, these linguistic improvements in post stroke aphasia participants were remarkable. The results indicate that the CIAT protocol used in this study may be a useful tool in language restoration after stroke. These initial findings should be confirmed in a larger, randomized study.
强制性失语症疗法（CIAT）对有失语症导致的缺血性中风病史的个体具有潜在益处。这项试点研究的目的是实施最初的德国CIAT方案，完善治疗计划，并确认其对慢性失语症患者的疗效。
材料/方法：我们翻译并修改了最初的CIAT方案，以纳入语义、句法和语音语言产生方面的个体技能水平层次结构，同时限制不使用行为。三名患有中度至重度中风后失语症的男性参与者连续5天每天接受3 - 4小时的CIAT治疗。测试前和测试后包括正式语言评估、故事复述的语言分析以及迷你沟通活动日志（mini - CAL）。
2名患者在理解和言语技能方面有显著改善，单词总数增加（分别为31%和95%），故事复述任务的话语数量增加（分别为57%和75%）。所有参与者在至少一项语言测量上都有改善。没有参与者注意到mini - CAL有主观改善。
鉴于治疗时间仅为1周，中风后失语症参与者的这些语言改善是显著的。结果表明，本研究中使用的CIAT方案可能是中风后语言恢复的有用工具。这些初步发现应在更大规模的随机研究中得到证实。
