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Intensive Aphasia Therapy and Constraint Induced Therapy for Aphasia:  A Discussion of Current Evidence and Clinical Experience Gail Lommen MS CCC-SLP North Memorial  763-520-7375 [email_address]
 
Tissue Plasminogen Activator   (t-PA) 1997 ,[object Object],[object Object]
Interventional Stroke Therapy
Intra-Arterial Thrombolysis
Carotid Stents ,[object Object],[object Object],[object Object]
Stroke Prevalence ,[object Object],[object Object],[object Object],[object Object],[object Object],Source: Stroke Facts: NSA 2004
Introduction ,[object Object],[object Object],[object Object],[object Object]
Introduction ,[object Object]
Constraint Induced Aphasia Therapy
[object Object]
Constraint Induced Aphasia Therapy (CIAT)   (general outline for our discussion) ,[object Object],[object Object],[object Object],[object Object],[object Object]
CIAT History and Evidence ,[object Object],[object Object],[object Object],[object Object]
CIAT History and Evidence ,[object Object],[object Object]
CIAT History and Evidence ,[object Object],[object Object],[object Object]
CIAT History and Evidence ,[object Object],Investigated whether intensive language oriented therapy (versus functional) lead to improvement beyond the rate of spontaneous recovery and whether it is effective beyond 12 months post.
CIAT History and Evidence ,[object Object],76 patients received 9 hours of therapy per week over a period of 6-8 weeks. With intensive therapy, improvement went beyond what is expected with spontaneous recovery (92 controls in a previous study who had not received  Tx) in 78% of the patients treated up to 4 months and 46% of those treated from 4-12 months.
CIAT History and Evidence ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
CIAT History and Evidence ,[object Object],[object Object]
CIAT History and Evidence ,[object Object],[object Object]
CIAT History and Evidence ,[object Object],[object Object],[object Object]
CIAT History and Evidence ,[object Object],[object Object]
CIAT History and Evidence ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
CIAT History and Evidence ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
CIAT History and Evidence ,[object Object],[object Object]
CIAT History and Evidence ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
CIAT History and Evidence ,[object Object],[object Object],[object Object],[object Object],[object Object]
CIAT History and Evidence ,[object Object],[object Object]
CIAT History and Evidence ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
CIAT History and Evidence ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
CIAT History and Evidence ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
CIAT History and Evidence ,[object Object],[object Object]
CIAT History and Evidence ,[object Object],[object Object],[object Object],[object Object]
CIAT History and Evidence ,[object Object],[object Object],[object Object],[object Object]
CIAT History and Evidence ,[object Object],[object Object]
CIAT History and Evidence ,[object Object],[object Object]
CIAT History and Evidence ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
CIAT Recent Trends ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
CIAT Recent Trends ,[object Object],[object Object],[object Object]
CIAT Recent Trends Neuroplasticity ,[object Object],[object Object],[object Object],[object Object]
CIAT Recent Trends Neuroplasticity ,[object Object],[object Object],[object Object]
Intensive Aphasia Therapy at North Memorial ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Intensive Aphasia Therapy at North Memorial ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Intensive Aphasia Therapy at North Memorial ,[object Object],[object Object],[object Object],[object Object],[object Object]
Intensive Aphasia Therapy at North Memorial ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
 
 
Western Aphasia Battery (2002-2009) ,[object Object],[object Object],[object Object],[object Object],[object Object],11% 68.0 62.6 All Pts. (120) 5% 89.9 85.8 Mild (47) 11% 61.9 56.0 Moderate (52) 27% 33.9 27.3 Severe (21) Ave.  % Change Average Post-treatment WAB Aphasia Quotient Average Pre-treatment WAB Quotient  
(t-Test: Paired Two Sample for Means) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Hypothesized Mean Difference  (zero, no difference) was rejected.  The treatment made statistically significant difference in WAB Quotients
(% change in  WAB AQ by individual Patient)
Repeat participants WAB AQ n=19
Test of Adolescent/Adult Word Finding N=28
Constraint Induced Aphasia Therapy Evidence Based Practice ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Constraint Induced Aphasia Therapy Evidence Based Practice ,[object Object],[object Object],[object Object],[object Object]
CIAT Future trends ,[object Object],[object Object],[object Object],[object Object]
CIAT Future Trends ,[object Object]

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Intensive Aphasia Program

Editor's Notes

  1. Introduction: Thank you When invited to MSHA – general discussion about the work we are doing with aphasia Rather than simply discussing what we’ve done I chose the one topic of CIAT Growing momentum in the past 10 years. Many facilities are doing book clubs, groups conversation opportunities etc…. This seems to be generating some strong evidence and may have a strong influence on the way we practice