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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]
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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]
ย 
ย 
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 ย 
(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 โ€“ general discussion about the work we are doing with aphasia Rather than simply discussing what weโ€™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 etcโ€ฆ. This seems to be generating some strong evidence and may have a strong influence on the way we practice