Outcomes from a pilot dose comparison study of naming therapy in aphasia
Outcomes from a pilot dose comparison study of naming therapy in aphasia
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DOI：
10.1080/02687038.2022.2144112
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发表时间：
2022-11-19
期刊：
影响因子：
2
通讯作者：
Rose，Miranda L.
中科院分区：
文献类型：
--
作者：
Harvey，Sam;Carragher，Marcella;Rose，Miranda L.
背景失语症患者对失语症治疗的反应差异很大。治疗剂量可能是理解治疗反应变异性和优化失语症恢复的重要因素;然而，指导卒中后失语症康复剂量处方的经验证据有限。在本研究中，我们使用了一种新的方法来个性化剂量处方，并探讨了剂量对慢性卒中后失语症治疗反应的影响。MethodThis pilot study used a multiple-baseline design with follow-up at 4- and 12-weeks with replications across 4 people with chronic post-stroke anomia.在治疗前，完成了一系列全面的认知和语言测试。然后，参与者进行了一段时间的提示图片命名治疗（45分钟的会议，每周五天，为期三周），共15个会议（11.25小时）。参与者被分配了四组图片-三种治疗条件（低剂量，中等剂量和高剂量）各一组，一组为未治疗的对照组。每个剂量条件下提供的命名机会的数量根据个体的治疗前图片命名准确性和速度进行校准。广义线性混合效应模型用于评估治疗期间的学习效果、这些效果的维持以及剂量-反应关系。治疗过程中提供的命名机会数量）。正如预期，个体治疗反应差异很大。三名参与者在治疗期间表现出对探测项目的图片命名准确性显著提高，不同参与者和剂量的反应特征不同。所有参与者都能够在治疗后的定制298项物体图片命名测试中准确地命名更多的图片。然而，没有参与者表现出显着的治疗前后收益相对于未经处理的项目，虽然一个人表现出改善命名治疗四周后，在高剂量条件下处理的项目。这些参与者之间的剂量-反应关系表现出更多的显着结果命名探针在高剂量的条件下，可能表明优越性的高剂量条件下，较低剂量的线索图片命名treatment.ConclusionModest治疗效果和变量的剂量-反应关系进行了观察。我们探讨了剂量的作用，认知因素，如自我监测能力，和语言因素，如潜在的词汇语义和语音处理，可能会影响这些参与者的治疗反应。确定了今后研究的途径。
BackgroundPeople with aphasia vary considerably in response to aphasia treatments. Treatment dose is likely to be an important factor in understanding treatment response variability and optimising aphasia recovery; however, there is limited empirical evidence to guide dose prescription in post-stroke aphasia rehabilitation. In the present study, we used a novel approach to personalise dose prescription and explored the effect of dose on treatment response in chronic post-stroke aphasia.AimsExamine the effect of providing personalised doses of a cued picture naming treatment (Kendall et al., 2014) on acquisition and maintenance of picture naming outcomes.MethodThis pilot study used a multiple-baselines design with follow-up at 4- and 12-weeks with replication across four people with chronic post-stroke anomia. Prior to treatment, a comprehensive battery of cognitive and language tests was completed. Participants then undertook a period of cued picture naming treatment (45-minute sessions, five days per week for three weeks) totalling 15 sessions (11.25 hours). Participants were allocated four picture sets – one each for three treated conditions (low dose, moderate dose, and high dose) and one for an untreated control set. The number of naming opportunities provided per dose condition was calibrated against individuals’ pre-treatment picture naming accuracy and speed. Generalised linear mixed effects models were used to evaluate learning effects during treatment, maintenance of these effects, and dose-response relationships.OutcomesParticipants received 99% of prescribed treatment doses (i.e., number of naming opportunities provided over the course of treatment). As anticipated, individual treatment responses varied substantially. Three participants demonstrated significantly improved picture naming accuracy on probed items during treatment, with varying response profiles by participant and dose. All participants were able to name more pictures accurately on a bespoke 298-item object picture naming test following treatment. However, no participant demonstrated significant pre-post treatment gains relative to untreated items, although one person demonstrated improved naming four weeks after treatment for items treated under the high dose condition. Dose-response relationships amongst these participants exhibited a greater number of significant results on naming probes in the high dose condition, possibly suggesting superiority of the high dose condition over lower doses of cued picture naming treatment.ConclusionModest treatment effects and variable dose-response relationships were observed. We explore the role of dose, cognitive factors such as self-monitoring abilities, and linguistic factors such as underlying lexical-semantic and phonological processing that may have influenced treatment response in these participants. Avenues for future research are identified.