Effect Of Verb Network Strengthening Treatment on Lexical Retrieval in Aphasia

动词网络强化治疗对失语症词汇检索的影响

• 批准号: 8089804
• 负责人: Lisa Anna Marie Edmonds
• 金额: --
• 依托单位: VETERANS HEALTH ADMINISTRATION
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-04-01 至 2014-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8089804
• 关键词: Affect; Aftercare; American; Aphasia; Clinical Trials; Communication; Comprehension; Cues; Data; Disease; Effectiveness; Experimental Designs; Family member; Friends; Goals; Hour; Housing; Investigation; Language; Language Disorders; Language Therapy; Length; Literature; Maintenance; Measures; Medical; Names; Nickel; Nurses; Outcome Measure; Participant; Patient Agents; Persons; Phase; Production; Proxy; Questionnaires; Rehabilitation therapy; Reporting; Retrieval; Semantics; Site; Specificity; Speech; Stroke; Structure; Symptoms; System; Testing; Therapeutic; Time; Training; United States; Veterans; base; design; disability; experience; health administration; improved; indexing; lexical retrieval; response; standard of care; stroke recovery; sugar; treatment effect

DESCRIPTION (provided by applicant): Stroke is the leading cause of disability in the United States today, and aphasia, a language disorder that affects production and comprehension of language, remains one of the most devastating aspects of stroke recovery. Nearly 800,000 Americans will experience a stroke each year, and up to 40% of those will also experience aphasia. The most prominent symptom of aphasia is difficulty retrieving words, especially in sentence production and connected speech (e.g., telling a story, having a conversation). The current project examines the effect Verb Network Strengthening Treatment (VNeST), a language therapy, on the ability of persons with moderate aphasia to retrieve words in sentences and connected speech. The primary goals of VNeST are to 1) increase the specificity of nouns and verbs in sentences, 2) maximize improvement to untrained words across a variety of language tasks, and 3) engage and challenge participants with salient and relevant treatment materials and activities. Fifteen persons with aphasia will receive VNeST for 10 weeks for 4 hours per week. Treatment tasks involve the retrieval of nouns related to a target verb. For example, for the verb measure, participants would come up with people who measure and what they measure (e.g., carpenter/lumber, chef/sugar). They would then answer questions related to why, where, and when these things might occur (e.g., for carpenter/measure, they might say "to get the right length of board," (why) "at a construction site," (where) and "when building a house" (where)). Cues and assistance are provided to the participants when they are unable to complete any given task. As the participants improve, cues are reduced. Prior to treatment, testing will be conducted on participants to establish their abilities to retrieve words in the following contexts: 1) naming pictures of objects and actions, 2) sentences, and 3) connected speech. Participants and a family member or friend (i.e., proxy) will also complete a questionnaire about how the participant is able to communicate in everyday tasks (e.g., indicating yes or no, providing medical information). During the treatment phase, sentence production abilities on items related to treatment will be examined in order to determine how word retrieval abilities are changing with treatment. After the completion of treatment, all measures examined prior to treatment (including the questionnaire) will be re-examined in order to determine whether improvement was observed. Additionally, participants will complete testing one more time 3 months after the completion of treatment to determine if post-treatment improvements were maintained. Finally, an analysis of improvement over time across the treatment phase will be examined in order to determine the rate of improvement (or lack of it) over time. All statistical analyses will use group data (i.e., group design), but additional examination of improvements for each participant (i.e., single subject design) will also be conducted. Thus, the overall experimental design is a mix of group and single subject analyses. The findings from this study will help to inform aphasia treatment practices and potentially allow for a larger study with more participants in a clinical trial. PUBLIC HEALTH RELEVANCE: Within the Veterans Health Administration, there are approximately 5,000 new strokes each year that are associated with aphasia and which require rehabilitation. Aphasia is a language disorder which affects the ability to comprehend and/or produce language. The most prominent symptom of aphasia is difficulty retrieving words, especially in sentences and connected speech. The current project evaluates the effect of Verb Network Strengthening Treatment (VNeST) on the ability to retrieve words in sentence and connected speech for persons with moderate aphasia. The primary goal of VNeST is to target carefully selected networks of words in order to maximize the ability to retrieve trained and untrained words in sentences and connected speech. Such improvements can potentially aid the communicative effectiveness for a person with aphasia. Further, the results of this study could potentially inform standard of care for persons with aphasia within the VA system by introducing an efficient treatment approach that maximizes treatment gains.

描述（由申请人提供）： 中风是当今美国残疾的主要原因，失语症是一种影响语言产生和理解的语言障碍，仍然是中风恢复的最具破坏性的方面之一。每年有近80万美国人会经历中风，其中高达40%的人也会经历失语症。失语症最突出的症状是难以提取单词，特别是在句子产生和连接语音（例如，讲一个故事，进行一次对话）。目前的项目研究了动词网络强化治疗（VNeST），一种语言治疗，对中度失语症患者在句子和连接语音中检索单词的能力的影响。VNeST的主要目标是1）增加句子中名词和动词的特异性，2）在各种语言任务中最大限度地提高未经训练的单词，3）用突出和相关的治疗材料和活动吸引和挑战参与者。15名失语症患者将接受VNeST治疗10周，每周4小时。处理任务包括提取与目标动词相关的名词。例如，对于动词测量，参与者会想出测量的人和他们测量的东西（例如，木匠/木材，厨师/糖）。然后，他们将回答与这些事情可能发生的原因、地点和时间有关的问题（例如，对于carpenter/measure，他们可能会说“to get the right length of board，”（why）“at a construction site，”（where）和“when building a house”（where））。当参与者无法完成任何给定的任务时，会向他们提供提示和帮助。随着参与者的进步，提示会减少。在治疗之前，将对参与者进行测试，以确定他们在以下背景下检索单词的能力：1）命名物体和动作的图片，2）句子，以及3）连接语音。参与者和家庭成员或朋友（即，代理）还将完成关于参与者如何能够在日常任务中进行通信的调查表（例如，指示是或否，提供医疗信息）。在治疗阶段，将检查与治疗相关的项目的句子生成能力，以确定单词检索能力如何随治疗而变化。治疗完成后，将重新检查治疗前检查的所有指标（包括问卷），以确定是否观察到改善。此外，受试者将在治疗完成后3个月再完成一次测试，以确定治疗后的改善是否得到维持。最后，将检查整个治疗阶段随时间推移的改善分析，以确定随时间推移的改善率（或缺乏改善）。所有统计分析将使用组数据（即，组设计），但对每个参与者的改进进行额外检查（即，单受试者设计）。因此，总体实验设计是组和单个受试者分析的混合。本研究的发现将有助于为失语症治疗实践提供信息，并可能允许进行更大规模的研究，让更多参与者参与临床试验。 公共卫生相关性： 在退伍军人健康管理局，每年大约有5,000例新发中风与失语症有关，需要康复。失语症是一种语言障碍，影响理解和/或产生语言的能力。失语症最突出的症状是难以提取单词，特别是在句子和连接的语音中。目前的项目评估动词网络强化治疗（VNeST）对中度失语症患者在句子和连接语音中提取单词的能力的影响。VNeST的主要目标是针对精心选择的单词网络，以最大限度地提高在句子和连接语音中检索训练和未训练单词的能力。这种改善可能有助于失语症患者的沟通有效性。此外，这项研究的结果可能会通过引入一种有效的治疗方法，最大限度地提高治疗效果，为VA系统内失语症患者的护理标准提供信息。