The Comparative Effects of Multi-modality and Constraint-induced Aphasia Therapy-Plus Treatments for Severe Chronic Aphasia

Attard, Michelle Christine and Rose, Miranda Lee and Lanyon, Lucette (2012) The Comparative Effects of Multi-modality and Constraint-induced Aphasia Therapy-Plus Treatments for Severe Chronic Aphasia. [Clinical Aphasiology Paper]

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Abstract

Anomia is a characteristic symptom of aphasia. Impairments in functional communication associated with aphasia have been found to negatively impact upon an individual‟s quality of life (QoL) in a number of areas, including independence and the ability to participate in social and leisure activities (Cruice, Worrall, & Hickson, 2006). Our review of the literature suggests that measurement of treatment effects has been influenced by treatment type and intensity, the measurement phases applied, the outcome measures used, aphasia severity and type, and the presence of concomitant impairments. It is clear that both constraint-induced and alternative/multi-modality treatments can be effective for reducing anomia. However, the question of which treatments, particularly constraint-induced and alternative/multi-modality treatments, are most efficacious for certain types, severities, and chronicities of aphasia remains unanswered. Only three known studies (Barthel, Meinzer, Djundja, & Rockstroh, 2008; Kurland, Baldwin, & Tauer, 2010; Maher et al., 2006) have involved direct comparisons between constraint-induced and multi-modality interventions. This is a particularly interesting comparison, given the great distinction between the two forms of therapy, and the interpretation that the research underpinning the principle of constraint in aphasia rehabilitation is inconclusive. Further, a number of methodological flaws in the reviewed studies weaken the research findings. Thus, we identified a need for continued study in this area.

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