Pairing Word Retrieval and Physical Endurance Tasks to Treat Anomia in People With Aphasia
| Status: | Withdrawn |
|---|---|
| Conditions: | Neurology |
| Therapuetic Areas: | Neurology |
| Healthy: | No |
| Age Range: | 19 - Any |
| Updated: | 6/15/2018 |
| Start Date: | May 1, 2018 |
| End Date: | June 8, 2018 |
Pairing Word Retrieval and Physical Endurance Tasks to Treat Anomia
Many individuals have difficulty with word retrieval, also called anomia, following
cerebrovascular accident (CVA). These difficulties impede effective communication in everyday
conversations and can negatively impact the resumption of pre-injury activities. Even after
rehabilitation specifically targeting these areas, many individuals report persistent
difficulties with anomia. Additionally, most individuals report that these difficulties
worsen when distracted, fatigued, or when attempting to divide attention between tasks. Given
that everyday activities frequently require efficient communication when attention is divided
(e.g., walking and talking), it is important to investigate viable interventions to improve
these skills.
Recovery from CVA and resumption of pre-injury activities is best supported by rehabilitation
interventions that are functional and directly related to the tasks individuals aim to
resume. For example, a therapy task requiring an individual to generate a grocery list and
then go to a grocery store to acquire the items on the list has a greater impact on recovery
for the underlying language and cognitive skills than a series of generic language and
cognition tasks completed in a therapy room. In addition to this, interventions that
incorporate dual-task practices tend to have better outcomes than more traditional
single-task practices.
The aim of this study is to compare the effectiveness of pairing word retrieval tasks with
physical endurance tasks versus presenting them in isolation. Additionally, this study will
investigate whether improvements in word retrieval and physical endurance generalize to the
functional, everyday task of holding a conversation while walking. The researchers
hypothesize that participants will perform better on word retrieval tasks after participating
in dual language and physical tasks than after participating in language tasks presented in
isolation.
cerebrovascular accident (CVA). These difficulties impede effective communication in everyday
conversations and can negatively impact the resumption of pre-injury activities. Even after
rehabilitation specifically targeting these areas, many individuals report persistent
difficulties with anomia. Additionally, most individuals report that these difficulties
worsen when distracted, fatigued, or when attempting to divide attention between tasks. Given
that everyday activities frequently require efficient communication when attention is divided
(e.g., walking and talking), it is important to investigate viable interventions to improve
these skills.
Recovery from CVA and resumption of pre-injury activities is best supported by rehabilitation
interventions that are functional and directly related to the tasks individuals aim to
resume. For example, a therapy task requiring an individual to generate a grocery list and
then go to a grocery store to acquire the items on the list has a greater impact on recovery
for the underlying language and cognitive skills than a series of generic language and
cognition tasks completed in a therapy room. In addition to this, interventions that
incorporate dual-task practices tend to have better outcomes than more traditional
single-task practices.
The aim of this study is to compare the effectiveness of pairing word retrieval tasks with
physical endurance tasks versus presenting them in isolation. Additionally, this study will
investigate whether improvements in word retrieval and physical endurance generalize to the
functional, everyday task of holding a conversation while walking. The researchers
hypothesize that participants will perform better on word retrieval tasks after participating
in dual language and physical tasks than after participating in language tasks presented in
isolation.
All data collection will occur at Quality Living (QLI).
The researchers will administer a set of standardized assessments prior to initiating the
intervention program to determine eligibility for study participation as well as to gather
descriptive information about the language abilities of participants. Assessments will
include the Western Aphasia Battery - Revised and the Boston Naming Test. In addition to
performing language assessments, participants will respond to demographic and injury-related
questions and will identify preferred topics of conversation. The researchers will obtain
information about each participant's physical status by referring to the physical therapy
assessments and associated documentation completed by a QLI physical therapist shortly after
the individual's arrival at QLI.
Intervention will occur five days per week and will take place during participants' regularly
scheduled speech therapy sessions. Two intervention sessions will occur daily, one held in
the morning and the second held in the afternoon. Depending on the activities performed on a
given day, the total time devoted to intervention sessions will be 10 to 30 minutes (i.e., 5
to 15 minutes per session).
During each intervention session, the researchers will measure performance on one or more of
the following tasks: (a) five trials of generative naming given a unique category and
one-minute response period per trial, (b) distance traveled using an exercise machine for
five minutes, (c) generative naming given unique categories and one-minute response periods
and distance traveled using an exercise machine when performing both tasks simultaneously for
five minutes, (d) number of words generated in five minutes in response to conversational
topic prompts, (e) distance traveled when walking for five minutes, and (f) number of words
generated in response to conversational topic prompts and distance traveled when walking when
performing both tasks simultaneously for five minutes. The first three measures comprise
intervention tasks, and the remaining three are generalization measures.
Intervention and generalization sessions will follow an overlapping ABAB or BABA format, with
the first day of each phase being an overlap day. Participants will be randomly assigned to
begin the intervention either with an A or B phase. On overlap days, the researchers will
collect measures on all six intervention and generalization activities, with three being
performed during a fifteen-minute morning session and three being performed during a
fifteen-minute afternoon session. For participants in the A phase, the researchers will
collect measures two times daily for each of the subsequent four days on the generative
naming and exercise machine activities performed as independent tasks; for participants in
the B phase, the researchers will collect measures two times daily for each of the subsequent
four days on the generative naming and exercise machine activities performed as simultaneous
tasks. A phase sessions will last ten minutes each, and B phase sessions will last five
minutes each. The cycle of A and B phases will repeat throughout a participants inpatient
stay at QLI. A QLI physical therapist will be present to monitor safety during performance of
physical activities. The researchers will audio record all generative naming and
conversational discourse activities for later analysis.
Participants will only perform naming, discourse, and physical endurance tasks that are
included as part of their routine speech-language therapy and physical therapy sessions.
However, completion of the physical endurance tasks will not occur during the participants'
physical therapy sessions; instead, they will occur during speech-language therapy sessions.
The naming and discourse tasks will also occur during the participants' speech-language
therapy sessions.
The researchers will administer a set of standardized assessments prior to initiating the
intervention program to determine eligibility for study participation as well as to gather
descriptive information about the language abilities of participants. Assessments will
include the Western Aphasia Battery - Revised and the Boston Naming Test. In addition to
performing language assessments, participants will respond to demographic and injury-related
questions and will identify preferred topics of conversation. The researchers will obtain
information about each participant's physical status by referring to the physical therapy
assessments and associated documentation completed by a QLI physical therapist shortly after
the individual's arrival at QLI.
Intervention will occur five days per week and will take place during participants' regularly
scheduled speech therapy sessions. Two intervention sessions will occur daily, one held in
the morning and the second held in the afternoon. Depending on the activities performed on a
given day, the total time devoted to intervention sessions will be 10 to 30 minutes (i.e., 5
to 15 minutes per session).
During each intervention session, the researchers will measure performance on one or more of
the following tasks: (a) five trials of generative naming given a unique category and
one-minute response period per trial, (b) distance traveled using an exercise machine for
five minutes, (c) generative naming given unique categories and one-minute response periods
and distance traveled using an exercise machine when performing both tasks simultaneously for
five minutes, (d) number of words generated in five minutes in response to conversational
topic prompts, (e) distance traveled when walking for five minutes, and (f) number of words
generated in response to conversational topic prompts and distance traveled when walking when
performing both tasks simultaneously for five minutes. The first three measures comprise
intervention tasks, and the remaining three are generalization measures.
Intervention and generalization sessions will follow an overlapping ABAB or BABA format, with
the first day of each phase being an overlap day. Participants will be randomly assigned to
begin the intervention either with an A or B phase. On overlap days, the researchers will
collect measures on all six intervention and generalization activities, with three being
performed during a fifteen-minute morning session and three being performed during a
fifteen-minute afternoon session. For participants in the A phase, the researchers will
collect measures two times daily for each of the subsequent four days on the generative
naming and exercise machine activities performed as independent tasks; for participants in
the B phase, the researchers will collect measures two times daily for each of the subsequent
four days on the generative naming and exercise machine activities performed as simultaneous
tasks. A phase sessions will last ten minutes each, and B phase sessions will last five
minutes each. The cycle of A and B phases will repeat throughout a participants inpatient
stay at QLI. A QLI physical therapist will be present to monitor safety during performance of
physical activities. The researchers will audio record all generative naming and
conversational discourse activities for later analysis.
Participants will only perform naming, discourse, and physical endurance tasks that are
included as part of their routine speech-language therapy and physical therapy sessions.
However, completion of the physical endurance tasks will not occur during the participants'
physical therapy sessions; instead, they will occur during speech-language therapy sessions.
The naming and discourse tasks will also occur during the participants' speech-language
therapy sessions.
Inclusion Criteria:
- Have acquired brain injury due to left cerebrovascular accident (CVA)
- Be older than 19 years of age
- Speak English as a native language
- Be less than 3 months post-left CVA at the time of participation initiation
- Use natural speech as a primary means of communicating
- Have hearing adequate for conversational speech
- Have mild to moderate deficits in word retrieval and physical endurance as a result of
left CVA
- Be currently receiving treatment services at Quality Living for CVA-related deficits
Exclusion Criteria:
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