Efficacy of Language Games as Therapy for Post Stroke Aphasia "AphasiaGame"

Not yet recruiting

Phase N/A Results N/A

Trial Description

Aphasia is a language impairment experienced by about one third of stroke patients. This often devastating condition is treated by speech and language therapists (SLTs). There is evidence that language games delivered at the right intensity are an efficacious means of improving communication for people with post stroke aphasia. However, it is unclear which mechanism of language facilitation used in a game works best. This study will provide evidence for the "active ingredient" of a game, together with measures of efficacy, feasibility and enjoyment compared to standard aphasia therapy.

Detailed Description

Aphasia is a language impairment experienced by about one third of stroke patients. This often devastating condition is treated by speech and language therapists (SLTs). There is evidence that language games delivered at the right intensity are an efficacious means of improving communication for people with post stroke aphasia. However, it is unclear which mechanism of language facilitation used in a game works best. This study will provide evidence for the "active ingredient" of a game, together with measures of efficacy, feasibility and enjoyment compared to standard aphasia therapy.
Participants with moderate-severe difficulties will play picture naming games, involving self-cuing using gesture and circumlocution. Those with mild difficulties will play story-telling games, using similar self-cuing techniques. Change in language performance will be measured and compared to that achieved by the same participants following an episode of standard aphasia therapy from their local SLT (i.e. normal care).
This study will build on a growing evidence base for the efficacy of therapeutic language games in post stroke aphasia. In today's resource-constrained National Health Service, SLTs are continually searching for cost-effective, innovative ways of delivering therapy. Language games based on sound neuro-scientific principles have the potential to deliver improvements in functional communication by means of an enjoyable and motivating activity, and moreover can be done cost effectively. Improvements have been demonstrated from the acute through to the chronic stage of stroke. A number of factors are said to contribute to the outcomes achieved: intensity of training, behavioural relevance and focussed use of capacities. This study intends to explore in more depth some of the specific behaviours that can occur spontaneously or than can be prompted to facilitate language. The aim is to uncover the "active ingredient", and thereby ensure that participants can benefit maximally from therapeutic language games.
This study will contribute to the search for cost effective treatment for post-stroke aphasia, which offers ease and flexibility of delivery, is enjoyable and motivating for patients, and works.

Conditions

Interventions

  • Standard Therapy Other
    Intervention Desc: usual clinical care
    ARM 1: Kind: Experimental
    Label: game therapy then standard therapy
    Description: participants will take part in language game therapy followed by standard aphasia therapy
    ARM 2: Kind: Experimental
    Label: standard therapy then game therapy
    Description: participants will have standard aphasia therapy first then will take part in language game therapy
  • Language game therapy Other
    Intervention Desc: participants will take part in 3 different types of game therapy, differentiated by type of language facilitation offered, or no facilitation
    ARM 1: Kind: Experimental
    Label: game therapy then standard therapy
    Description: participants will take part in language game therapy followed by standard aphasia therapy
    ARM 2: Kind: Experimental
    Label: standard therapy then game therapy
    Description: participants will have standard aphasia therapy first then will take part in language game therapy

Trial Design

  • Allocation: Non-Randomized
  • Masking: Open Label
  • Purpose: Treatment
  • Endpoint: Efficacy Study
  • Intervention: Crossover Assignment

Outcomes

Type Measure Time Frame Safety Issue
Primary Comprehensive Aphasia Test (Swinburn et al 2004) Assessment carried out prior to commencement of language game therapy, and immediately after language game therapy, 10 week interval. Assessment also carried out prior to and immediately after standard therapy, approx 12 week interval. No
Primary Communication Outcomes After Stroke Scale (Long et al, 2008) Assessment carried out prior to commencement of language game therapy, and immediately after language game therapy, 10 week interval. Assessment also carried out prior to and immediately after standard therapy, approx 12 week interval. No
Primary Picture naming of words targeted in game therapy Assessment carried out prior to commencement of language game therapy, and immediately after language game therapy, 10 week interval. Assessment also carried out prior to and immediately after standard therapy, approx 12 week interval. No
Primary Picture description of words targeted in game therapy Assessment carried out prior to commencement of language game therapy, and immediately after language game therapy, 10 week interval. Assessment also carried out prior to and immediately after standard therapy, approx 12 week interval. No
Secondary Picture naming of words targeted in game therapy to ascertain effects of different facilitatory techniques - multiple baseline measure Assessment carried out immediately after game 1 and game 2, at 4 weeks and 7 weeks. No
Secondary Picture description of words targeted in game therapy to ascertain effects of different facilitatory techniques - multiple baseline measure Assessment carried out immediately after game 1 and game 2, at 4 weeks and 7 weeks. No

Sponsors