Effects of semantic treatment on verbal communication and linguistic processing in aphasia after stroke: a randomized controlled trial.
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BACKGROUND AND PURPOSE: Semantic deficits, deficits in word meaning, have a large impact on aphasic patients' verbal communication. We investigated the effects of semantic treatment on verbal communication in a randomized controlled trial. METHODS: Fifty-eight patients with a combined semantic and phonological deficit were randomized to receive either semantic treatment or the control treatment focused on word sound (phonology). Fifty-five patients completed pretreatment and posttreatment assessment of verbal communication (Amsterdam Nijmegen Everyday Language Test [ANELT]). In an on-treatment analysis (n=46), treatment-specific effects on semantic and phonological measures were explored. RESULTS: Both groups improved on the ANELT, with no difference between groups in overall score (difference, -1.1; 95% confidence interval [CI], -5.3 to 3.1). After semantic treatment, patients improved on a semantic measure (mean improvement, 2.9; 95% CI, 1.2 to 4.6), whereas after phonological treatment, patients improved on phonological measures (mean improvement, 3.0; 95% CI, 1.4 to 4.7, and 3.0; 95% CI, 1.2 to 4.7). CONCLUSIONS: No differences in primary outcome were noted between the 2 treatments. Our findings challenge the current notion that semantic treatment is more effective than phonological treatment for patients with a combined semantic and phonological deficit. The selective gains on the semantic and phonological measures suggest that improved verbal communication was achieved in a different way for each treatment group.
- Comparative Study
- Aged, 80 and over
- Research Support, Non-U.S. Gov't
- Middle Aged
- Treatment Outcome
- Single-Blind Method
- Referral and Consultation
- *Verbal Behavior
- Articulation Disorders/etiology/*therapy
- Cerebrovascular Accident/complications/physiopathology/*rehabilitation
- Language Therapy/*methods
- Neuropsychological Tests