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(Stroke. 2001;32:1621.)
© 2001 American Heart Association, Inc.
Original Contribution |
Constraint-Induced Therapy of Chronic Aphasia After Stroke
From the MRC Cognition and Brain Sciences Unit (F.P.), Cambridge, UK; Department of Psychology (F.P., B.G., T.E. B.M., B.R.), University of Konstanz, Konstanz; Lurija Institute of Rehabilitation Research (F.P., B.G.); Neurological Hospital Schmieder (P.K.), Allensbach, Germany; and the Department of Psychology (E.T.), University of Alabama at Birmingham, Birmingham, Ala.
Correspondence and reprint requests to Friedemann Pulvermüller, Cognition and Brain Sciences Unit, Medical Research Council, 15 Chaucer Rd, Cambridge CB2 2EF, UK.
Abstract—Patients
with chronic aphasia were assigned randomly to a group to receive
either conventional aphasia therapy or constraint-induced (CI) aphasia
therapy, a new therapeutic technique requiring intense practice over a
relatively short period of consecutive days. CI aphasia therapy is
realized in a communicative therapeutic environment constraining
patients to practice systematically speech acts with which they have
difficulty. Patients in both groups received the same amount of
treatment (30 to 35 hours) as 10 days of massed-practice language
exercises for the CI aphasia therapy group (3 hours per day minimum; 10
patients) or over a longer period of 
4 weeks for the conventional
therapy group (7 patients). CI aphasia therapy led to significant and
pronounced improvements on several standard clinical tests, on
self-ratings, and on blinded-observer ratings of the patients’
communicative effectiveness in everyday life. Patients who received the
control intervention failed to achieve comparable improvements. Data
suggest that the language skills of patients with chronic aphasia can
be improved in a short period by use of an appropriate massed-practice
technique that focuses on the patients’ communicative needs.
Key Words: aphasia • physical therapy • speech therapy • treatment outcome
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