8 method for the treatment of post-stroke aphasia. The factors that can aﬀect the improvement of aphasia are ﬁrst, indi- vidual factors such as age, sex, education, and handedness; second, neurological factors such as the severity of aphasia at onset [3], treatment period [3], and cause and sites of brain damage; third, treatment-related factors, including the intensity and duration of language therapy, and the methods used. There were no signiﬁcant diﬀerences in these factors between the two groups in the present study. The exclusion of diﬀerences in the factors that aﬀect aphasia recovery between the groups enabled the acquisition of more accurate results. In addition, we believe that this study reﬂects clinical circumstances more accurately than previous studies. We used a pragmatic method to investigate the eﬀects of oriental medicine therapy itself on post-stroke aphasia recovery. We believe that this method better reﬂects the individualized character of oriental medicine. Furthermore, we used an objective tool such as the K-WAB to estimate the eﬀect of oriental medicine therapy on post-stroke aphasia. K-WAB is a standardized test for the evaluation of aphasia. The above points demonstrate the reliability and objectivity of the present results. A possible mechanism which can explain the result obtained is as follows: oriental medicine therapy aﬀects neural plasticity related to the recovery of language func- tions such as diaschisis, redundancy, and vicariation [27]. “Diaschisis” means language function that is indirectly damaged has declined for a short period since onset and these functions will be recovered as time passes. “Redundancy” indicates that a language area that is not involved can lead to the recovery of aphasia. Lastly, “vicariation” refers to a brain area that is not in charge of everyday language, but assumes an important role in the recovery from aphasia. Vicariation is assumed a major mechanism of Large artery atherosclerosis (LAA) type stroke patients’ aphasia recovery. Vicariation has been considered ineﬀective because most patients with severe aphasia and extensive brain damage have a tendency to recover slowly. Howevere, we think that a major mechanism of oriental medicine on the recovery of post-stroke aphasia is thought to be vicariation. In this study, 55.3% of COT group patients exhibited an LAA-type ischemic stroke, which was of a higher proportion than in the OLT group. However, the improvement of the COT group was better than that of the OLT group. Furthermore, the COT group exhibited a greater improvement than the OLT group among severely aphasic patients at onset (Figure 2). Therefore, we consider the eﬀect of conventional therapy to be mostly mediated by diaschisis and redundancy and only slightly by vicariation. However, the co-administration of oriental medicine therapy may increase the inﬂuence of vicariation. As a result, the COT group exhibited a greater improvement among severely aphasic patients, indicating that oriental therapy can act as a catalyst of vicariation and that it can be eﬀective when it is administered in combination with language therapy. However, this eﬀect is not limited to the language func- tion area. According to previous studies, oriental medicine can also aﬀect the improvement of motor functions in stroke patients [24]. The results of previous studies showed that oriental medicine can have an eﬀect on neural plasticity Evidence-Based Complementary and Alternative Medicine related to the recovery of motor function. Together with the present results, these studies suggest that oriental medicine can aﬀect brain neural plasticity in relation to both language and motor functions, and the improvement of aphasia may be the result of the activation of whole-brain neural plasticity. Future studies should assess the recovery of language disorders together with other stroke symptoms to validate this hypothesis. 5. Conclusion The present study assessed the eﬀect of co-administration of oriental medicine therapy with language therapy on post- stroke aphasia 6 months before stroke onset. This study was conducted as a comparative, observational, and pragmatic study. The results of this study are as follows. (1) The COT group exhibited a greater improvement than the OLT group in the total AQ score and most subsection scores. In particular, there were statisti- cally signiﬁcant diﬀerences in total AQ score and sub- sections such as spontaneous speech, content deliv- ery, comprehension, auditory verbal comprehension, and command performance. (2) Among severe aphasic patients, the improvement of the COT group was better than that of the OLT group There was statistically signiﬁcant diﬀerences in distri- bution of severe aphasia of the COT group. However, there were no statistically signiﬁcance in the OLT group. Therefore, we suggest that combination therapy with the administration of oriental medicine therapies and language therapy can be helpful in the treatment of post-stroke aphasic patients 6 months before stroke onset. Conﬂict of Interests The authors declare that they have no conﬂict of interests. References [1] P. M. Pedersen, H. S. Jørgensen, H. Nakayama, H. O. Raaschou, and T. S. Olsen, “Aphasia in acute stroke: Incidence, determinants, and recovery,” Annals of Neurology, vol. 38, no. 4, pp. 659–666, 1995. [2] K. Hojo, S. Watanabe, H. Tasaki et al., “Recovery in aphasia (Part 1),” No To Shinkei, vol. 37, no. 8, pp. 791–797, 1985. [3] C. M. Shewan and A. Kertesz, “Eﬀects of speech and language treatment on recovery from aphasia,” Brain and Language, vol. 23, no. 2, pp. 272–299, 1984. [4] W. Lendrem and N. B. 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