Virtual Reality Based Sensorimotor Speech Therapy
Condition: Broca's Aphasia
MeSH terms: Aphasia; Aphasia, Broca
Study type: Interventional

Summary: 
      The purpose of this study is to determine whether VR based language rehabilitation scenario
      based on the core premises of ILAT has a beneficial effect on the linguistic performance
      (faster retrieval of the target lexicon and general fluency) of Broca's aphasia patients.
      Furthermore, it aims at testing the effects of cueing (visual and auditory) on word
      retrieval.
    

Detailed description: 
      Acquired brain lesions such as stroke often result the most common disabling neurological
      damages (Carter et al, 2012). 35-40% of stroke patients suffer serious language deficits and
      patients are frequently left with chronic disabilities which adversely impact their quality
      of life. Thus, the need for efficient rehabilitation methods increases. Recent studies show
      that Broca's area and the premotor cortex are anatomically coupled (Pulvermuller 2005)
      suggesting that for a therapy to be effective, in the brain there must be an interaction
      between linguistic neural system, motor and sensory circuits, memory, planning and monitoring
      (Kurland et al, 2012). These hypotheses led to the establishment of the so-called Intensive
      Language-Action Therapy (ILAT) (Pulvermuller 2012) which promotes motor movement during
      language practice. Thus, ILAT is an action-embedded language therapy grounded in three main
      principles: intense practice, overcoming learned non-use, and promoting motor actions (no
      compensations). Recently, a number of studies examined the functionality of virtual reality
      based rehabilitation systems that aim at post stroke motor recovery of upper extremities
      (Boian et al., 2002; Cameirão, Badia, Oller, & Verschure, 2010; Jack et al., 2001; Saposnik
      et al., 2010). In the present study, the goal is to further validate VR based language
      rehabilitation system based on the core principles of ILAT implemented within the environment
      of the rehabilitation Gaming System (RGS). Additionally, the goal is to investigate the
      effects of cueing on word retrieval. It was shown that conduction and Broca's aphasics
      exhibit the highest responsiveness to cueing (Li & Williams 1989). In order to overcome
      subsequent disturbances in word retrieval mechanisms, a number of cueing methods have been
      established to improve both the immediate and long term lexical access (Howard 2000). Both
      semantic and phonemic cues act as primes and are usually administered by the therapist in a
      written or oral manner containing phonological, semantic or syntactic information about the
      target word (Howard et al. 1985, Howard2000). Here, the investigators will implement the
      system with videos representing the lip motion representative for a correct pronunciation of
      the target words, as well as a representative sound (i.e. barking sound in case of dog). The
      investigators expect that the proposed system will be efficient in treating post stroke
      chronic Broca's aphasia patients according to the standard scales such as Boston Naming Test
      and Communicative Activity Log.
    

Intervention name(s): VR-based sensorimotor aphasia therapy; Control Group (conventional aphasia rehabilitation)
Intervention type(s): Behavioral; Behavioral
Intervention description(s): VR-based sensorimotor aphasia therapy. 8 weeks, 1 session a week, 30min-1h per session of language and motor therapy using using VR rehabilitation gaming system. The patients will play in pairs.; 8 weeks, 1 session a week, 30min-1h per session of conventional aphasia rehabilitation training the same vocabulary as the experimental group.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Participant, Outcomes Assessor)
Primary purpose: Treatment
Keywords: stroke; broca's aphasia; priming; Intensive language-action therapy; Rehabilitation gaming system