Speeded Anomia Treatment in Chronic Post-stroke Aphasia

Study Overview
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Brief Summary
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The main aim of the study is to investigate the effect of a novel, speeded anomia therapy (Conroy et al., 2018) in a large population of patients with chronic post-stroke aphasia. The treatment will be delivered via a web application (QuickWord).

Detailed Description
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The main aim is to test the clinical efficacy of a novel, web based, rehabilitation approach to aphasic word-finding difficulties (QuickWord). In an initial development and case-series evaluation, Conroy et al (2018, Brain) found that training for both speed as well as accuracy of naming generated much better outcomes to picture naming accuracy and also augmented the carry-over to connected speech production. This is a randomised, crossover, clinical trial of QuickWord in a group of aphasic patients in the chronic post-stroke period. The comparison will be standard care. The main outcome measures are clinically relevant improvement in naming to confrontation, and spontaneous use of the target vocabulary in a connected speech sample (detailed picture description). Secondary outcome includes measured use of the vocabulary in a story-telling, connected speech assessment (retelling of the Cinderella story).

Official Title
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Testing the Effect of Speeded Anomia Therapy in Patients With Chronic Post-stroke Aphasia: a Cross-over Randomized Controlled Trial

Conditions
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Aphasia

Intervention / Treatment
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* Behavioral: Speeded anomia therapy


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Native English speakers Age 18 years or above Stroke (any type) greater than 12 months post onset No history of neurological disorders / psychiatric disorders Normal or corrected-to-normal hearing & vision Able to give informed consent Currently not receiving Speech & Language therapy Minimal repetition skills (>40% on an immediate word repetition test) Evidence of naming difficulties (<90% in Boston Naming Test - Goodglass et al., 1983) Exclusion Criteria: Non-native English speakers Less than 18 years old Stroke less than 12 months post onset History of neurological disorders / psychiatric disorders Uncorrected hearing & vision Unable to give informed consent Currently receiving Speech & Language therapy Insufficient repetition skills (<40% on an immediate word repetition test) Good naming performance (>90% in Boston Naming Test - Goodglass et al., 1983)

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Crossover Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Speeded anomia therapy<br>21h of anomia therapy | Behavioral: Speeded anomia therapy<br>* The speeded anomia therapy was introduced as RISP (Repeated, Increasingly Speeded Production) by Conroy et al. (2018). Participants are asked to name the picture presented to them before an auditory stimulus ('beep' sound) at the end of item presentation. In each session the allotted response time is gradually reduced. After an incorrect response, participants are asked to repeat the word three times.<br>|
| No Intervention: Standard care<br>Participants' typical daily routine | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Speeded anomia therapy effect in reaction time | Change in reaction time in single-item picture naming | Measured over 10 weeks (Week 0, Week 2, Week 4, Week 6, Week 10) | 
| Speeded anomia therapy effect in accuracy | Change in accuracy in single-item picture naming | Measured over 10 weeks (Week 0, Week 2, Week 4, Week 6, Week 10) | 
| Generalisation to connected speech | Change in word retrieval in composite picture description. Participants will be asked to describe composite pictures (from the Where's Waldo/Wally? publications). | Measured over 10 weeks (Week 0, Week 2, Week 4, Week 6, Week 10) | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Generalisation to story-telling connected speech | Change in narrative speech production. Participants will be asked to narrate the Cinderella story. A checklist with some of the most frequently used nouns (data obtained from AphasiaBank database) will be used. | Measured over 10 weeks (Week 0, Week 2, Week 4, Week 6, Week 10) | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Speech Disorders, Anomia, Language Disorders, Communication Disorders