Clinical trial NCT02332915: Treatment Intensity - Apraxia of Speech
Official title: Effect of Intensity of Treatment on Rehabilitation of Acquired Apraxia of Speech
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Aphasia
CVA
Apraxia of Speech
Keywords: apraxia
aphasia
rehabilitation
efficacy
intensity
Lead sponsor: VA Office of Research and Development
Sponsor class: FED
First posted: 2015-01-07
Enrollment: 36
Sex: ALL
Minimum age (years): 21
Maximum age (years): 90
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: CROSSOVER
Primary purpose: TREATMENT

Brief summary: A growing neurorehabilitation literature suggests that intense treatment may be desired to maximize the effects of therapy following neurologic injury. This investigation is designed to facilitate the development of efficacious, clinically applicable treatment for acquired apraxia of speech by examining the effects of intensity of treatment (e.g., 9 hours per week vs. 3 hours per week, while holding total number of sessions constant) with a group of speakers who have chronic apraxia of speech and aphasia.

Detailed description: This research was designed to examine the effects of treatment intensity on outcomes associated with an established treatment for acquired apraxia of speech (AOS). Intensity in the form of dose frequency and total intervention duration was evaluated with Sound Production Treatment (SPT). The investigators examined the effects of intense dose frequency (nine, one-hour sessions per week) and traditional dose frequency (three, one hour sessions per week). Total number of treatment sessions was held constant allowing for comparison of total intervention duration (27 sessions over 3 weeks versus 27 sessions over 9 weeks). A two-phase, group cross-over design was used. Thirty-six participants with chronic aphasia and AOS were recruited. Twenty-four participants completed then entire study and were quasi-randomly assigned to one of two treatment groups - intense first or traditional first (12 per group). One group received SPT applied with intense dose frequency (SPT-I) followed by SPT applied with traditional dose frequency (SPT-T). The other group received the treatments in the reverse order (SPT-T followed by SPT-I). A two week no treatment interval separated the treatment phases. The outcomes of interest addressed changes in trained and untrained speech behaviors.

Eligibility criteria: Inclusion Criteria:

* Veterans and non Veterans
* Males or females
* Stroke survivor who is at least 4 months post-stroke
* Speaker of English since childhood
* Ability to pass a pure-tone hearing screening (aided or unaided)
* currently non-hospitalized
* Age 21 to 90 years

Exclusion Criteria:

* neurological condition other than stroke
* currently clinically depressed
* history of speech/language problems prior to stroke
* untreated psychopathology

Primary outcomes:
measure: Accuracy of Articulation of TREATED ITEMS Measured as Effect Size - Change From Baseline to End of Treatment Phase
timeFrame: Pre treatment, 2 weeks following the first treatment phase, 2 weeks following the second treatment phase
measure: Accuracy of Articulation of Untreated Items (Generalization) Measured as Effect Size - Change From Baseline to End of Treatment Phase
timeFrame: Pre treatment, 2 weeks following the first treatment phase, 2 weeks following the second treatment phase
Secondary outcomes:
measure: Speech Intelligibility - Percent Intelligible Words Comparing Baseline to End of Treatment Phases
timeFrame: Pre treatment & 2 weeks following each treatment phase
Other outcomes:
Locations:
city: Pittsburgh
country: United States
facility: VA Pittsburgh Healthcare System University Drive Division, Pittsburgh, PA
state: Pennsylvania
city: Salt Lake City
country: United States
facility: VA Salt Lake City Health Care System, Salt Lake City, UT
state: Utah
Study officials:
affiliation: VA Salt Lake City Health Care System, Salt Lake City, UT
name: Julie L Wambaugh, PhD
role: PRINCIPAL_INVESTIGATOR
References:
citation: Wambaugh JL, Wright S, Boss E, Mauszycki SC, DeLong C, Hula W, Doyle PJ. Effects of Treatment Intensity on Outcomes in Acquired Apraxia of Speech. Am J Speech Lang Pathol. 2018 Mar 1;27(1S):306-322. doi: 10.1044/2017_AJSLP-16-0188.
citation: Wambaugh JL, Wright S, Nessler C, Mauszycki SC, Bunker L, Boss E, Zhang Y, Hula WD, Doyle PJ. Further Study of the Effects of Treatment Intensity on Outcomes of Sound Production Treatment for Acquired Apraxia of Speech: Does Dose Frequency Matter? Am J Speech Lang Pathol. 2020 Feb 7;29(1):263-285. doi: 10.1044/2019_AJSLP-19-00005. Epub 2020 Feb 3.