Motor Imagery for Treatment Enhancement and Efficacy in Persons With Apraxia of Speech
NCT Number: NCT06467136
Acronym: MI-TEE
Status: RECRUITING
Study Type: INTERVENTIONAL
Phases: NA
Conditions: Apraxia, Oral|Apraxia of Speech
Interventions: BEHAVIORAL: Sound production treatment|BEHAVIORAL: Motor Imagery Practice
Sponsor: University of Central Florida
Collaborators: National Institutes of Health (NIH)|National Institute on Deafness and Other Communication Disorders (NIDCD)
Sex: ALL
Age: ADULT, OLDER_ADULT
Enrollment: 18
Study Design: Allocation: RANDOMIZED|Intervention Model: PARALLEL|Masking: SINGLE (OUTCOMES_ASSESSOR)|Primary Purpose: TREATMENT
Start Date: 2023-12-11
Completion Date: 2026-07-31
Locations: University of Central Florida Innovation Rehabilitation Center, Orlando, Florida, 32826, United States

Summary:
Treatment of post-stroke apraxia of speech (AOS) requires frequent and ongoing practice with a speech-language pathologist to facilitate lasting behavioral change, which is costly and, therefore, inaccessible to many patients. Thus, there is a critical need to identify novel, cost-effective ways to supplement speech therapy to increase opportunities for practice and optimize treatment outcomes. Our long-term goal is to develop an effective, home-practice, computer-based, motor imagery protocol Motor Imagery for Treatment Enhancement and Efficacy (MI-TEE) which will serve as an adjunct to routine speech therapy to optimize treatment response in persons with AOS. The overall objectives of this application are to (i) evaluate the acceptability and feasibility of MI-TEE as a home practice program and (ii) determine the efficacy of MI-TEE with speech therapy, compared to speech therapy alone, in improving speech production in people with AOS. Our central hypothesis is that MI-TEE will be an accessible, feasible, and efficacious adjunct to speech therapy. To attain our objectives, the following specific aims will be pursued using two single-subject experimental designs with multiple baselines across participants (n=18): 1) Evaluate the acceptability and feasibility of MI-TEE as an adjunct to speech therapy for the rehabilitation of AOS; and 2) Compare the efficacy of adjunctive MI-TEE plus standard speech therapy to standard speech therapy alone. Under the first aim, observational data, surveys, and semi-structured interviews will be employed to assess the acceptability (perceived satisfaction, appropriateness, and intent to continue use) and feasibility (recruitment, retention, and intervention adherence rates) of MI-TEE. For the second aim, accuracy of articulation for trained words and untrained words (generalization) will be measured pre-treatment, repeatedly during the treatment phase, and post-treatment. Improvements in speech accuracy will be documented using a binary scoring system (correct/incorrect). Multilevel analyses will be used to address rate of acquisition, overall change, and response variation across participants.

Primary Outcome Measures: Acceptability, Participants will complete acceptability surveys and meet individually with a member of the research team to engage in semi-structured interviews.82 Acceptability data will include perceived satisfaction and appropriateness, experience with MI-TEE, and intent to continue use., Assessment of acceptability will occur after completion of the 8.3 week treatment program|Recruitment feasibility, Feasibility data will be collected by research staff throughout the study and will include recruitment feasibility, the percent of eligible individuals agreeing to participate in the MI-TEE program., Through study completion, up to 24 weeks.|Adherence rates, Feasibility data will be collected by research staff throughout the study and will include adherence rates, the participants ability to adhere to the MI-TEE protocol., Start of MI-TEE program to the end of the 8.3 week treatment program for each participant.|Retention rate, Feasibility data will be collected by research staff throughout the study and will include retention rates, the percent of participants who complete the entire MI-TEE program., Start of MI-TEE enrollment to the end of the 8.3 week treatment program for each participant.|Rate of change, The dependent variable is rate of change for accuracy of sound production in experimental words produced during probes., From enrollment to the end of maintenance at 10 weeks, total of up to 23 weeks.