Recovery from moderate aphasia in the first year poststroke: Effect of type of therapy

Objectives: (1) To determine whether 2 model-based remediation programs affect writing performance in unselected subjects with moderate aphasia and whether there is consequent improvement in everyday life, and (2) to interpret the potential chancres observed by recourse to a theoretical model. Design: Consecutive sample, multiple baseline, within subject crossover study. Setting: Ambulatory care units. Participants: Eight subjects with moderate aphasia from 6 to 12 months postonset. Intervention: A standardized test for reading and writing skills was given at the beginning and the end of each therapy program and I month after therapy stopped. Main Outcome Measures: Functional outcome measures were the Communicative Abilities in Daily Living (CADL) test and subtests from standardized aphasia assessment. Results: After the 2 programs, there was improved writing performance, which was maintained after therapy stopped. Patterns of improvement corresponded to each of the 2 programs. Learning transfer was observed on the CADL test and functional writing, but gains on oral language were limited. Only 1 program was effective for 6 of the 8 patients. Conclusion: Specific rehabilitation programs aid recovery from aphasic symptoms from 6 to 12 months postonset. Individual response is linked to type of treatment. The interpretation is linked to a model-based description of aphasic symptoms and mechanisms of functional recovery.