Melodic intonation therapy in post-stroke nonfluent aphasia: a randomized pilot trial.

Abstract

Objective: To collect data to estimate the sample size of a definitive randomised clinical trial to evaluate the effects of Melodic Intonation Therapy in poststroke nonfluent aphasia. Design: A randomised, crossover, interventional pilot trial. Setting: Departments of Neurology and Rehabilitation from a university general hospital. Participants: Stroke survivors with poststroke nonfluent aphasia. Interventions: Patients randomised to group 1 had treatment with Melodic Intonation Therapy first (12 sessions over 6 weeks) followed by no treatment; the patients in group 2 started active treatment between 3 and 6 months after their inclusion in the study, serving as waiting list controls for the first phase. Main measures: The Communicative Activity Log (CAL) questionnaire and the Boston Diagnostic Aphasia Examination (BDAE) were evaluated at baseline, and at 6 and 12 weeks. Results: Twenty patients were included. Four of the patients allocated to group 2 crossed over to group 1, receiving the treatment at first. Intention-to-treat analysis: after adjustment for baseline scores, the mean difference in the CAL evaluation from baseline in the treated group was 8.5 points (95% CI, 0.11–17.0; P=.043), with no significant change in any of the BDAE sections. Per protocol analysis showed similar results with a clear treatment effect (P=.043) on the CAL. Conclusions: Melodic Intonation Therapy might have a positive effect on the communication skills of stroke survivors with nonfluent aphasia as measured by the CAL questionnaire. A full-scale trial with at least 27 patients per group is necessary to confirm these results.