Melodic intonation therapy in post-stroke nonfluent aphasia: a randomized pilot trial.
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2018
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Clinical rehabilitation
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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.
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Keywords
Ischaemic stroke, Aphasia, Melodic intonation therapy