100 Participants Needed

Speech-Language Therapy for Aphasia

(TERRA Trial)

Recruiting at 2 trial locations
HA
LA
SS
KP
Overseen ByKelli Powell, B.S.
Age: 18+
Sex: Any
Trial Phase: Academic
Sponsor: University of South Carolina
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)

Trial Summary

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications.

What data supports the effectiveness of the treatment Speech-Language Therapy for Aphasia?

Research shows that phonologically-focused therapy, like Phonological Components Analysis (PCA), can significantly improve naming abilities in people with aphasia, with many maintaining improvements over time. Additionally, phonological treatments may be particularly beneficial for individuals with more severe impairments and apraxia of speech, while semantic treatments might be more effective for those with milder impairments and fluent speech.12345

Is speech-language therapy for aphasia safe for humans?

The research does not report any safety concerns for speech-language therapy methods like Phonological Cueing Treatment (PCT) and Semantic Feature Analysis (SFA) in people with aphasia, suggesting these treatments are generally safe for humans.13456

How does the Speech-Language Therapy for Aphasia treatment differ from other treatments?

This treatment is unique because it combines phonologically-focused tasks, which help with sound retrieval, and semantically-focused tasks, which aid in understanding word meanings, to improve naming abilities in people with aphasia. It is tailored to individual needs, with phonological tasks benefiting those with severe impairments and apraxia of speech, while semantic tasks are more effective for those with milder impairments and fluent speech.23678

What is the purpose of this trial?

Speech-language therapy is generally found to be helpful in the rehabilitation of aphasia. However, not all patients with aphasia have access to adequate treatment to maximize their recovery. The goal of this project is to compare the efficacy of telerehabilitation or Aphasia Remote Therapy (ART) to the more traditional In-Clinic Therapy (I-CT).

Research Team

JF

Julius Fridriksson, Ph.D

Principal Investigator

University of South Carolina

Eligibility Criteria

This trial is for English-speaking adults aged 21-80 who've had a left hemisphere stroke at least a year ago and can consent to treatment. They must be MRI compatible without metal implants or claustrophobia, and have no history of other brain diseases or severe speech/comprehension impairments.

Inclusion Criteria

I am between 21 and 80 years old.
Participants must be magnetic resonance imaging (MRI) compatible (e.g., no metal implants, not claustrophobic) on a 3-Tesla (3T) scanner.
I can give my own consent or appoint someone to do it for me.
See 2 more

Exclusion Criteria

I have no history of brain injuries or neurological diseases.
I have not had a stroke affecting both sides of my brain or in the cerebellum or brainstem.
I can speak and understand well enough to participate in therapy.
See 3 more

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive 3 weeks of daily semantically-focused treatment and 3 weeks of daily phonologically-focused treatment, either remotely or in-clinic

6 weeks
Daily sessions (remote or in-person)

Follow-up

Participants are monitored for changes in speech production and quality of life after treatment

6 months
Follow-up assessments at 6 months

Treatment Details

Interventions

  • Phonologically-focused therapy tasks
  • Semantically-focused therapy tasks
Trial Overview The TERRA study compares two types of speech-language therapy for aphasia after a stroke: one delivered remotely (ART) and the other in-clinic (I-CT). It aims to see if telerehabilitation is as effective as traditional methods.
Participant Groups
2Treatment groups
Experimental Treatment
Active Control
Group I: Aphasia Remote Therapy (ART)Experimental Treatment2 Interventions
All participants in this group will receive 3 weeks of daily semantically-focused treatment (semantic feature analysis, semantic barrier task and verb network strengthening therapy) and 3 weeks of daily phonologically-focused treatment (phonological components analysis, phonological production task, phonological judgment task). Participants will be randomized to order of treatment. All treatment will be done remotely with a speech-language pathologist through an online platform using therapy applications. Participants will be provided with teletherapy kits (including an Internet hotspot if needed) to complete the therapy tasks.
Group II: In-Clinic Therapy (I-CT)Active Control2 Interventions
All participants in this group will receive 3 weeks of daily semantically-focused treatment (semantic feature analysis, semantic barrier task and verb network strengthening therapy) and 3 weeks of daily phonologically-focused treatment (phonological components analysis, phonological production task, phonological judgment task). Participants will be randomized to order of treatment. All treatment will be done in person with a speech-language pathologist at the UofSC Aphasia Lab.

Find a Clinic Near You

Who Is Running the Clinical Trial?

University of South Carolina

Lead Sponsor

Trials
233
Recruited
122,000+

National Institute on Deafness and Other Communication Disorders (NIDCD)

Collaborator

Trials
377
Recruited
190,000+

Medical University of South Carolina

Collaborator

Trials
994
Recruited
7,408,000+

Findings from Research

In a study of eight individuals with aphasia, phonologically-based treatment (Phonological Components Analysis, PCA) led to significant improvements in naming accuracy for seven participants, with most maintaining these gains at follow-up.
Semantic therapy (Semantic Feature Analysis, SFA) was less effective, particularly for those with semantic deficits, highlighting the importance of matching treatment approaches to individual word retrieval breakdowns for optimal outcomes.
A comparison of semantic feature analysis and phonological components analysis for the treatment of naming impairments in aphasia.van Hees, S., Angwin, A., McMahon, K., et al.[2022]
In a study of 104 individuals with chronic post-stroke aphasia, semantically focused treatment was found to be more effective than phonologically focused treatment for improving naming performance, regardless of treatment order.
Participants with milder speech impairments and fluent speech were more likely to respond positively to semantic treatment, while those with more severe impairments and apraxia of speech benefited more from phonological treatment.
Individualized response to semantic versus phonological aphasia therapies in stroke.Kristinsson, S., Basilakos, A., Elm, J., et al.[2022]
In a study involving three chronic aphasia speakers, Phonological Cueing Treatment (PCT) and Semantic Cueing Treatment (SCT) were tested for their effectiveness in improving action naming, with positive results for some participants.
Action naming improved for Speaker 1 (who received SCT) and Speaker 3 (who received both treatments), indicating that these cueing treatments can be beneficial for certain individuals with aphasia, though results may vary depending on the type of treatment and the grammatical category of the words.
Effects of two lexical retrieval cueing treatments on action naming in aphasia.Wambaugh, JL., Doyle, PJ., Martinez, AL., et al.[2009]

References

A comparison of semantic feature analysis and phonological components analysis for the treatment of naming impairments in aphasia. [2022]
Individualized response to semantic versus phonological aphasia therapies in stroke. [2022]
Effects of two lexical retrieval cueing treatments on action naming in aphasia. [2009]
A case series comparison of semantically focused vs. phonologically focused cued naming treatment in aphasia. [2018]
Using a combined working memory - Semantic feature analysis approach to treat anomia in aphasia: A Pilot Study. [2023]
A Systematic Review of Semantic Feature Analysis Therapy Studies for Aphasia. [2019]
What Does a Cue Do? Comparing Phonological and Semantic Cues for Picture Naming in Aphasia. [2019]
The effectiveness of semantic feature analysis: an evidence-based systematic review. [2018]
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