Choir Singing for Aphasia

Recruiting at 3 trial locations

Overseen By Narges Bayat, Master

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: University of Ottawa

Disqualifiers: Neurological, Psychiatric, Substance abuse, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Approved in 3 Jurisdictions This treatment is already approved in other countries

Compensation: Varies

Number of Visits: 14

Duration: 12 weeks

50 Participants Needed

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. It is best to consult with the trial coordinators or your doctor for guidance.

What data supports the effectiveness of the treatment Community Choir Singing, Choir Therapy, Music Therapy for Aphasia, Singing Therapy?

Research shows that group-based singing interventions can improve communication and speech production in people with chronic aphasia, as well as enhance social participation and reduce caregiver burden. Singing therapy has been found to strengthen breathing, improve speech articulation, and increase communicative behaviors in aphasia patients. ^{1 2 3 4 5}

Is choir singing therapy safe for people with aphasia or other conditions?

Research on choir singing therapy for conditions like aphasia, stroke, and Parkinson's disease suggests it is generally safe and well-tolerated. Participants have reported positive experiences, and no significant safety concerns have been highlighted in the studies. ^{1 4 6 7 8}

How does choir singing treatment for aphasia differ from other treatments?

Choir singing treatment for aphasia is unique because it uses group singing to improve speech, leveraging the brain's ability to process music and rhythm, which can be more effective than traditional speech therapy alone. This approach is particularly beneficial as it combines social interaction with therapy, potentially enhancing motivation and engagement. ^{1 2 8 9 10}

What is the purpose of this trial?

The goal of this randomized controled trial is to test the effects of assigning people with chronic post-stroke aphasia to 12 weekly choir sessions, compared to usual care. The main question it aims to answer is: Does the assignment to a choir singing program causes a beneficial effect on functional communication and language recovery as well as psychosocial outcomes compared to usual care in the rehabilitation of people with chronic post-stroke aphasia? Participants will have: 12 in-person choir-singing sessions (1 session/week, 1,5 h/session, total 18h) conducted by a choir master, and home singing training (3 x 30-minutes-sessions/week, total 18h)

Research Team

Carole Anglade, PhD

Principal Investigator

Université de Montréal

Édith Durand, PhD

Principal Investigator

Université du Québec à Trois-Rivières

Jennifer Bugos, PhD

Principal Investigator

University of South Florida

Frank Russo, PhD

Principal Investigator

Toronto Metropolitan University

Anna Zumbansen, PhD

Principal Investigator

University of Ottawa

Arla Good, PhD

Principal Investigator

Toronto Metropolitan University

Eligibility Criteria

This trial is for individuals with chronic post-stroke aphasia, which is a language disorder that occurs after a stroke. Participants should be interested in joining choir sessions and committed to additional singing practice at home.

Inclusion Criteria

People with chronic aphasia following stroke

English or French as language of daily use

My last stroke was more than 6 months ago.

Exclusion Criteria

Regular music making in the past 6 months

Hearing deficit that cannot be corrected and might impair testing

Presence of neurological/psychiatric co-morbidity or substance abuse

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants engage in 12 weekly choir sessions and home singing training

12 weeks

12 in-person sessions, weekly home training

Follow-up

Participants are monitored for safety and effectiveness after treatment

2 months

Follow-up assessments at 2 months post-treatment

Crossover Extension

Participants in the usual care group receive the choir intervention

12 weeks

Treatment Details

Interventions

• Community Choir Singing

Trial Overview The study tests if joining a choir and practicing singing at home can help improve communication skills, language abilities, and overall well-being compared to the usual care received after a stroke.

Participant Groups

Group I: BA Group Experimental Treatment 2 Interventions

First usual care, then choir

Group II: AB Group Experimental Treatment 2 Interventions

First choir, then usual care

Community Choir Singing is already approved in Canada, United States for the following indications:

Approved in Canada as Community Choir Singing for:

• Rehabilitation of chronic post-stroke aphasia

Approved in United States as Community Choir Singing for:

• Rehabilitation of chronic post-stroke aphasia

Who Is Running the Clinical Trial?

University of Ottawa

Lead Sponsor

Trials

231

Recruited

267,000+

Toronto Metropolitan University

Collaborator

Trials

95

Recruited

19,300+

Université de Montréal

Collaborator

Trials

223

Recruited

104,000+

University of South Florida

Collaborator

Trials

433

Recruited

198,000+

Université du Québec à Trois-Rivières

Collaborator

Trials

48

Recruited

4,500+

Findings from Research

The Speech-Music Therapy for Aphasia (SMTA) method showed promising results in improving speech production in a 5-year-old boy with childhood apraxia of speech (CAS) after 10 weeks of treatment, indicating its potential efficacy.

Improvements were noted in speech motor skills, particularly in producing consonant clusters and consistency, suggesting that SMTA may help with complex speech tasks, although measuring overall intelligibility in daily communication remains challenging.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Speech and Music Therapy in the Treatment of Childhood Apraxia of Speech: An Introduction and a Case Study. van Tellingen, M., Hurkmans, J., Terband, H., et al.[2023]

Music therapy can significantly benefit nonfluent aphasia patients by improving their breathing, vocal abilities, and overall communication skills, as highlighted by various techniques focusing on rhythm, pitch, and memory.

The effectiveness of these music therapy techniques is influenced by the choice of music and the interactive delivery method, suggesting that different acoustic and social cues can enhance or hinder speech improvement in patients.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effective music therapy techniques in the treatment of nonfluent aphasia. Tomaino, CM.[2012]

Neurologic music therapy (NMT) significantly improved language function, including the aphasia quotient, in post-stroke patients, particularly in those with subacute aphasia, after one month of treatment.

Speech language therapy (SLT) also showed benefits, but primarily in chronic stroke patients, with no significant improvements observed in subacute patients, highlighting the potential advantages of NMT in earlier recovery stages.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The therapeutic effect of neurologic music therapy and speech language therapy in post-stroke aphasic patients. Lim, KB., Kim, YK., Lee, HJ., et al.[2021]

A study involving 54 patients with chronic aphasia showed that a 4-month group-based singing intervention significantly improved communication and speech production compared to standard care, with benefits lasting up to 9 months.

The singing intervention also enhanced social participation for patients and reduced caregiver burden, indicating positive effects on both patients' and caregivers' psychosocial well-being.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Efficacy of a multicomponent singing intervention on communication and psychosocial functioning in chronic aphasia: a randomized controlled crossover trial. Siponkoski, ST., Pitkäniemi, A., Laitinen, S., et al.[2023]

In a study involving 20 stroke patients with chronic aphasia, those who received 30 sessions of active music therapy (MT) alongside speech language therapy (SLT) showed significant improvements in spontaneous speech compared to those who only received SLT.

Additionally, 50% of the patients in the experimental group reported enhanced vitality, suggesting that combining MT with SLT may provide greater overall benefits in rehabilitation for aphasia.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Improvement of spontaneous language in stroke patients with chronic aphasia treated with music therapy: a randomized controlled trial. Raglio, A., Oasi, O., Gianotti, M., et al.[2017]

The pilot randomized controlled trial (RCT) successfully recruited 42 participants with post-stroke aphasia, achieving an 83% retention rate, indicating that the SPA intervention is feasible for a larger study.

Participants found the singing groups acceptable and manageable, with high attendance and adherence to the intervention, suggesting that a definitive RCT could effectively assess the impact of the SPA intervention on well-being and social participation.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Singing for people with aphasia (SPA): results of a pilot feasibility randomised controlled trial of a group singing intervention investigating acceptability and feasibility. Tarrant, M., Carter, M., Dean, SG., et al.[2021]

Choral singing therapy (CST) is perceived by individuals with stroke and Parkinson's disease as an enjoyable way to improve mood, communication, and overall quality of life, addressing their unmet needs.

Participation in CST helps individuals self-manage symptoms related to their conditions, such as social isolation and communication difficulties, suggesting it could be a valuable addition to rehabilitation programs.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Choral singing therapy following stroke or Parkinson's disease: an exploration of participants' experiences. Fogg-Rogers, L., Buetow, S., Talmage, A., et al.[2019]

A survey of 395 speech-language pathologists in France revealed that 98% recognize singing as a therapeutic tool for communication disorders, but many lack training in its application, particularly in structured melodic therapy.

While 62% of clinicians acknowledge the benefits of group singing for patients, they often do not implement it due to a lack of accessible choirs, highlighting a need for more community resources and research to support this therapeutic approach.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Singing for the Rehabilitation of Acquired Neurogenic Communication Disorders: Continuing the Evidence Dialogue with a Survey of Current Practices in Speech-Language Pathology. Behaghel, E., Zumbansen, A.[2022]

In a study involving eight brain-damaged patients with speech disorders, singing did not improve the pronunciation of familiar lyrics compared to speaking, but notes were produced better than words.

However, when patients sang along with an auditory model while learning new songs, they recalled more words than when they spoke, suggesting that choral singing can be a beneficial method for improving speech intelligibility in therapy.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Making non-fluent aphasics speak: sing along! Racette, A., Bard, C., Peretz, I.[2006]

Music therapy was successfully used to treat a 79-year-old patient with chronic severe aphasia, demonstrating that patients with severe cognitive impairments can still benefit from rehabilitation techniques.

The patient showed significant improvements in communication skills, including the ability to sing spontaneously, memorize meaningful words, and identify body parts, indicating the potential efficacy of music therapy in speech rehabilitation.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Singing therapy can be effective for a patient with severe nonfluent aphasia. Yamaguchi, S., Akanuma, K., Hatayama, Y., et al.[2015]

References

1. United States pubmed.ncbi.nlm.nih.gov

Speech and Music Therapy in the Treatment of Childhood Apraxia of Speech: An Introduction and a Case Study. [2023]

2. United States pubmed.ncbi.nlm.nih.gov

Effective music therapy techniques in the treatment of nonfluent aphasia. [2012]

3. Korea (South) pubmed.ncbi.nlm.nih.gov

The therapeutic effect of neurologic music therapy and speech language therapy in post-stroke aphasic patients. [2021]

4. England pubmed.ncbi.nlm.nih.gov

Efficacy of a multicomponent singing intervention on communication and psychosocial functioning in chronic aphasia: a randomized controlled crossover trial. [2023]

5. England pubmed.ncbi.nlm.nih.gov

Improvement of spontaneous language in stroke patients with chronic aphasia treated with music therapy: a randomized controlled trial. [2017]

6. England pubmed.ncbi.nlm.nih.gov

Singing for people with aphasia (SPA): results of a pilot feasibility randomised controlled trial of a group singing intervention investigating acceptability and feasibility. [2021]

7. England pubmed.ncbi.nlm.nih.gov

Choral singing therapy following stroke or Parkinson's disease: an exploration of participants' experiences. [2019]

8. Switzerland pubmed.ncbi.nlm.nih.gov

Singing for the Rehabilitation of Acquired Neurogenic Communication Disorders: Continuing the Evidence Dialogue with a Survey of Current Practices in Speech-Language Pathology. [2022]

9. England pubmed.ncbi.nlm.nih.gov

Making non-fluent aphasics speak: sing along! [2006]

10. England pubmed.ncbi.nlm.nih.gov

Singing therapy can be effective for a patient with severe nonfluent aphasia. [2015]