Effectiveness of Transcranial Direct Current Stimulation as an Adjuvant to Aphasia Treatment Following Stroke: Evidence From Systematic Reviews and Meta-Analyses.

Purpose: Transcranial direct current stimulation (tDCS) is a neuromodulation tool to amplify neural excitability and enhance outcomes associated with speech-language therapy (SLT). Stimulation currents to the left and right hemispheres vary in applying anodal (excitatory), cathodal (inhibitory), or bihemispheric signals. Several systematic reviews (SRs) and meta-analyses (MAs) have summarized the large literature examining tDCS for aphasia rehabilitation.

Effectiveness of Constraint-Induced Language Therapy for Aphasia: Evidence From Systematic Reviews and Meta-Analyses.

Purpose: Constraint-induced language therapy (CILT) is an aphasia treatment that incorporates neuroplasticity principles of forced verbal use and high-intensity training to facilitate language recovery in individuals with stroke-induced aphasia (Pulvermüller et al., 2001). The burgeoning CILT literature has led to systematic reviews (SRs) that summarize treatment results.

Applying Appraisal Tools in Aphasia Systematic Reviews: A Tutorial.

Purpose: A systematic review (SR) represents a rigorous process of identifying and summarizing current research to answer specific clinical questions. Not all SRs present high-quality information, because they do not adhere to established standards of conduct or reporting. This tutorial aims to (a) describe two tools developed in epidemiology for reporting (PRISMA 2020; Preferred Reporting Items for Systematic Reviews and Meta-Analyses) and appraising (AMSTAR 2; A MeaSurement Tool to Assess Systematic Reviews) SRs and (b) exemplify the use of AMSTAR 2.

Executive Functions and Student Success During Physical Therapist Education: An Exploratory Study.

Background: Clinical reasoning relies on executive functions (EFs) that manage attention, inhibition, organization, and decision-making. Assessment of EFs may help identify students who excel at clinical reasoning, yet data showing this relationship in physical therapy (PT) education programs are lacking. The primary purpose of this exploratory study was to examine EFs in relationship to success in PT educational programs.

Cognitive Assessments for Patients With Neurological Conditions: A Preliminary Survey of Speech-Language Pathology Practice Patterns.

Purpose Speech-language pathologists (SLPs) are often responsible for assessing cognitive disorders that affect communication for individuals with diagnosed or suspected acute or degenerative neurological conditions. However, consensus on appropriate assessment tools for various neurological disorders remains elusive. This preliminary survey was conducted to study current practices in the use of published and unpublished tools by SLPs when assessing cognitive-communication impairments across common neurologic conditions.

Neuroplasticity and aphasia treatments: new approaches for an old problem.

Given the profound impact of language impairment after stroke (aphasia), neuroplasticity research is garnering considerable attention as means for eventually improving aphasia treatments and how they are delivered. Functional and structural neuroimaging studies indicate that aphasia treatments can recruit both residual and new neural mechanisms to improve language function and that neuroimaging modalities may hold promise in predicting treatment outcome. In relatively small clinical trials, both non-invasive brain stimulation and behavioural manipulations targeting activation or suppression of specific cortices can improve aphasia treatment outcomes.

Quality Appraisal of Systematic Reviews for Behavioral Treatments of Attention Disorders in Traumatic Brain Injury.

Objective: This review appraised the quality of systematic reviews (SRs) and meta-analyses (MAs) to summarize research on behavioral interventions for attention disorders in persons with traumatic brain injury.

Methods: A search of 7 databases revealed 15 MAs/SRs reporting outcomes for attention treatments in traumatic brain injury. Two examiners independently coded the quality of reviews with the Critical Appraisal of Systematic Review or Meta-Analysis and the Evidence in Augmentative and Alternative Communication Systematic Review Scale.

Critical appraisal of systematic reviews of executive function treatments in TBI.

Objective: To appraise the quality of systematic reviews (SRs) and meta-analyses (MAs) that summarize the treatment literature for executive function (EF) impairments following traumatic brain injury (TBI).

Methods: We used five data sources (PubMed; PsycINFO; ANCDS.org; Cochrane Collaboration; American Speech-Language-Hearing Association Compendium; Psychological Database for Brain Impairment Treatment Efficacy) and identified 19 reviews that met eligibility criteria (adults with TBI; behavioural treatments for EF impairments; no pharmacologic treatments).

A comparison of intention and pantomime gesture treatment for noun retrieval in people with aphasia.

Purpose: The effects of intention gesture treatment (IGT) and pantomime gesture treatment (PGT) on word retrieval were compared in people with aphasia.

Method: Four individuals with aphasia and word retrieval impairments subsequent to left-hemisphere stroke participated in a single-participant crossover treatment design. Each participant viewed target nouns on a computer screen in 2 counterbalanced training phases.

Contrasting effects of errorless naming treatment and gestural facilitation for word retrieval in aphasia.

We compared the effects of two treatments for aphasic word retrieval impairments, errorless naming treatment (ENT) and gestural facilitation of naming (GES), within the same individuals, anticipating that the use of gesture would enhance the effect of treatment over errorless treatment alone. In addition to picture naming, we evaluated results for other outcome measures that were largely untested in earlier ENT studies. In a single participant crossover treatment design, we examined the effects of ENT and GES in eight individuals with stroke-induced aphasia and word retrieval impairments (three semantic anomia, five phonological anomia) in counterbalanced phases across participants.

Intensity of aphasia therapy: evidence and efficacy.

Determining the optimal amount and intensity of treatment is essential to the design and implementation of any treatment program for aphasia. A growing body of evidence, both behavioral and biological, suggests that intensive therapy positively impacts outcomes. We update a systematic review of treatment studies that directly compares conditions of higher and lower intensity treatment for aphasia.

Translational research in aphasia: from neuroscience to neurorehabilitation.

Purpose: In this article, the authors encapsulate discussions of the Language Work Group that took place as part of the Workshop in Plasticity/NeuroRehabilitation Research at the University of Florida in April 2005.

Method: In this narrative review, they define neuroplasticity and review studies that demonstrate neural changes associated with aphasia recovery and treatment. The authors then summarize basic science evidence from animals, human cognition, and computational neuroscience that is relevant to aphasia treatment research.

Functional MRI of language in aphasia: a review of the literature and the methodological challenges.

Animal analogue studies show that damaged adult brains reorganize to accommodate compromised functions. In the human arena, functional magnetic resonance imaging (fMRI) and other functional neuroimaging techniques have been used to study reorganization of language substrates in aphasia. The resulting controversy regarding whether the right or the left hemisphere supports language recovery and treatment progress must be reframed.

Semantic-phonologic treatment for noun and verb retrieval impairments in aphasia.

Nouns and verbs differ in their neural and psycholinguistic attributes. It is not known whether these differences lead to distinct patterns of response to treatment for individuals with word retrieval impairments associated with aphasia. Eight participants with naming disorders induced by left hemisphere strokes were treated with a semantic-phonologic treatment protocol for nouns and verbs using a single participant multiple baseline design.

Effects of gesture+verbal treatment for noun and verb retrieval in aphasia.

Links between verbs and gesture knowledge suggest that verb retrieval may be particularly amenable to gesture+verbal training (GVT) in aphasia compared to noun retrieval. This study examines effects of GVT for noun and verb retrieval in nine individuals with aphasia subsequent to left hemisphere stroke. Participants presented an array of noun and verb retrieval deficits, including impairments of semantic and/or phonologic processing.

Management of anomia.

Anomia is a complex, commonly occurring symptom of aphasia with different underlying causes. A number of behavioral approaches to rehabilitation of anomia have been described. Some are restitutive in nature and attempt to reactivate lexical-semantic or phonological representations to improve word retrieval.

Treatment of adynamia in aphasia.

Transcortical motor aphasia (TCMA) is an acquired impairment of language expression that occurs following neurologic damage that affects left frontal cortex and spares perisylvian regions. In some individuals with TCMA, verbal expression is rendered nonfluent due to difficulty spontaneously initiating and elaborating upon verbal messages. Nonfluency arises from impaired activation of intended messages and inhibition of competing verbal expressions.