Recovery from moderate aphasia in the first year poststroke: Effect of type of therapy

Objectives: (1) To determine whether 2 model-based remediation programs aff ect writing performance in unselected subjects with moderate aphasia and wh ether there is consequent improvement in everyday life, and (2) to interpre t the potential chancres observed by recourse to a theoretical model. Design: Consecutive sample, multiple baseline, within subject crossover stu dy. Setting: Ambulatory care units. Participants: Eight subjects with moderate aphasia from 6 to 12 months post onset. Intervention: A standardized test for reading and writing skills was given at the beginning and the end of each therapy program and I month after ther apy stopped. Main Outcome Measures: Functional outcome measures were the Communicative A bilities in Daily Living (CADL) test and subtests from standardized aphasia assessment. Results: After the 2 programs, there was improved writing performance, whic h was maintained after therapy stopped. Patterns of improvement corresponde d to each of the 2 programs. Learning transfer was observed on the CADL tes t and functional writing, but gains on oral language were limited. Only 1 p rogram was effective for 6 of the 8 patients. Conclusion: Specific rehabilitation programs aid recovery from aphasic symp toms from 6 to 12 months postonset. Individual response is linked to type o f treatment. The interpretation is linked to a model-based description of a phasic symptoms and mechanisms of functional recovery.