Authors: Haro-Martínez AM, Lubrini G, Madero-Jarabo R, Díez-Tejedor E, Fuentes B
Title: Melodic intonation therapy in post-stroke nonfluent aphasia: a randomized pilot trial
Source: Clinical Rehabilitation 2019 33(1): 44-53
Year: 2019
Research Design: Randomised Controlled Trial
Rating Score: 06/10
This rating is confirmed
Eligibility specified - Y
Random allocation - Y
Concealed allocation - Y
Baseline comparability - Y
Blind subjects - N
Blind therapists - N
Blind assessors - Y
Adequate follow-up - N
Intention-to-treat analysis - Y
Between-group comparisons - N
Point estimates and variability - Y

Objective:To collect data to estimate the sample size of a definitive randomized controlled trial to evaluate the effects of Melodic Intonation Therapy in post-stroke nonfluent aphasia.Design:A randomized, crossover, interventional pilot trial.Setting:Departments of Neurology and Rehabilitation from a university general hospital.Participants:Stroke survivors with post-stroke nonfluent aphasia.Interventions:Patients randomized to group 1 had treatment with Melodic Intonation Therapy first (12 sessions over six weeks) followed by no treatment; the patients in group 2 started active treatment between three and six 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 six 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% confidence interval (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.Conclusion: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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