Authors: Cherney LR, Van Vuuren S
Title: Complexity and Feedback During Script Training in Aphasia: A Feasibility Study
Source: Archives of Physical Medicine and Rehabilitation 2022 103: S205-S214
Year: 2022
Research Design: Randomised Controlled Trial
Rating Score: 07/10
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 - Y
Intention-to-treat analysis - N
Between-group comparisons - Y
Point estimates and variability - Y

Objective: To explore the effect of complexity and feedback on script training outcomes in aphasia Design: Randomized balanced single-blind 2 x 2 factorial design. Setting(s): Freestanding urban rehabilitation hospital. Participant(s): Adults with fluent and nonfluent aphasia (at least 6 months post onset). Intervention(s): Experimental treatment was AphasiaScripts, a computer-based script training program. Scripts were 10-turns long and developed at different complexity levels to allow for comparison of high vs low complexity. The program was modified to contrast high vs low feedback conditions during sentence practice. Participants were instructed to practice three 30-minute sessions per day, 6 days per week for 3 weeks. Main Outcome Measure(s): Gains achieved from baseline in accuracy and rate of production of trained and untrained script sentences at post treatment and at 3-, 6-, and 12-weeks after the end of treatment. Result(s): Sixteen participants completed the intervention. On the trained script, gains were statistically significant for both accuracy and words per minute at post treatment and 3-, 6-, and 12-week maintenance. Gains on the untrained script were smaller than on the trained script; they were statistically significant only for accuracy at post treatment and 3-week maintenance. Complexity had an influence on accuracy at post-treatment (F1=4.8391, P=.0501) and at maintenance (F1=5.3391, P=.0413). Practicing scripts with high complexity increased accuracy by 11.33% at post treatment and by 9.90% at maintenance compared with scripts with low complexity. Participants with nonfluent aphasia made greater gains than those with fluent aphasia. There was no significant effect of feedback. Conclusion(s): This study reinforces script training as a treatment option for aphasia. Results highlight the use of more complex scripts to better promote acquisition and maintenance of script production skills. There is a need for further investigation of these variables with larger samples and with other types of aphasia treatments.

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