Effects of semantic treatment on verbal communication and linguistic processing in aphasia after stroke: a randomized controlled trial.
OBJECTIVE
Semantic deficits, deficits in word meaning, have a large impact on aphasic patients' verbal communication. We investigated the effects of semantic treatment on verbal communication in a randomized controlled trial.


METHODS
Fifty-eight patients with a combined semantic and phonological deficit were randomized to receive either semantic treatment or the control treatment focused on word sound (phonology). Fifty-five patients completed pretreatment and posttreatment assessment of verbal communication (Amsterdam Nijmegen Everyday Language Test [ANELT]). In an on-treatment analysis (n=46), treatment-specific effects on semantic and phonological measures were explored.


RESULTS
Both groups improved on the ANELT, with no difference between groups in overall score (difference, -1.1; 95% confidence interval [CI], -5.3 to 3.1). After semantic treatment, patients improved on a semantic measure (mean improvement, 2.9; 95% CI, 1.2 to 4.6), whereas after phonological treatment, patients improved on phonological measures (mean improvement, 3.0; 95% CI, 1.4 to 4.7, and 3.0; 95% CI, 1.2 to 4.7).


CONCLUSIONS
No differences in primary outcome were noted between the 2 treatments. Our findings challenge the current notion that semantic treatment is more effective than phonological treatment for patients with a combined semantic and phonological deficit. The selective gains on the semantic and phonological measures suggest that improved verbal communication was achieved in a different way for each treatment group.
Doesborgh
Suzanne J C
SJ
Erasmus MC, Department of Neurology and Neuropsychology, Rotterdam, The Netherlands.
van de Sandt-Koenderman
Mieke W E
MW
Dippel
Diederik W J
DW
van Harskamp
Frans
F
Koudstaal
Peter J
PJ
Visch-Brink
Evy G
EG
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001037:Aphasia / Q000209:etiology / Q000628:therapy*; D001184:Articulation Disorders / Q000209:etiology / Q000628:therapy*; D005260:Female; D006801:Humans; D007808:Language Therapy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D012017:Referral and Consultation; D012660:Semantics; D016037:Single-Blind Method; D020521:Stroke / Q000150:complications / Q000503:physiopathology; D000071939:Stroke Rehabilitation; D016896:Treatment Outcome; D014705:Verbal Behavior