Effectiveness of melodic intonation therapy in a case of aphasia following right hemisphere stroke

摘要

Background: The use of Melodic Intonation Therapy (MIT) in the clinical setting is suggested to be based on several criteria; however, some persons with aphasia not meeting these criteria may still benefit from this approach.Aims: The purpose of this research was to explore the effectiveness of utilising MIT to improve expressive language in a person with global aphasia following right hemisphere stroke.Methods & Procedures: A participant with global aphasia following right hemisphere haemorrhagic stroke completed a 7-week treatment programme utilising MIT. Sessions were held 5 days a week, for two and a half hours per day. Non-linguistic cognitive activities (COG) were also utilised briefly in each session as a break (BRK) from MIT. The Aphasia Diagnostic Profiles (ADP), American Speech-Language-Hearing Association-Functional Assessment of Communication Skills and the Stroke and Aphasia Quality of Life Scale-39 were administered pre- and post-treatment to assess for the treatment-related change.Outcomes & Results: The participant responded well to MIT, completing the elementary level in 25 sessions and progressing through the intermediate level until the end of the treatment period at session 30. Performance on the ADP suggested decreased aphasia severity characterised by improved auditory comprehension, repetition, average phrase length and elicited gestures. Functional communication was slightly improved, whereas quality of life did not change. It was reported by the spouse, caregiver and clinician that the participant began using several novel phrases in appropriate context over the course of the treatment.Conclusions: The MIT may be a valid treatment of global aphasia following right hemisphere stroke, providing more options to practising clinicians working with this population. It is likely that the criteria ruling out those with impaired auditory comprehension and those with right hemisphere lesions, regardless of lesion location, are too restrictive. Most likely, good and poor candidates for MIT can better be identified using intrahemispheric lesion location information, rather than interhemispheric.