Every year in Sweden, thousands of people suffer from stroke, often resulting in aphasia.
One of the most common and persistent symptoms in aphasia is anomia, i.e., word finding
difficulties. Anomia affects an individual's ability to communicate and can constitute an
obstacle to active participation in social activities and working life with reduced
quality of life as consequence.
Speech and language therapy has proved to be effective with significant training outcomes
for people with aphasia (Brady, Kelly, Godwin, Enderby, & Campbell, 2016). However,
concerning treatment of anomia a major challenge is to achieve generalization to
untrained items and to connected speech. Most interventions train to name single words,
with very little improvement in naming of untrained items, or generalization in daily
language use (Kiran & Thompson, 2003; Kristensson et al., 2022). Typically, word-finding
therapies target nouns. Training effects of verbs have been reported to a lesser extent
and found to be smaller than that of nouns (Webster & Whitworth, 2012). Edmonds and
coworkers (2009, 2011, 2014; Furnas & Edmonds, 2014) have developed an intervention
protocol called Verb Network Strengthening Treatment (VNeST) which aims at improving
production of nouns and verbs in sentence context by stimulating retrieval of verbs and
possible subjects/agents and objects/patients for the given verbs (e.g., "The pupil
writes a letter"). So far, results from single-case experimental design studies performed
by Edmonds and colleagues are promising, showing generalization to untrained items and to
other tasks (object naming, verb naming, and partly connected speech). The same promising
results were observed even when Verb Network Strengthening Treatment (VNeST) was
delivered remotely via a computer program (Furnas & Edmonds, 2014). In a single case
experimental design study carried out by our group via telerehabilitation (Torinsson et
al., submitted) in two individuals with mild-to-moderate and moderate-to-severe aphasia,
we found that one participant improved significantly in word retrieval when producing
sentences containing either trained verbs or semantically related verbs that were not
targeted in treatment, suggesting generalization to untrained words. The other
participant did not show any significant improvement for either trained or untrained
items. Yet, an increase of production of correct information units (a measure of how
informative verbal production is in an individual) could be observed in this participant
four weeks after treatment. The results of this Swedish study seem to be in line with
previous findings by Edmonds and colleagues. However, to our knowledge, the effects of
intervention have not been investigated in larger groups of patients in a randomized
controlled trial. Hence, this study aims to evaluate treatment effects of the VNeST
protocol via telerehabilitation in individuals with post-stroke aphasia through a
randomized controlled trial (RCT).
Outcome measures include measures of naming ability on word and sentence level as well as
in connected speech. Measures of participant reported perception of functional
communication as well as health related quality of life (PROMs) are also included.
