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Objectives: This study aimed to systematically evaluate the effects of constraint-induced aphasia therapy (CIAT) for aphasic patients reported by randomized controlled trials. Methods: Relevant randomized controlled trials were retrieved from 11 electronic databases. A methodological quality assessment was conducted in accordance with the Cochrane Handbook, and meta-analyses were performed by using RevMan 5.2. A descriptive analysis was conducted when the included trials were not suitable for a meta-analysis. Results: A total of 12 trials were included. A statistically significant group difference was shown from the meta-analysis in the results measured by the Western Aphasia Battery (random-effects model, MD = 1.23, 95% CI = 0.31 to 2.14, P 0.05) and Aachen Aphasia Test (fixed-effects model, MD = −1.11, 95% CI = −4.49 to 2.27, P > 0.05). The descriptive analysis showed positive results in language performances of naming, repetition, and comprehension. Conclusion: This systematic review indicated that CIAT was efficient for improving language performance with regard to naming, comprehension, repetition, written language, and oral language based on the current evidence. And this review provides some meaningful guides for clinical practice: expand the therapy duration to 2 or 3 h per day, focus on naming, and choose the best assessment tool. It also indicates a need for more rigorous, large-scale, and high-quality trials in the future.

© 2018 National Research University Higher School of Economics. All rights reserved. This review focuses on language deficits in post-stroke aphasia, their rehabilitation and potential new developments based on current knowledge of human brain function. Language impairments in post-stroke aphasia often become chronic and cause significant communicative difficulties for patients. Though standard rehabilitation methods provide some language improvements, they are usually moderate and often decay over a period of time. These traditional rehabilitation approaches are usually based on existing conventions formed through decades of clinical practice; whilst valuable, they are not often rooted in up-to-date neuroscientific knowledge. In recent decades, human neuroscience has developed at a very high speed, not least due to the advent of non-invasive brain imaging techniques. Currently, it has reached the stage where neuroscientific knowledge can inform clinical practice, and help upgrade the traditional approaches using modern neuroscience tools. Furthermore, traditional practices typically apply the same routines to different patients, even though the nature of the individual deficit —and hence the care needed — are never the same. For instance, aphasic patients demonstrate a massive variety of improvement patterns during natural language recovery. This might be caused by individual differences in the functioning of language neural networks and their dynamics after stroke. Although the problem of individual variability in aphasia is well-known, there is still no comprehensive understanding of all factors that impact this variability. As we highlight in this review, the issue is of high importance for planning language therapy on individual basis. We also analyze neuroscientific underpinnings and clinical efficiency of a language therapy, which is widely used for chronic aphasia rehabilitation —constraint-induced aphasia therapy.

The role of the two hemispheres in the neurorehabilitation of language is still under dispute. This study explored the changes in language-evoked brain activation over a 2-week treatment interval with intensive constraint induced aphasia therapy (CIAT), which is also called intensive language action therapy (ILAT). Functional magnetic resonance imaging (fMRI) was used to assess brain activation in perilesional left hemispheric and in homotopic right hemispheric areas during passive listening to high and low-ambiguity sentences and non-speech control stimuli in chronic non-fluent aphasia patients. All patients demonstrated significant clinical improvements of language functions after therapy. In an event-related fMRI experiment, a significant increase of BOLD signal was manifest in right inferior frontal and temporal areas. This activation increase was stronger for highly ambiguous sentences than for unambiguous ones. These results suggest that the known language improvements brought about by intensive constraint-induced language action therapy at least in part relies on circuits within the right-hemispheric homologs of left-perisylvian language areas, which are most strongly activated in the processing of semantically complex language.

The role of the two hemispheres in the neurorehabilitation of language is still under dispute. This study explored the changes in language-evoked brain activation over a two-week treatment interval with intensive constraint induced aphasia therapy (CIAT), which is also called intensive language action therapy (ILAT). Functional magnetic resonance imaging (fMRI) was used to assess brain activation in perilesional left hemispheric and in homotopic right hemispheric areas during passive listening to high and low-ambiguity sentences and non-speech control stimuli in chronic non-fluent aphasia patients. All patients demonstrated significant clinical improvements of language functions after therapy. In an event-related fMRI experiment, a significant increase of BOLD signals was manifest in right inferior frontal and temporal areas. This activation increase was stronger for highly ambiguous sentences than for unambiguous ones. These results suggest that the known language improvements brought about by intensive constraint-induced language action therapy at least in part relies on circuits within the right-hemispheric homologues of left-perisylvian language areas, which are most strongly activated in the processing of semantically complex language.

Aphasia is prevalent in people following stroke, which can have a significant impact on the quality of life of the patients with stroke. One of the new methods for treatment of patients with aphasia is constraint-induced aphasia therapy (CIAT). The aim of this study was to investigate the efficacy of CIAT on naming deficits in individuals with chronic aphasia. This study had a prospective, single-subject study with A-B-A design. The CIAT was administered to two patients with chronic aphasia. Participants were a 57-year-old male and a 45-year-old female and had a stroke 60 and 36 months ago, respectively. In this study, the naming test was used as the outcome measure. The naming test was administered in three baseline sessions with 1 week interval between tests (phase A). Patients received CIAT for four consecutive weeks (3 days/week). Four measurements were taken during the treatment phase (phase B). In follow-up phase (phase A) two other measurements were performed. Visual analysis consisting of level, regression line, and variability were used to determine the effects of CIAT on naming. Both participants increased scores on naming test after phase A and B. The mean of the naming score improved from the baseline to the intervention phase in both participants. There was a positive trend in naming scores during the treatment phase compared with the trend in the baseline demonstrated by both participants. The results of this study showed that the CIAT can be effective in improving the naming deficit in patients with chronic post-stroke aphasia.