ORIGINAL ARTICLE   Open access

European Journal of Physical and Rehabilitation Medicine 2025 February;61(1):9-18

DOI: 10.23736/S1973-9087.24.08576-9

Copyright © 2024 THE AUTHORS

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language: English

Rehabilitation of post-stroke aphasia by a single protocol targeting phonological, lexical, and semantic deficits with speech output tasks: a randomized controlled trial

Elisabetta BANCO ¹ ✉, Lorenzo DIANA ¹, Carlotta CASATI ¹, Luigi TESIO ^{1, 2}, Giuseppe VALLAR ^{1, 3}, Nadia BOLOGNINI ^{1, 2}

¹ Laboratory of Neuropsychology, Department of Neurorehabilitation Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy; ² Department of Biomedical Sciences for Health, University of Milan, Milan, Italy 3 Department of Psychology, NeuroMI-Milan Center for Neuroscience, University of Milano-Bicocca, Milan, Italy

BACKGROUND: The defective spoken output of persons with aphasia has anomia as a main clinical manifestation. Improving anomia is therefore a main goal of any language treatment.
AIM: This study assessed the effectiveness of a novel, 2-week, rehabilitation protocol (PHOLEXSEM), focused on PHonological, SEmantic, and LExical deficits, aiming at improving lexical retrieval, and, generally, spoken output.
DESIGN: A prospective, randomized controlled trial.
SETTING: In-patient and out-patient population of the Neurorehabilitation Unit of the Istituto Auxologico Italiano IRCCS, Milan, Italy.
POPULATION: The sample comprised 44 adults with aphasia due to left brain damage; 22 of them were assigned to the experimental (PHOLEXSEM) group, whereas 22 were assigned to the control group that received the Promoting Aphasics Communicative Effectiveness (PACE) protocol.
METHODS: All participants were treated 30-min daily for two weeks. The PHOLEXSEM training included 3 sets of exercises: 1) non-word, word, and phrase repetition; 2) semantic feature analysis by naming; 3) phonemic, semantic, and verb recall. Treatment effects were evaluated with tasks and items different from those used for training, to assess generalization effects.
RESULTS: After the PHOLEXSEM treatment, repetition, naming, lexical retrieval and sentence comprehension improved more than in the control - PACE - group, with gains generalizing to non-trained items. These improvements were independent of aphasia chronicity and only marginally influenced by demographic factors.
CONCLUSIONS: The 2-week PHOLEXSEM training, by targeting spoken output, ameliorates different aspects of aphasia, ranging from speech production (i.e., phonology and lexical retrieval) to comprehension.
CLINICAL REHABILITATION IMPACT: The PHOLEXSEM training is a useful and easy-to-administer intervention to improve post-stroke language deficits in adults of different ages, levels of education, duration, type, and severity of aphasia.

KEY WORDS: Aphasia; Language therapy; Anomia; Articulation disorders; Semantics