- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04433351
Sensory-Motor Integration for Speech Rehabilitation in Patients With Post-stroke Aphasia (SEMO)
Evaluation of an Enriched Speech Rehabilitation Program Combining Speech Therapy and Sensory-motor Integration in Aphasic Patients
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Study Type
Enrollment (Anticipated)
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: University Hospital, Grenoble
- Phone Number: +33 04 76 76 68 14
- Email: tmontagnon@chu-grenoble.fr
Study Locations
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-
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Grenoble, France, 38043
- Recruiting
- CHU Grenoble Alpes
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Contact:
- Baciu Monica
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- patients with late sub-acute and chronic post-stroke (> 4 months) non-fluent aphasia after lesion in the dominant hemisphere for language
- native speakers of French
- normal or corrected to normal vision
- satisfying all criteria for the MRI examination
Exclusion Criteria:
- patients with comprehension deficits, hemi-spatial neglect or upper limb apraxia
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Non-Randomized
- Interventional Model: Crossover Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: SE cohort
Patients in the SE cohort will carry out first the simple rehabilitation protocol (S, 4 weeks) followed by enriched rehabilitation (E, 4 weeks).
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The enriched rehabilitation is based on the use of sensory-motor integration in addition to conventional speech therapy. The sensory-motor integration method is based on the Ultraspeech-player software. This software allows therapists to display movements of speech articulators (tongue and lips) recorded on a reference speaker during production of vowels or consonants (isolated or combined). Sagittal movements of the tongue are recorded using ultrasound and front views of lip movements are captured through video imaging. During rehabilitation with the Ultraspeech-player software, patients will be seated in front of a computer screen, observe articulatory movements and listen to phonemes. Then, they will be required to repeat each of them five times and move on to the next phoneme, with the agreement of the experimenter.
Other Names:
The simple rehabilitation is based on conventional speech therapy.
The conventional speech therapy will be provided by the speech therapist.
Classically, the speech therapist uses word production with repetition and naming exercises.
The therapist will show the patient series of pictures associated or not with written words, and the patient is required to name them and/or read aloud the word.
In case of impossibility to perform the task, the therapist may can help the patient by using the indexing method or by asking the patient to repeat after him/her.
According to patient's competencies and progress, the difficulty of reeducation can increase progressively.
Other Names:
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Experimental: ES cohort
Patients in the ES cohort will carry out first the enriched rehabilitation protocol (E, 4 weeks) followed by simple rehabilitation (S, 4 weeks).
|
The enriched rehabilitation is based on the use of sensory-motor integration in addition to conventional speech therapy. The sensory-motor integration method is based on the Ultraspeech-player software. This software allows therapists to display movements of speech articulators (tongue and lips) recorded on a reference speaker during production of vowels or consonants (isolated or combined). Sagittal movements of the tongue are recorded using ultrasound and front views of lip movements are captured through video imaging. During rehabilitation with the Ultraspeech-player software, patients will be seated in front of a computer screen, observe articulatory movements and listen to phonemes. Then, they will be required to repeat each of them five times and move on to the next phoneme, with the agreement of the experimenter.
Other Names:
The simple rehabilitation is based on conventional speech therapy.
The conventional speech therapy will be provided by the speech therapist.
Classically, the speech therapist uses word production with repetition and naming exercises.
The therapist will show the patient series of pictures associated or not with written words, and the patient is required to name them and/or read aloud the word.
In case of impossibility to perform the task, the therapist may can help the patient by using the indexing method or by asking the patient to repeat after him/her.
According to patient's competencies and progress, the difficulty of reeducation can increase progressively.
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Evaluation of acoustic changes in the speech signal before and after each rehabilitation protocol
Time Frame: Baseline pre-intervention; immediately after the first intervention; immediately after the second intervention
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Assessment of acoustic properties (formants, voice onset time and spectral moments) with a phoneme repetition task.
Repeated phonemes are isolated vowels, semi-consonants in vowel context and consonants in /a/ context with the consonants (C) placed in initial (/Ca/) or medial (/aCa/) positions.
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Baseline pre-intervention; immediately after the first intervention; immediately after the second intervention
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Clinical language assessment 1a
Time Frame: Baseline pre-intervention
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Assessment of oral and written expression with BDAE (Boston Diagnostic Aphasia Examination).
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Baseline pre-intervention
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Evaluation of changes in language abilities before and after rehabilitation - Clinical language assessment 1b
Time Frame: Immediately after the first intervention; immediately after the second intervention
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Assessment of oral expression (picture naming) with BDAE (Boston Diagnostic Aphasia Examination).
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Immediately after the first intervention; immediately after the second intervention
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Clinical language assessment 2a
Time Frame: Baseline pre-intervention
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Assessment of transcoding (word/sentence repetition and syllable/word reading) with BDAE (Boston Diagnostic Aphasia Examination).
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Baseline pre-intervention
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Evaluation of changes in language abilities before and after rehabilitation - Clinical language assessment 2b
Time Frame: Immediately after the first intervention; immediately after the second intervention
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Assessment of transcoding (word repetition and word reading) with BDAE (Boston Diagnostic Aphasia Examination).
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Immediately after the first intervention; immediately after the second intervention
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Evaluation of changes in language abilities before and after each rehabilitation protocol - Clinical language assessment 3
Time Frame: Baseline pre-intervention; immediately after the first intervention; immediately after the second intervention
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Assessment of verbal fluency with phonemic and semantic fluency tasks.
The patient must generate words that satisfy certain criteria: beginning with a particular letter (phonemic fluency) or belonging to a particular semantic category (semantic fluency).
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Baseline pre-intervention; immediately after the first intervention; immediately after the second intervention
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Clinical language assessment 4
Time Frame: Baseline pre-intervention
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Assessment of bucco-facial praxia with MT-86 (Montreal-Toulouse aphasia language examination protocol).
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Baseline pre-intervention
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Evaluation of changes in language abilities before and after each rehabilitation protocol - Clinical language assessment 5
Time Frame: Baseline pre-intervention; immediately after the first intervention; immediately after the second intervention
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Assessment of phonemic discrimination with BALE (Batterie Analytique du Langage Ecrit).
|
Baseline pre-intervention; immediately after the first intervention; immediately after the second intervention
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Evaluation of changes in language abilities before and after each rehabilitation protocol - Clinical language assessment 6
Time Frame: Baseline pre-intervention; immediately after the first intervention; immediately after the second intervention
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Assessment of phonological awareness with a rhyme detection task.
The patient must decide whether two heard words rhyme or not.
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Baseline pre-intervention; immediately after the first intervention; immediately after the second intervention
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Evaluation of changes in cognitive level before and after each rehabilitation protocol - Neuropsychological assessment 1
Time Frame: Baseline pre-intervention; immediately after the first intervention; immediately after the second intervention
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Assessment of general cognitive level with CASP (Cognitive Assessment Scale for Stroke Patients).
CASP evaluates several abilities (naming, comprehension, inhibition, flexibility etc.) and the global score is out of 36.
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Baseline pre-intervention; immediately after the first intervention; immediately after the second intervention
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Evaluation of changes in specific executive functions before and after each rehabilitation protocol - Neuropsychological assessment 2
Time Frame: Baseline pre-intervention; immediately after the first intervention; immediately after the second intervention
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Assessment of visuo-spatial span with the Corsi blocks task.
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Baseline pre-intervention; immediately after the first intervention; immediately after the second intervention
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Evaluation of changes in specific executive functions before and after each rehabilitation protocol - Neuropsychological assessment 3
Time Frame: Baseline pre-intervention; immediately after the first intervention; immediately after the second intervention
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Assessment of non-verbal fluency with the Ruff figural fluency test.
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Baseline pre-intervention; immediately after the first intervention; immediately after the second intervention
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Evaluation of changes in specific executive functions before and after each rehabilitation protocol - Neuropsychological assessment 4
Time Frame: Baseline pre-intervention; immediately after the first intervention; immediately after the second intervention
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Assessment of executive functions with the TMT A-B (Trail Making Test A-B).
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Baseline pre-intervention; immediately after the first intervention; immediately after the second intervention
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Evaluation of changes in non-verbal episodic memory before and after each rehabilitation protocol - Neuropsychological assessment 5
Time Frame: Baseline pre-intervention; immediately after the first intervention; immediately after the second intervention
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Assessment of non-verbal episodic memory with BEM84 (Batterie d'Efficience Mnésique de Signoret).
This test contains an immediate recall task (score out of 12) and a delayed recall task (score out of 12).
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Baseline pre-intervention; immediately after the first intervention; immediately after the second intervention
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Evaluation of changes in mental rotation abilities before and after each rehabilitation protocol - Neuropsychological assessment 6
Time Frame: Baseline pre-intervention; immediately after the first intervention; immediately after the second intervention
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Assessment of mental rotation abilities.
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Baseline pre-intervention; immediately after the first intervention; immediately after the second intervention
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Evaluation of mood changes before and after each rehabilitation protocol - Neuropsychological assessment 7
Time Frame: Baseline pre-intervention; immediately after the first intervention; immediately after the second intervention
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Assessment of depression with Aphasic Depression Rating Scale (ADRS; score out of 32; a score lower than 7 is for "no depression").
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Baseline pre-intervention; immediately after the first intervention; immediately after the second intervention
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Evaluation of mood changes before and after each rehabilitation protocol - Neuropsychological assessment 8
Time Frame: Baseline pre-intervention; immediately after the first intervention; immediately after the second intervention
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Assessment of anxiety with Hamilton scale (score out of 56; a score lower or equal to 12 is for "normal anxiety"; a score between 12 and 20 is for "mild anxiety"; a score between 20 and 25 is for "moderate anxiety"; a score higher than 25 is for "severe anxiety").
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Baseline pre-intervention; immediately after the first intervention; immediately after the second intervention
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Neuropsychological assessment 9
Time Frame: Baseline pre-intervention
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Assessment of familiarity degree with digital tools with an in-house test developed by the neuropsychologists from our clinical setting.
This task allows to evaluate the use of the computer tools, its frequency of use and the type of activities carried out.
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Baseline pre-intervention
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Evaluation of brain network activation (with measurement of BOLD, Blood Oxygen Level Dependent) before and after rehabilitation - Evaluation-brain 1
Time Frame: Baseline pre-intervention; immediately after the first intervention
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Assessment of brain networks modulation with fMRI (functional MRI) tasks : word repetition (repeating a heard word), picture-prompted rhyme detection (judging if verbal labels of pictures presented in pairs rhyme or not), auditory rhyme detection (decide whether two heard words rhyme of not), picture naming (naming pictures) and word reading (reading visually presented words).
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Baseline pre-intervention; immediately after the first intervention
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Evaluation of brain functional connectivity before and after rehabilitation - Evaluation-brain 2
Time Frame: Baseline pre-intervention; immediately after the first intervention
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Assessment of functional connectivity with rs-fMRI (resting state-functional MRI).
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Baseline pre-intervention; immediately after the first intervention
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Evaluation of brain anatomical connectivity before and after rehabilitation - Evaluation-brain 3
Time Frame: Baseline pre-intervention; immediately after the first intervention
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Assessment of diffuse white-matter changes in multiple bundles with MRI-DTI (Diffusion Tension Imaging).
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Baseline pre-intervention; immediately after the first intervention
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Evaluation of changes in inner speech abilities before and after each rehabilitation protocol - Inner speech testing 1
Time Frame: Baseline pre-intervention; immediately after the first intervention; immediately after the second intervention
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Evaluate inner speech abilities with an introspective questionnaire
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Baseline pre-intervention; immediately after the first intervention; immediately after the second intervention
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Evaluation of changes in inner speech abilities before and after each rehabilitation protocol - Inner speech testing 2
Time Frame: Baseline pre-intervention; immediately after the first intervention; immediately after the second intervention
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Evaluate inner speech abilities with a behavioral task (homophone detection task)
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Baseline pre-intervention; immediately after the first intervention; immediately after the second intervention
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Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Monica Baciu, MD PhD, University Hospital, Grenoble & Laboratoire de Psychologie et NeuroCognition
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Anticipated)
Study Completion (Anticipated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- 2020-A00720-39
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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