The Effect of Traditional Speech Therapy in Fluent and Nonfluent Post-stroke Aphasia

Aphasia, an impairment of language resulting from brain damage, is traditionally treated with Speech-Language Therapy (SLT) in Russia. However, the efficacy of the conventional impairment-based SLT approach for different types of aphasia remains unclear. This longitudinal study aims to evaluate the general outcomes of traditional SLT and their persistence in fluent and non-fluent aphasia types, as classified by Luria's taxonomy. The research involved thirty-seven individuals with chronic post-stroke aphasia, diagnosed with non-fluent, fluent, or mixed aphasia types. Participants underwent personalized SLT sessions, tailored to their individual impairments and were assessed via the Russian Aphasia Test (RAT) at four time points: baseline, pre-therapy, post-therapy, and four weeks after therapy. The Friedman tests, along with pairwise Nemenyi and Wilcoxon tests revealed the increase in Overall Aphasia Quotient for all groups. Moreover, people with fluent deficits improved in comprehension and noun production; people with non-fluent aphasia showed improvement in production subtests, namely Action Naming, Sentence and Discourse Production, in accordance with the primary deficits found in these types. This can testify for the positive effect of the impairment-focused approach. No significant difference, however, was found between assessments conducted right before and directly after therapy, so the positive changes cannot be attributed to the therapeutic intervention exclusively and can be explained by other factors. Nevertheless, the study has shed a light on the current state of Russian therapeutic practices. Further research should be made evaluating other outcomes of the traditional impairment-based therapy in chronic post-stroke aphasia.