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Induced restriction therapy in treatment of aphasia after a stroke
Induced restriction therapy has recently been explored and its application keeps on expanding. The most common application of the method is in the motor disorders treatment. However, studies have shown that the principle of the method can be successfully used for the treatment of other stroke consequences, for example, aphasia.
It was found that prolonged speech disorders develop in patients tendency to gesture, similarly to how the patient ceases to use the paralyzed limb after a stroke. Such a reaction is an adaptation, but in this case it does not lead to benefit, but, on the contrary, makes further therapy impossible. Therefore, the development of such a reaction must be prevented. This is the main goal of the induced restriction therapy (Constraint-Induced Therapy).
Principle of the technique
To reach the desired result one must follow certain principles. Besides, they are not connected to any exact dysfunction but carry a more general character.
- Restriction. This means that it is necessary to limit the patient to using an alternative to the damaged function.
- Coercion. It is necessary to put the patient in such a situation, when he is forced to use the damaged function on an instinctive level. It is very difficult to achieve the necessary "desire power" in another way.
- Constant practice. The effect is achieved only with intensive and constant execution of procedures.
Following these principles achieves improvements. The method was most effective when restoring the activity of a paralyzed hand.
Application for aphasia treatment
Principles of this method have recently been applied for stroke rehabilitation. When it goes about restoring the speech, restriction means prevention of gestures, drawing, writing and other substitution methods. Coercion presupposes the situation when communication is available only by means of speech. Constant practice – 2-4 hours a day.
In this case, the activities of the patient to which these principles are applied; do not significantly differ from the typical neurorehabilitation program, but the main difference is the exactness of the patient's speech.
To date, induced restriction therapy has only just been introduced in the restoration of speech function. Its use has already yielded positive results for many patients, but the method can only be used under the supervision of an experienced specialist: you cannot allow patient’s fatigue and the program should not be started during an early stage of rehabilitation after a stroke.
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