Effects of Combining Modified Response Elaboration Training, Semantic Feature Analysis, and Arm Ability Training on Cognitive, Language, and Motor Recovery in Poststroke Broca's Aphasia: A Randomized Controlled Trial Publisher Pubmed



Sabermoghadam R ; Karimi M ; Zeinalzadeh A ; Sangsefidi N ; Farzadfard MT ; Sobhanirad D
Source: American journal of speech-language pathology Published:2026

Abstract

PURPOSE: Stroke survivors often face problems in language, motor, and cognitive skills because the neural networks for these functions overlap. Consequently, the recovery is complex and requires a multimodal approach. This study examined the interactions among linguistic, motor, and cognitive processes. We also evaluated how integrating speech and language therapy (SLT) with arm ability training (AAT) affects recovery in patients with Broca's aphasia. METHOD: This was a prospective, assessor-blinded, three-arm, parallel-group, randomized controlled trial with an open-label design. Forty-five participants in the chronic stage of recovery were randomly allocated to three groups: SLT, AAT, and combined SLT + AAT. The interventions lasted for 3 weeks. Motor, cognitive, and language functions were assessed before, during (Weeks 1 and 2), and after the intervention. Both within-group and between-groups analyses and growth rates were examined. RESULTS: All motor metrics, including abduction (75.56%), flexion (82.22%), endurance (102.03%), and strength (207.78%), improved significantly more in the SLT + AAT group than in the SLT and AAT groups alone (p < .05). The cognitive score of the combined group increased by 71.86%, whereas that of the SLT and AAT groups improved by 39.56% and 29.01%, respectively. The SLT + AAT group's language function showed improvement, particularly naming ability from 64.00 ± 19.57 to 83.67 ± 8.12 (p < .001). CONCLUSIONS: Language, cognition, and motor processes have both mutual and synergistic relationships. Although each intervention alone was effective, the combined SLT and AAT offered superior outcomes. Overall, these findings support the use of holistic and cross-modal strategies to enhance neuroplasticity and to promote recovery. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.31360018.