Rhythmic Stimulation and Auditory Masking as Fluency Inducing Techniques in Patients with Post-Stroke Aphasia

Nonfluent aphasia often includes difficulties in fluent speech production, and apraxia of speech (AOS) is a motor programming disorder that commonly co-occurs with aphasia. Rhythmic stimulation, auditory masking, and delayed, frequency-shifted feedback (altered auditory feedback [AAF]) have been shown to effectively increase fluency in people who stutter (another fluency disorder in adults), as well as in some speakers with aphasia. This study investigated the effect of metronomic stimulation on fluency, defined as decreased disfluent time and increased syllable rate, as compared to baseline, auditory masking, and AAF conditions in speakers with aphasia and AOS. Five speakers produced 20 sentences in seven conditions, including masking, AAF, and metronomic stimulation conditions, as well as four control conditions. Results indicated that one of the five speakers responded with a significant decrease in disfluent time with metronomic stimulation (Z= -3.26, p = .003), as determined by the Wilcoxon Rank-Sum test. No speaker significantly improved in fluency during the masking condition, and all speakers declined in fluency during the AAF condition. The one positive responder had a less fluent form of aphasia than most other participants, and also had apraxia of speech. These results suggest that metronomic stimulation may increase fluency in speakers with nonfluent aphasia and apraxia of speech.Bachelor of Scienc