Journal of Advances in Medicine and Medical Research

Aims: The main objective of the study was to find out the effectiveness of the Melodic Intonation Therapy (MIT) program in the management of patients with non-fluent aphasia.

Background: Language is the source of human life and power. Aphasia is the most common cause of language deficits in adults. Non-fluent aphasia most commonly results from a lesion in the left frontal lobe involving the left posterior inferior frontal region known as Broca’s area, and patients who are non-fluent usually have the ability to comprehend the speech of others but are unable to produce words themselves. Most of the non-fluent aphasic patients receive traditional therapy and practice the word repetition and phrases. Mechanisms are also taught in traditional therapy to compensate for lost language function such as drawing and using phrases that are easier to pronounce. Melodic Intonation Therapy (MIT) is a treatment approach for patients with non-fluent aphasia to express verbal expression. In this study researcher intended to find out the level of improvement that occurred in the expressive language of patients with non-fluent aphasia through the use of MIT.

Study Design: The study was conducted following the pre-experimental research design of quantitative design.

Place and Duration of Study: The research took place in the adult neurology units of the Speech & Language Therapy (SLT) departments of the Centre for the Rehabilitation of the Paralysed (CRP), Savar and Mirpur, Bangladesh, from October 2012 to January 2013. Although the data are from more than a decade ago, the essential clinical presentations and intervention strategies outlined are still pertinent to contemporary SLT practice. These findings still hold valuable lessons for the management of similar cases, particularly in under resourced settings, where most of the problems and solutions offered still apply today.

Methodology: The study was conducted following the pre-experimental research design of quantitative design. The specific type of pre-experimental research which was used in this study was the pretest-posttest design. Four participants were selected purposively with non-fluent aphasia from the adult neurology unit of Speech & Language Therapy department CRP, Savar (4 participants) and Mirpur (2 participants).  Patients were allocated for MIT and they received 12 – 16 sessions of treatment in this quantitative same subject design study. Patients were assessed two times (before and after giving MIT) by using three subtests (Repetition, Sentence case and Confrontation Naming) of Boston Diagnostic Aphasia Examination (BDAE) established by Goodglass & Kaplan in 1972. The data was analyzed by using related ‘t’ test. In this study, the hypothesis was one-tailed as it was predicting a specific direction to the results. To support the hypothesis and/or to reject the null hypothesis the investigator has used related ‘t’ test to find out ‘p’ value so that the result can be significant.

Results: The result shows positive changes in all the outcome areas of language after receiving MIT. The ‘p’ value (by which we can measure the significance of the result) of the different variables are repetition of word (<.01), repetition of phrase (<.025), responsive naming (<.005) and confrontation naming (<.01). This means that MIT was effective for patients with non-fluent aphasia. Overall, the study findings were statistically significant at p < .01.

Conclusion: MIT has a positive and significant effect on the improvement of repetition of word, repetition of phrase, responsive naming and confrontation naming in this particular study. For long term effectiveness MIT program should be started as early as possible as part of best practice for patients with non-fluent aphasia.