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Efficacy of intensive aphasia therapy in patients with chronic stroke: a randomised controlled trial
OBJECTIVE: Recent evidence has fuelled the debate on the role of massed practice in the rehabilitation of chronic post-stroke aphasia. Here, we further determined the optimal daily dosage and total duration of intensive speech-language therapy. METHODS: Individuals with chronic aphasia more than 1 y...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6031278/ https://www.ncbi.nlm.nih.gov/pubmed/29273692 http://dx.doi.org/10.1136/jnnp-2017-315962 |
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author | Stahl, Benjamin Mohr, Bettina Büscher, Verena Dreyer, Felix R Lucchese, Guglielmo Pulvermüller, Friedemann |
author_facet | Stahl, Benjamin Mohr, Bettina Büscher, Verena Dreyer, Felix R Lucchese, Guglielmo Pulvermüller, Friedemann |
author_sort | Stahl, Benjamin |
collection | PubMed |
description | OBJECTIVE: Recent evidence has fuelled the debate on the role of massed practice in the rehabilitation of chronic post-stroke aphasia. Here, we further determined the optimal daily dosage and total duration of intensive speech-language therapy. METHODS: Individuals with chronic aphasia more than 1 year post-stroke received Intensive Language-Action Therapy in a randomised, parallel-group, blinded-assessment, controlled trial. Participants were randomly assigned to one of two outpatient groups who engaged in either highly-intensive practice (Group I: 4 hours daily) or moderately-intensive practice (Group II: 2 hours daily). Both groups went through an initial waiting period and two successive training intervals. Each phase lasted 2 weeks. Co-primary endpoints were defined after each training interval. RESULTS: Thirty patients—15 per group—completed the study. A primary outcome measure (Aachen Aphasia Test) revealed no gains in language performance after the waiting period, but indicated significant progress after each training interval (gradual 2-week t-score change [CI]: 1.7 [±0.4]; 0.6 [±0.5]), independent of the intensity level applied (4-week change in Group I: 2.4 [±1.2]; in Group II: 2.2 [±0.8]). A secondary outcome measure (Action Communication Test) confirmed these findings in the waiting period and in the first training interval. In the second training interval, however, only patients with moderately-intensive practice continued to make progress (Time-by-Group interaction: P=0.009, η (2)=0.13). CONCLUSIONS: Our results suggest no added value from more than 2 hours of daily speech-language therapy within 4 weeks. Instead, these results demonstrate that even a small 2-week increase in treatment duration contributes substantially to recovery from chronic post-stroke aphasia. |
format | Online Article Text |
id | pubmed-6031278 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-60312782018-07-06 Efficacy of intensive aphasia therapy in patients with chronic stroke: a randomised controlled trial Stahl, Benjamin Mohr, Bettina Büscher, Verena Dreyer, Felix R Lucchese, Guglielmo Pulvermüller, Friedemann J Neurol Neurosurg Psychiatry Cognitive Neurology OBJECTIVE: Recent evidence has fuelled the debate on the role of massed practice in the rehabilitation of chronic post-stroke aphasia. Here, we further determined the optimal daily dosage and total duration of intensive speech-language therapy. METHODS: Individuals with chronic aphasia more than 1 year post-stroke received Intensive Language-Action Therapy in a randomised, parallel-group, blinded-assessment, controlled trial. Participants were randomly assigned to one of two outpatient groups who engaged in either highly-intensive practice (Group I: 4 hours daily) or moderately-intensive practice (Group II: 2 hours daily). Both groups went through an initial waiting period and two successive training intervals. Each phase lasted 2 weeks. Co-primary endpoints were defined after each training interval. RESULTS: Thirty patients—15 per group—completed the study. A primary outcome measure (Aachen Aphasia Test) revealed no gains in language performance after the waiting period, but indicated significant progress after each training interval (gradual 2-week t-score change [CI]: 1.7 [±0.4]; 0.6 [±0.5]), independent of the intensity level applied (4-week change in Group I: 2.4 [±1.2]; in Group II: 2.2 [±0.8]). A secondary outcome measure (Action Communication Test) confirmed these findings in the waiting period and in the first training interval. In the second training interval, however, only patients with moderately-intensive practice continued to make progress (Time-by-Group interaction: P=0.009, η (2)=0.13). CONCLUSIONS: Our results suggest no added value from more than 2 hours of daily speech-language therapy within 4 weeks. Instead, these results demonstrate that even a small 2-week increase in treatment duration contributes substantially to recovery from chronic post-stroke aphasia. BMJ Publishing Group 2018-06 2017-12-22 /pmc/articles/PMC6031278/ /pubmed/29273692 http://dx.doi.org/10.1136/jnnp-2017-315962 Text en © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted. This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ |
spellingShingle | Cognitive Neurology Stahl, Benjamin Mohr, Bettina Büscher, Verena Dreyer, Felix R Lucchese, Guglielmo Pulvermüller, Friedemann Efficacy of intensive aphasia therapy in patients with chronic stroke: a randomised controlled trial |
title | Efficacy of intensive aphasia therapy in patients with chronic stroke: a randomised controlled trial |
title_full | Efficacy of intensive aphasia therapy in patients with chronic stroke: a randomised controlled trial |
title_fullStr | Efficacy of intensive aphasia therapy in patients with chronic stroke: a randomised controlled trial |
title_full_unstemmed | Efficacy of intensive aphasia therapy in patients with chronic stroke: a randomised controlled trial |
title_short | Efficacy of intensive aphasia therapy in patients with chronic stroke: a randomised controlled trial |
title_sort | efficacy of intensive aphasia therapy in patients with chronic stroke: a randomised controlled trial |
topic | Cognitive Neurology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6031278/ https://www.ncbi.nlm.nih.gov/pubmed/29273692 http://dx.doi.org/10.1136/jnnp-2017-315962 |
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