A comparison of aphasia therapy outcomes before and after a Very Early Rehabilitation programme following stroke. Issue 2 (March 2014)

• Record Type: Journal Article
• Authors: Godecke, Erin; Ciccone, Natalie A.; Granger, Andrew S.; Rai, Tapan; West, Deborah; Cream, Angela; Cartwright, Jade; Hankey, Graeme J.
• Is Part Of: International journal of language & communication disorders. Volume 49:Issue 2(2014)
• Page Start: 149
• Page End: 161
• Publication Date: 2014-03
• Subjects: Communicative disorders -- Periodicals; Speech therapy -- Periodicals; Speech disorders -- Periodicals; Language disorders -- Periodicals; 616.855
• DOI: 10.1111/1460-6984.12074
• Languages: English
• ISSNs: 1368-2822

Abstract

<abstract abstract-type="main"> <title>Abstract</title> <sec id="jlcd12074-sec-0010" sec-type="section"> <title>Background</title> <p>Very early aphasia rehabilitation studies have shown mixed results. Differences in therapy intensity and therapy type contribute significantly to the equivocal results.</p> </sec> <sec id="jlcd12074-sec-0020" sec-type="section"> <title>Aims</title> <p>To compare a standardized, prescribed very early aphasia therapy regimen with a historical usual care control group at therapy completion (4–5 weeks post‐stroke) and again at follow‐up (6 months).</p> </sec> <sec id="jlcd12074-sec-0030" sec-type="section"> <title>Methods & Procedures</title> <p>This study compared two cohorts from successive studies conducted in four Australian acute/sub‐acute hospitals. The studies had near identical recruitment, blinded assessment and data‐collection protocols. The Very Early Rehabilitation (VER) cohort (<italic>N</italic> = 20) had mild–severe aphasia and received up to 20 1‐h sessions of impairment‐based aphasia therapy, up to 5 weeks. The control cohort (<italic>n</italic> = 27) also had mild–severe aphasia and received usual care (UC) therapy for up to 4 weeks post‐stroke. The primary outcome measure was the Aphasia Quotient (AQ) and a measure of communicative efficiency (DA) at therapy completion. Outcomes were measured at baseline, therapy completion and 6 months post‐stroke and were compared using Generalised Estimating Equations (GEE) models.</p> </sec> <sec id="jlcd12074-sec-0040" sec-type="section"> <title>Outcomes & Results</title> <p>After controlling for initial aphasia and stroke disability, the GEE models demonstrated that at the primary end‐point participants receiving VER achieved 18% greater recovery on the AQ and 1.5% higher DA scores than those in the control cohort. At 6 months, the VER participants maintained a 16% advantage in recovery on the AQ and 0.6% more on DA scores over the control cohort participants.</p> </sec> <sec id="jlcd12074-sec-0050" sec-type="section"> <title>Conclusions & Implications</title> <p>A prescribed, impairment‐based aphasia therapy regimen, provided daily in very early post‐stroke recovery, resulted in significantly greater communication gains in people with mild–severe aphasia at completion of therapy and at 6 months, when compared with a historical control cohort. Further research is required to demonstrate large‐scale and long‐term efficacy.</p> </sec> </abstract>