Effectiveness of Speech Therapy for Aphasic Stroke Patients

Lincoln, Nadina B.; Mulley, Graham; Jones, Anna; McGuirk, Elizabeth; Lendrem, Wendy; Mitchell, J R A

doi:10.1016/s0140-6736(84)91690-8

Cited by 231 publications

(67 citation statements)

References 11 publications

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“…Two studies provided their results in graph format. 10,11 The bitmap coordinates of the mean scores from these studies were recorded and their values calculated relative to the bitmap coordinates of the y axis. Eight studies, therefore, provided the appropriate data to allow determination of the relationship between intensity of therapy provided and outcome (see Table 2).…”

Section: Relationship Between Intensity Of Therapy Provided and Outcomentioning

confidence: 99%

Intensity of Aphasia Therapy, Impact on Recovery

Bhogal

Teasell

Speechley

2003

Stroke

626

342

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Background-It has been speculated that the conflicting results demonstrated across poststroke aphasia therapy studies might be related to differences in intensity of therapy provided across studies. The aim of this study is to investigate the relationship between intensity of aphasia therapy and aphasia recovery. Methods-A MEDLINE literature search was conducted to retrieve clinical trials investigating aphasia therapy after stroke.Changes in mean scores from each study were recorded. Intensity of therapy was recorded in terms of length of therapy, hours of therapy provided per week, and total hours of therapy provided. Pearson correlation was used to assess the relationship between changes in mean scores of outcome measures and intensity of therapy. Results-Studies that demonstrated a significant treatment effect provided 8.8 hours of therapy per week for 11.2 weeks versus the negative studies that only provided Ϸ2 hours per week for 22.9 weeks. On average, positive studies provided a total of 98.4 hours of therapy, whereas negative studies provided 43.6 hours of therapy. Total length of therapy time was found to be inversely correlated with hours of therapy provided per week (Pϭ0.003) and total hours of therapy provided (Pϭ0.001). define aphasia as "the loss of ability to communicate orally, through signs, or in writing, or the inability to understand such communications; the loss of language usage ability." Darley 2 noted that aphasia is generally described as an impairment of language resulting from focal brain damage to the language-dominant cerebral hemisphere. This serves to distinguish aphasia from the language and cognitivecommunication problems associated with non-languagedominant hemisphere damage, dementia, and traumatic brain injury. 3 However, defining aphasia as purely a disorder of language may oversimplify a complex clinical entity. Kertesz 4 clinically described aphasia as a "neurologically central disturbance of language characterized by paraphasias, word finding difficulty, and variably impaired comprehension, associated with disturbance of reading and writing, at times with dysarthria, non-verbal constructional and problemsolving difficulty and impairment of gesture."The most effective means of treating aphasia after stroke has yet to be determined, and studies investigating the efficacy of speech and language therapy (SLT) for patients See Editorial Comment, page 992 suffering aphasia after stroke have yielded conflicting results. One possible explanation for the observed heterogeneity of findings across studies is a difference in intensity of therapy. 5,6 We have noted that the failure to identify a consistent benefit might have been due to the low intensity of SLT applied in the negative studies, whereas higher intensities of therapy were present in positive studies. 7 A meta-analysis that included all patients suffering from aphasia, not just stroke patients, revealed that the more intensive the therapy, the greater the improvement. 8 The objective of the present study is to investiga...

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Section: Relationship Between Intensity Of Therapy Provided and Outcomentioning

confidence: 99%

Intensity of Aphasia Therapy, Impact on Recovery

Bhogal

Teasell

Speechley

2003

Stroke

626

342

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“…During that time at least 20 large-scale group treatment studies, enrolling 60 or more patients, and several smaller group studies including at least 10 participants, were published (see, for example, Basso, Capitani, & Vignolo, 1979;Vignolo, 1964;Wertz et al, 1986). Unlike the findings of psychotherapy studies, the results of these group studies largely showed that treatment results in general improvement in language, although, in some cases the treatment effects were not particularly strong or were lacking (Lincoln et al, 1984). However, like the psychotherapy literature, the treatment provided was only vaguely described, for example, Vignolo (1964) provided "traditional" treatment, or was unspecified (Lincoln et al, 1984), and often the clinicians delivering the treatment varied within studies.…”

Section: A Bit Of Historymentioning

confidence: 99%

“…Unlike the findings of psychotherapy studies, the results of these group studies largely showed that treatment results in general improvement in language, although, in some cases the treatment effects were not particularly strong or were lacking (Lincoln et al, 1984). However, like the psychotherapy literature, the treatment provided was only vaguely described, for example, Vignolo (1964) provided "traditional" treatment, or was unspecified (Lincoln et al, 1984), and often the clinicians delivering the treatment varied within studies. Therefore, it is impossible to glean from such studies what treatment variables affected language improvement, and, in addition, the treatment is impossible to replicate.…”

Section: A Bit Of Historymentioning

confidence: 99%

Single subject controlled experiments in aphasia: The science and the state of the science

Thompson

2006

Journal of Communication Disorders

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This paper discusses the use of single subject controlled experimental designs for investigating the effect of treatment for aphasia. A brief historical perspective is presented, followed by discussions of the advantages and disadvantages of single subject and group approaches, the basic requirements of single subject experimental research, and crucial considerations in design selection. In the final sections, results of reviews of published single subject controlled experiments are discussed, with emphasis on internal validity issues, the number of participants enrolled in published studies, operational specification of the dependent and independent variables, and reliability of measurement.

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“…The reaction to stop referrals to SL therapy following the 1984 trial's 73 negative findings arguably set back service development, as RCTs were largely avoided by aphasia researchers until recently. ACT NoW answers several questions very well but should not be used to address others outside its remit.…”

Section: Implications For Clinical Practicementioning

confidence: 99%

Clinical effectiveness, cost-effectiveness and service users’ perceptions of early, well-resourced communication therapy following a stroke: a randomised controlled trial (the ACT NoW Study).

Bowen

Hesketh²,

Patchick³

et al. 2012

Health Technol Assess

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on behalf of the ACT NoW investigatorsHow to obtain copies of this and other HTA programme reports An electronic version of this title, in Adobe Acrobat format, is available for downloading free of charge for personal use from the HTA website (www.hta.ac.uk). A fully searchable DVD is also available (see below).Printed copies of HTA journal series issues cost £20 each (post and packing free in the UK) to both public and private sector purchasers from our despatch agents.Non-UK purchasers will have to pay a small fee for post and packing. For European countries the cost is £2 per issue and for the rest of the world £3 per issue. How to order:-fax (with credit card details) -post (with credit card details or cheque) -phone during office hours (credit card only).Additionally the HTA website allows you to either print out your order or download a blank order form. Contact details are as follows:Synergie UK (HTA Department) Digital House, The Loddon Centre Wade Road Basingstoke Hants RG24 8QW Email: orders@hta.ac.uk Tel: 0845 812 4000 -ask for 'HTA Payment Services' (out-of-hours answer-phone service) Fax: 0845 812 4001 -put 'HTA Order' on the fax header Payment methods Paying by chequeIf you pay by cheque, the cheque must be in pounds sterling, made payable to University of Southampton and drawn on a bank with a UK address.Paying by credit card You can order using your credit card by phone, fax or post. SubscriptionsNHS libraries can subscribe free of charge. Public libraries can subscribe at a reduced cost of £100 for each volume (normally comprising 40-50 titles). The commercial subscription rate is £400 per volume (addresses within the UK) and £600 per volume (addresses outside the UK). Please see our website for details. Subscriptions can be purchased only for the current or forthcoming volume.How do I get a copy of HTA on DVD?Please use the form on the HTA website (www.hta.ac.uk/htacd/index.shtml). HTA on DVD is currently free of charge worldwide.The website also provides information about the HTA programme and lists the membership of the various committees. HTA NIHR Health Technology Assessment programmeThe Health Technology Assessment (HTA) programme, part of the National Institute for Health Research (NIHR), was set up in 1993. It produces high-quality research information on the effectiveness, costs and broader impact of health technologies for those who use, manage and provide care in the NHS. 'Health technologies' are broadly defined as all interventions used to promote health, prevent and treat disease, and improve rehabilitation and long-term care. The research findings from the HTA programme directly influence decision-making bodies such as the National Institute for Health and Clinical Excellence (NICE) and the National Screening Committee (NSC). HTA findings also help to improve the quality of clinical practice in the NHS indirectly in that they form a key component of the 'National Knowledge Service' . The HTA programme is needs led in that it fills gaps in the evidence needed by the NHS. There a...

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Effectiveness of Speech Therapy for Aphasic Stroke Patients

Cited by 231 publications

References 11 publications

Intensity of Aphasia Therapy, Impact on Recovery

Intensity of Aphasia Therapy, Impact on Recovery

Single subject controlled experiments in aphasia: The science and the state of the science

Clinical effectiveness, cost-effectiveness and service users’ perceptions of early, well-resourced communication therapy following a stroke: a randomised controlled trial (the ACT NoW Study).

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