Efficacy of early cognitive-linguistic treatment and communicative treatment in aphasia after stroke: a randomised controlled trial (RATS-2)

Jong-Hagelstein, Marjolein; Sandt–Koenderman, W.M.E. van de; Prins, Niels D.; Dippel, Diederik W.J.; Koudstaal, Peter J.; Visch-Brink, Evy

doi:10.1136/jnnp.2010.210559

Cited by 45 publications

(40 citation statements)

References 25 publications

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“…particularly when considering the delicate nature of very early stroke recovery 1,4 and limitations in service delivery that many speech pathology services report. 24 Positive effects have been found from very early aphasia therapy in two small clinical randomised controlled trials 19,20 and from two trials in early recovery 25,26 . Yet few if any studies have included the amount of aphasia therapy in early aphasia recovery as a possible predictor in models of improved communication outcomes in post-stroke aphasia.…”

Section: Introductionmentioning

confidence: 99%

Amount of Therapy Matters in Very Early Aphasia Rehabilitation after Stroke: A Clinical Prognostic Model

et al. 2013

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Section: Introductionmentioning

confidence: 99%

Amount of Therapy Matters in Very Early Aphasia Rehabilitation after Stroke: A Clinical Prognostic Model

et al. 2013

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“…После перенесен-ного инсульта пациент, как правило, страдает не только от когнитивных расстройств, но и от эмоционального состоя-ния. Систематические клинические наблюдения [9] и сле-пые рандомизированные мультицентровые исследования [10] показывают, что работу с пациентами в остром пери-оде надо начинать с оказания психологической поддерж-ки, информирования и обучения пациента и его родствен-ников компенсаторным коммуникативным стратегиям. Это сформирует понимание ситуации и облегчит коммуника-цию между пациентом и окружающими его людьми.…”

Section: коррекция речевых расстройствunclassified

Speech Disorders and Their Correction in Post-Stroke Patients

Курушина¹,

Барулин²,

Куракова³

et al. 2017

Med. sov.

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Cтатья посвящена диагностике, классификации и реабилитации различных форм речевых нарушений у пациентов, пере-несших инсульт. Рассматриваются наиболее распространенные виды экспрессивных и импрессивных нарушений речи. Приведены основные диагностические признаки выделенных форм афазий и дизартрий. Предложен план программы реабилитации с включением как медикаментозных средств (Цераксон ® ), так и нефармакологических способов коррекции расстройств речи после инсульта.

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“…While preliminary research for early aphasia intervention has shown positive results (de Jong-Hagelstein et al 2011;Godecke et al 2012;Sickert et al 2013) there is no evidence (Brady et al 2012) to support the efficacy of very early post-stroke aphasia treatments in the long-term. This is a result of limitations in study methodology, difficulties with participant selection, reduced sample size, inconsistent application and description of aphasia therapy types and use of low intensity aphasia rehabilitation.…”

Section: Limitations Of Existing Aphasia Research and Future Researchmentioning

confidence: 99%

A comparison of aphasia therapy outcomes before and after a Very Early Rehabilitation programme following stroke

Godecke

Ciccone

Granger

et al. 2014

Intl J Lang & Comm Disor

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Background Very early aphasia rehabilitation studies have shown mixed results. Differences in therapy intensity and therapy type contribute significantly to the equivocal results. Aims 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). Methods & Procedures 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 (N = 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 (n = 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. Outcomes & Results 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. Conclusions & Implications 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.

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Efficacy of early cognitive-linguistic treatment and communicative treatment in aphasia after stroke: a randomised controlled trial (RATS-2)

Abstract: This study does not confirm the hypothesis that patients with aphasia after stroke benefit more from CLT, aimed at activation of the underlying semantic and phonologic processes, than from general, non-specific communicative treatment (ISRCTN67723958 Current Controlled Trials).

Cited by 45 publications

References 25 publications

Amount of Therapy Matters in Very Early Aphasia Rehabilitation after Stroke: A Clinical Prognostic Model

Amount of Therapy Matters in Very Early Aphasia Rehabilitation after Stroke: A Clinical Prognostic Model

Speech Disorders and Their Correction in Post-Stroke Patients

A comparison of aphasia therapy outcomes before and after a Very Early Rehabilitation programme following stroke

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