Rotterdam Aphasia Therapy Study (RATS) – 3: “The efficacy of intensive cognitive-linguistic therapy in the acute stage of aphasia”; design of a randomised controlled trial

Abstract

BackgroundAphasia is a severely disabling condition occurring in 20 to 25% of stroke patients. Most patients with aphasia due to stroke receive speech and language therapy. Methodologically sound randomised controlled trials investigating the effect of specific interventions for patients with aphasia following stroke are scarce. The currently available evidence suggests that intensive speech and language therapy is beneficial for restoration of communication, but the optimal timing of treatment is as yet unclear.In the Rotterdam Aphasia Therapy Study-3 we aim to test the hypothesis that patients with aphasia due to stroke benefit more from early intensive cognitive-linguistic therapy than from deferred regular language therapy.Methods/designIn a single blinded, multicentre, randomised controlled trial, 150 patients with first ever aphasia due to stroke will be randomised within two weeks after stroke to either early intensive cognitive-linguistic therapy (Group A) or deferred regular therapy (Group B). Group A will start as soon as possible, at the latest two weeks after stroke, with a four week period of one hour a day treatment with cognitive-linguistic therapy. In Group B professional speech and language therapy is deferred for four weeks. After this period, patients will follow the conventional procedure of speech and language therapy. Participants will be tested with an extensive linguistic test battery at four weeks, three months and six months after inclusion. Primary outcome measure is the difference in score between the two treatment groups on the Amsterdam-Nijmegen Everyday Language Test, a measure of everyday verbal communication, four weeks after randomisation.Trial registrationThis trial is registered in the Dutch Trial Register (http://www.trialregister.nl), NTR3271.

Factors predicting post-stroke aphasia recovery

“…In summary the type, duration, intensity and earlier commencement of aphasia therapy may be considered a determinant factor for better recovery (David et al 1982). The 'Rotterdam Aphasia Therapy Study-3' when concluded may give a better insight into the role of early-intensive cognitive therapy compared to regular language therapy (Nouwens et al 2013). [For summary see Table 3] …”

An International Perspective on Quality of Life in Aphasia: A Survey of Clinician Views and Practices from Sixteen Countries

“…Indeed, there is limited evidence on what speech and language therapy programs lead to gains in quality of life. Encouragingly, currently ongoing trials include either generic (EuroQoL) [37] quality of life measures [38] or stroke- and aphasia-specific measures (SAQOL-39g) [39,40], so this evidence will soon begin to emerge. Additionally, other interventions have specifically targeted psychosocial well-being in people with aphasia [41,42].…”

Validation of a prediction model for long-term outcome of aphasia after stroke

“…For external validation of the SPEAK-model we used data from the Rotterdam Aphasia Therapy Study (RATS) – 3, a randomized controlled trial (RCT) studying the efficacy of early initiated intensive cognitive-linguistic treatment for aphasia due to stroke, conducted between 2012 and 2014 [ 21 , 22 ]. RATS-3 was approved by an independent medical ethical review board.…”