Very Early Poststroke Aphasia Therapy: A Pilot Randomized Controlled Efficacy Trial

Abstract

Daily aphasia therapy in very early stroke recovery improved communication outcomes in people with moderate to severe aphasia.

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

“…The primary endpoint for this analysis was at therapy completion, which was a mean of 24 days (SD=12.3) post-stroke. These studies have been previously reported 19,20 and the merged data are outlined below.…”

“…The amount of intervention provided to the participants in these trials varied greatly and has been outlined in detail 19,20 . All direct therapy was provided by a trained speech and language therapist.…”

“…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.…”

“…Further description of the therapy provided to participants in each trial is outlined previously. 19,20 Trial 1: The treating therapists determined which therapy approach would be used and all therapies were provided as per published instructions. The therapies for the daily therapy group and the usual care group were Lexical-semantic (BOX) therapy, 28 Mapping Therapy 29 and Semantic Feature Analysis (SFA) 30 and adhered to principles of neurorehabilitation, incorporating repetitious trained activity together with facilitation of error-free learning.…”

“…The vast majority of this research, however, does not include people with aphasia in the very early (within two weeks) and early (two to six weeks) post-stroke recovery phases (See examples of studies investigating very early and early intervention). [13][14][15][16][17][18] Given the constant high demand for limited speech pathology services during (very) early recovery combined with the need to comply with health-funding regulators and the potential for therapy-induced recovery, 19,20 it is crucial that speech pathologists deliver evidence-based efficient and efficacious aphasia therapy interventions.…”