Abstract

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.

RAS ID

18152

Document Type

Journal Article

Date of Publication

1-1-2014

Faculty

Faculty of Health, Engineering and Science

School

School of Psychology and Social Science

Copyright

free_to_read

Publisher

Wiley

Comments

This is the peer reviewed version of the following article: [Godecke E., Ciccone N.A., Granger A.S., Rai T., West D., Cream A., Cartwright J., & Hankey G.J. (2014). A comparison of aphasia therapy outcomes before and after a Very Early Rehabilitation programme following stroke. International Journal of Language and Communication Disorders, 49(2), 149-161], which has been published in final form here. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.

Download

Share

 
COinS
 

Link to publisher version (DOI)

10.1111/1460-6984.12074