A comparison of aphasia therapy outcomes before and after a Very Early Rehabilitation programme following stroke
Version of Record online: 4 MAR 2014
© 2014 Royal College of Speech and Language Therapists
International Journal of Language & Communication Disorders
Volume 49, Issue 2, pages 149–161, March-April 2014
How to Cite
Godecke, E., Ciccone, N. A., Granger, A. S., Rai, T., West, D., Cream, A., Cartwright, J. and Hankey, G. J. (2014), A comparison of aphasia therapy outcomes before and after a Very Early Rehabilitation programme following stroke. International Journal of Language & Communication Disorders, 49: 149–161. doi: 10.1111/1460-6984.12074
- Issue online: 4 MAR 2014
- Version of Record online: 4 MAR 2014
- Manuscript Accepted: NOV 2013
- Manuscript Received: JAN 2013
- State Health and Research Advisory Council (SHRAC) Research Translation Project. Grant Number: RSD-02720
- Very Early Rehabilitation;
Very early aphasia rehabilitation studies have shown mixed results. Differences in therapy intensity and therapy type contribute significantly to the equivocal results.
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.