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A comparison of aphasia therapy outcomes before and after a Very Early Rehabilitation programme following stroke
Ciccone, Natalie A
;
West, Deborah
;
Rai, Tapan
;
Cartwright, Jade
;
Godecke, Erin
;
Hankey, Graeme J
;
Granger, Andrew S
;
Cream, Angela
In: Research outputs 2014 to 2021 (2014)
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.
Keyword:
80 and over
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[speech pathology]
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aged
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aphasia
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article
;
brain hemorrhage
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brain ischemia
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Cerebral Hemorrhage
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cerebrovascular accident
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cohort analysis
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Communication Sciences and Disorders
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disability
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Disability Evaluation
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female
;
follow up
;
Follow-Up Studies
;
human
;
Humans
;
Language Therapy
;
male
;
methodology
;
middle aged
;
speech therapy
;
stroke
;
time to treatment
;
Time-to-Treatment
;
treatment outcome
;
Very Early Rehabilitation
;
very elderly
URL:
https://ro.ecu.edu.au/cgi/viewcontent.cgi?article=1316&context=ecuworkspost2013
https://ro.ecu.edu.au/ecuworkspost2013/317
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