Jade Dignam1, David Copland2, Eril McKinnon2, Penni Burfein2, Kate O'Brien2, Anna Farrell2, Amy D Rodriguez2. 1. From the UQ Centre for Clinical Research (J.D., D.C., K.O., A.D.R.) and NHMRC Centre of Clinical Research Excellence in Aphasia Rehabilitation, School of Health and Rehabilitation Sciences (J.D., D.C., E.M., A.D.R.), The University of Queensland, Brisbane, Queensland, Australia; and Speech Pathology Department, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia (J.D., P.B., A.F.). j.dignam@uq.edu.au. 2. From the UQ Centre for Clinical Research (J.D., D.C., K.O., A.D.R.) and NHMRC Centre of Clinical Research Excellence in Aphasia Rehabilitation, School of Health and Rehabilitation Sciences (J.D., D.C., E.M., A.D.R.), The University of Queensland, Brisbane, Queensland, Australia; and Speech Pathology Department, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia (J.D., P.B., A.F.).
Abstract
BACKGROUND AND PURPOSE: Most studies comparing different levels of aphasia treatment intensity have not controlled the dosage of therapy provided. Consequently, the true effect of treatment intensity in aphasia rehabilitation remains unknown. Aphasia Language Impairment and Functioning Therapy is an intensive, comprehensive aphasia program. We investigated the efficacy of a dosage-controlled trial of Aphasia Language Impairment and Functioning Therapy, when delivered in an intensive versus distributed therapy schedule, on communication outcomes in participants with chronic aphasia. METHODS: Thirty-four adults with chronic, poststroke aphasia were recruited to participate in an intensive (n=16; 16 hours per week; 3 weeks) versus distributed (n=18; 6 hours per week; 8 weeks) therapy program. Treatment included 48 hours of impairment, functional, computer, and group-based aphasia therapy. RESULTS: Distributed therapy resulted in significantly greater improvements on the Boston Naming Test when compared with intensive therapy immediately post therapy (P=0.04) and at 1-month follow-up (P=0.002). We found comparable gains on measures of participants' communicative effectiveness, communication confidence, and communication-related quality of life for the intensive and distributed treatment conditions at post-therapy and 1-month follow-up. CONCLUSIONS: Aphasia Language Impairment and Functioning Therapy resulted in superior clinical outcomes on measures of language impairment when delivered in a distributed versus intensive schedule. The therapy progam had a positive effect on participants' functional communication and communication-related quality of life, regardless of treatment intensity. These findings contribute to our understanding of the effect of treatment intensity in aphasia rehabilitation and have important clinical implications for service delivery models.
BACKGROUND AND PURPOSE: Most studies comparing different levels of aphasia treatment intensity have not controlled the dosage of therapy provided. Consequently, the true effect of treatment intensity in aphasia rehabilitation remains unknown. Aphasia Language Impairment and Functioning Therapy is an intensive, comprehensive aphasia program. We investigated the efficacy of a dosage-controlled trial of Aphasia Language Impairment and Functioning Therapy, when delivered in an intensive versus distributed therapy schedule, on communication outcomes in participants with chronic aphasia. METHODS: Thirty-four adults with chronic, poststroke aphasia were recruited to participate in an intensive (n=16; 16 hours per week; 3 weeks) versus distributed (n=18; 6 hours per week; 8 weeks) therapy program. Treatment included 48 hours of impairment, functional, computer, and group-based aphasia therapy. RESULTS: Distributed therapy resulted in significantly greater improvements on the Boston Naming Test when compared with intensive therapy immediately post therapy (P=0.04) and at 1-month follow-up (P=0.002). We found comparable gains on measures of participants' communicative effectiveness, communication confidence, and communication-related quality of life for the intensive and distributed treatment conditions at post-therapy and 1-month follow-up. CONCLUSIONS:Aphasia Language Impairment and Functioning Therapy resulted in superior clinical outcomes on measures of language impairment when delivered in a distributed versus intensive schedule. The therapy progam had a positive effect on participants' functional communication and communication-related quality of life, regardless of treatment intensity. These findings contribute to our understanding of the effect of treatment intensity in aphasia rehabilitation and have important clinical implications for service delivery models.
Authors: Maya L Henry; H Isabel Hubbard; Stephanie M Grasso; Heather R Dial; Pélagie M Beeson; Bruce L Miller; Maria Luisa Gorno-Tempini Journal: J Speech Lang Hear Res Date: 2019-08-07 Impact factor: 2.297
Authors: Bruce Crosson; Amy D Rodriguez; David Copland; Julius Fridriksson; Lisa C Krishnamurthy; Marcus Meinzer; Anastasia M Raymer; Venkatagiri Krishnamurthy; Alexander P Leff Journal: J Neurol Neurosurg Psychiatry Date: 2019-05-04 Impact factor: 10.154