Deans' stroke musings: Intensive Versus Distributed Aphasia Therapy

Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Thursday, June 25, 2015

Intensive Versus Distributed Aphasia Therapy

This seems odd.
http://stroke.ahajournals.org/content/early/2015/06/18/STROKEAHA.115.009522.abstract

A Nonrandomized, Parallel-Group, Dosage-Controlled Study

Jade Dignam, BSpPath,
David Copland, PhD,
Eril McKinnon, BSpPath,
Penni Burfein, BSpPath,
Kate O’Brien, BSpPath,
Anna Farrell, PhD and
Amy D. Rodriguez, PhD

+ Author Affiliations

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.).

Correspondence to Jade Dignam, BSpPath, UQ Centre for Clinical Research, The University of Queensland, Herston, Queensland, 4029 Australia. E-mail j.dignam@uq.edu.au

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.