A Systematic Review of Maintenance Following Intensive Therapy Programs in Chronic Post-Stroke Aphasia: Importance of Individual Response Analysis

Disability and Rehabilitation

Menahemi-Falkov, M., Breitenstein, C., et al. (2022).

Disability and Rehabilitation, 44(20), 5811-5826.

This systematic review investigates the effects of behavioral aphasia treatments on language and/or communication and quality of life outcomes in adults with chronic stoke-induced aphasia.

National Health and Medical Research Council (Australia)

Through December 10, 2020

Peer-reviewed studies (not further specified)

44

For post-stroke adults with chronic aphasia, six out of eight group studies investigating verbal and multi-modal intensive aphasia therapy types reported statistically significant improvements and maintenance effects for within-subject group comparisons. At the initial follow-up evaluation after therapy (mean=8.34 weeks), 70.42% of clients demonstrated maintenance of impairment based outcome gains. At 20.62 weeks follow-up, 68.8% of clients showed maintenance of activity and participation gains. At 24 weeks follow-up, 53.33% of clients reported a maintenance of quality of life improvements. When the authors calculated minimal detectable change for individual patient data, only 22% of participants demonstrated significant gains after intensive aphasia therapy programs for language and/or communication and maintained that gain at follow-up. Clients were more likely to show later loss of therapy gains at follow-up if they had showed lower initial gains from therapy, had moderate-severe aphasia, and/or demonstrated reduced executive function skills post-stroke. Additional research on intensive aphasia treatment outcomes and follow-up maintenance is needed.