Intense speech therapy shows potential in post-ischemic aphasia

By Peter Sergo, medwireNews Reporter

Patients who have post-stroke aphasia might achieve slightly enhanced improvement in language and functional communication if they receive intensive - versus regular - speech and language therapy (SLT), a study finds.

The detected improvement was nonsignificant, but the researchers explain in the International Journal of Language & Communication Disorders that this may well be due to the small sample size.

"No significant treatment differences were found… when analysed by intention to treat or by per protocol," write Isabel Pavão Martins (Lisbon Faculty of Medicine, Portugal) and colleagues.

"Nonetheless, there was a tendency for those in IT [intensive treatment group] to have higher score changes compared with RT [regular treatment group] when the analysis was restricted to the patients who completed the study."

The randomized, rater-blinded study involved 30 patients who experienced aphasia within 3 months of a left hemisphere ischemic stroke.

Patients in IT (n=15) received daily 2-hour SLT sessions, 5 days per week, for 10 weeks. The RT counterpart had 2 hours of SLT once a week for 50 weeks. Patients in both groups received a total of 100 hours of SLT and were evaluated at 10, 50, and 62 weeks.

Intention-to-treat analysis revealed that the proportion of responders (n=13 for IT, n=12 for RT) who achieved a 15% increase in the Aphasia quotient (AQ) from baseline to 50 weeks did not significantly differ between the RT (75%) and IT (69.2%).

The analysis also found a nonsignificant difference between the groups when comparing the change at patients' last assessment from their baseline in AQ and functional communication profile (FCP).

In a per-protocol analysis of 18 patients who completed the study, 15 achieved an AQ improvement of 15 points above baseline at 50 weeks - without significant group differences.

Although IT patients obtained higher AQ and FCP scores than RT patients in all re-evaluations, a nonsignificant main effect for treatment groups remained and no significant differences were observed between groups based on AQ and FCP when comparing baseline to 50- or 62-week performances.

"Although this is the first study that provided the same type and same number of hours of therapy to both treatment groups, its results are quite comparable with published clinical trials… showing a consistent direction favouring intensive treatment but not reaching statistical significance," conclude the authors.

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