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Speech and language therapy for aphasia following stroke.

Abstract

BACKGROUND

Aphasia describes language impairment associated with a brain lesion.

OBJECTIVES

The objective of this review was to assess the effects of formal speech and language therapy and non-professional types of support from untrained providers for people with aphasia after stroke.

SEARCH STRATEGY

We searched the Cochrane Stroke Group Trials Register (last searched: March 1999), and reference lists of relevant articles to December 1998. We also contacted academic institutions and other researchers to identify further published and unpublished trials. We searched The International Journal of Disorders of Communication by hand (known by other names in the past), from 1969 to 1998. Date of most recent searches: January 1999.

SELECTION CRITERIA

Randomised controlled trials comparing: 1. Any type of formal speech and language therapy in any setting administered by trained speech and language therapists versus no treatment. 2. Any type of formal speech and language therapy in any setting administered by trained speech and language therapists versus any type of informal support for aphasia, given by speech and language therapists or volunteers, whether these were trained or untrained. 3. One type of speech and language therapy versus another type. Outcome measures included measures of any type of communication, other measures of functioning, numbers of drop-outs, and other non-clinical outcomes.

DATA COLLECTION AND ANALYSIS

The principal reviewer collected the data, and assessed the quality of the trials with independent data checking and methodological advice. If we could not perform a statistical combination of different studies, we sought missing data. Failing that we provided a description.

MAIN RESULTS

We considered sixty studies in detail, from which we identified twelve trials suitable for the review. Most of these trials were relatively old with poor or unassessable methodological quality. None of the trials was detailed enough for us to complete description and analysis. We could not determine whether formal speech and language therapy is more effective than informal support.

REVIEWER'S CONCLUSIONS

The main conclusion of this review is that speech and language therapy treatment for people with aphasia after a stroke has not been shown either to be clearly effective or clearly ineffective within a RCT. Decisions about the management of patients must therefore be based on other forms of evidence. Further research is required to find out if effectiveness of speech and language therapy for aphasic patients is effective. If researchers choose to do a trial, this must be large enough to have adequate statistical power, and be clearly reported.

Authors+Show Affiliations

Health Services Research Unit, University of Aberdeen, Polwarth Building, Foresterhill, Aberdeen, UK, AB25 2ZD. j.greener@abdn.ac.ukNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Review
Systematic Review

Language

eng

PubMed ID

10796360

Citation

Greener, J, et al. "Speech and Language Therapy for Aphasia Following Stroke." The Cochrane Database of Systematic Reviews, 2000, p. CD000425.
Greener J, Enderby P, Whurr R. Speech and language therapy for aphasia following stroke. Cochrane Database Syst Rev. 2000.
Greener, J., Enderby, P., & Whurr, R. (2000). Speech and language therapy for aphasia following stroke. The Cochrane Database of Systematic Reviews, (2), CD000425.
Greener J, Enderby P, Whurr R. Speech and Language Therapy for Aphasia Following Stroke. Cochrane Database Syst Rev. 2000;(2)CD000425. PubMed PMID: 10796360.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Speech and language therapy for aphasia following stroke. AU - Greener,J, AU - Enderby,P, AU - Whurr,R, PY - 2000/5/5/pubmed PY - 2000/7/8/medline PY - 2000/5/5/entrez SP - CD000425 EP - CD000425 JF - The Cochrane database of systematic reviews JO - Cochrane Database Syst Rev IS - 2 N2 - BACKGROUND: Aphasia describes language impairment associated with a brain lesion. OBJECTIVES: The objective of this review was to assess the effects of formal speech and language therapy and non-professional types of support from untrained providers for people with aphasia after stroke. SEARCH STRATEGY: We searched the Cochrane Stroke Group Trials Register (last searched: March 1999), and reference lists of relevant articles to December 1998. We also contacted academic institutions and other researchers to identify further published and unpublished trials. We searched The International Journal of Disorders of Communication by hand (known by other names in the past), from 1969 to 1998. Date of most recent searches: January 1999. SELECTION CRITERIA: Randomised controlled trials comparing: 1. Any type of formal speech and language therapy in any setting administered by trained speech and language therapists versus no treatment. 2. Any type of formal speech and language therapy in any setting administered by trained speech and language therapists versus any type of informal support for aphasia, given by speech and language therapists or volunteers, whether these were trained or untrained. 3. One type of speech and language therapy versus another type. Outcome measures included measures of any type of communication, other measures of functioning, numbers of drop-outs, and other non-clinical outcomes. DATA COLLECTION AND ANALYSIS: The principal reviewer collected the data, and assessed the quality of the trials with independent data checking and methodological advice. If we could not perform a statistical combination of different studies, we sought missing data. Failing that we provided a description. MAIN RESULTS: We considered sixty studies in detail, from which we identified twelve trials suitable for the review. Most of these trials were relatively old with poor or unassessable methodological quality. None of the trials was detailed enough for us to complete description and analysis. We could not determine whether formal speech and language therapy is more effective than informal support. REVIEWER'S CONCLUSIONS: The main conclusion of this review is that speech and language therapy treatment for people with aphasia after a stroke has not been shown either to be clearly effective or clearly ineffective within a RCT. Decisions about the management of patients must therefore be based on other forms of evidence. Further research is required to find out if effectiveness of speech and language therapy for aphasic patients is effective. If researchers choose to do a trial, this must be large enough to have adequate statistical power, and be clearly reported. SN - 1469-493X UR - https://www.unboundmedicine.com/medline/citation/10796360/Speech_and_language_therapy_for_aphasia_following_stroke_ L2 - https://doi.org/10.1002/14651858.CD000425 DB - PRIME DP - Unbound Medicine ER -
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