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Speech and language therapy for aphasia following stroke.

Abstract

BACKGROUND

Aphasia is an acquired language impairment following brain damage which affects some or all language modalities: expression and understanding of speech, reading and writing. Approximately one-third of people who have a stroke experience aphasia.

OBJECTIVES

To assess the effectiveness of speech and language therapy (SLT) for aphasia following stroke.

SEARCH STRATEGY

We searched the Cochrane Stroke Group Trials Register (last searched April 2009), MEDLINE (1966 to April 2009) and CINAHL (1982 to April 2009). In an effort to identify further published, unpublished and ongoing trials we handsearched the International Journal of Language and Communication Disorders, searched reference lists of relevant articles and contacted other researchers and authors.

SELECTION CRITERIA

Randomised controlled trials comparing SLT versus no SLT, SLT versus social support or stimulation, and one SLT intervention versus another SLT intervention. SLT refers to a formal speech and language therapy intervention that aims to improve language and communication abilities and in turn levels of communicative activity and participation. Social support and stimulation refers to an intervention which provides social support or communication stimulation but does not include targeted therapeutic interventions. Direct comparisons of different SLT interventions refers to SLT interventions that differ in terms of duration, intensity, frequency or method of intervention or in the theoretical basis for the SLT approach.

DATA COLLECTION AND ANALYSIS

Two review authors independently extracted the data and assessed the quality of included trials. We sought missing data from study investigators if necessary.

MAIN RESULTS

We included 30 trials (41 paired comparisons) in the review: 14 subcomparisons (1064 participants) compared SLT with no SLT; six subcomparisons (279 participants) compared SLT with social support and stimulation; and 21 subcomparisons (732 participants) compared two approaches to SLT. In general, the trials randomised small numbers of participants across a range of characteristics (age, time since stroke and severity profiles), interventions and outcomes. Suitable statistical data were unavailable for several measures.

AUTHORS' CONCLUSIONS

This review shows some indication of the effectiveness of SLT for people with aphasia following stroke. We also observed a consistency in the direction of results which favoured intensive SLT over conventional SLT, though significantly more people withdrew from intensive SLT than conventional SLT. SLT facilitated by a therapist-trained and supervised volunteer appears to be as effective as the provision of SLT by a professional. There was insufficient evidence to draw any conclusions in relation to the effectiveness of one SLT approach over another.

Authors+Show Affiliations

(a) Nursing, Midwifery and Allied Health Professions Research Unit, University of Stirling, Stirling, UK, (b) Speech and Hearing Sciences, Queen Margaret University, Edinburgh, UK.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Meta-Analysis
Review
Systematic Review

Language

eng

PubMed ID

20464716

Citation

Kelly, Helen, et al. "Speech and Language Therapy for Aphasia Following Stroke." The Cochrane Database of Systematic Reviews, 2010, p. CD000425.
Kelly H, Brady MC, Enderby P. Speech and language therapy for aphasia following stroke. Cochrane Database Syst Rev. 2010.
Kelly, H., Brady, M. C., & Enderby, P. (2010). Speech and language therapy for aphasia following stroke. The Cochrane Database of Systematic Reviews, (5), CD000425. https://doi.org/10.1002/14651858.CD000425.pub2
Kelly H, Brady MC, Enderby P. Speech and Language Therapy for Aphasia Following Stroke. Cochrane Database Syst Rev. 2010 May 12;(5)CD000425. PubMed PMID: 20464716.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Speech and language therapy for aphasia following stroke. AU - Kelly,Helen, AU - Brady,Marian C, AU - Enderby,Pam, Y1 - 2010/05/12/ PY - 2010/5/14/entrez PY - 2010/5/14/pubmed PY - 2010/6/17/medline SP - CD000425 EP - CD000425 JF - The Cochrane database of systematic reviews JO - Cochrane Database Syst Rev IS - 5 N2 - BACKGROUND: Aphasia is an acquired language impairment following brain damage which affects some or all language modalities: expression and understanding of speech, reading and writing. Approximately one-third of people who have a stroke experience aphasia. OBJECTIVES: To assess the effectiveness of speech and language therapy (SLT) for aphasia following stroke. SEARCH STRATEGY: We searched the Cochrane Stroke Group Trials Register (last searched April 2009), MEDLINE (1966 to April 2009) and CINAHL (1982 to April 2009). In an effort to identify further published, unpublished and ongoing trials we handsearched the International Journal of Language and Communication Disorders, searched reference lists of relevant articles and contacted other researchers and authors. SELECTION CRITERIA: Randomised controlled trials comparing SLT versus no SLT, SLT versus social support or stimulation, and one SLT intervention versus another SLT intervention. SLT refers to a formal speech and language therapy intervention that aims to improve language and communication abilities and in turn levels of communicative activity and participation. Social support and stimulation refers to an intervention which provides social support or communication stimulation but does not include targeted therapeutic interventions. Direct comparisons of different SLT interventions refers to SLT interventions that differ in terms of duration, intensity, frequency or method of intervention or in the theoretical basis for the SLT approach. DATA COLLECTION AND ANALYSIS: Two review authors independently extracted the data and assessed the quality of included trials. We sought missing data from study investigators if necessary. MAIN RESULTS: We included 30 trials (41 paired comparisons) in the review: 14 subcomparisons (1064 participants) compared SLT with no SLT; six subcomparisons (279 participants) compared SLT with social support and stimulation; and 21 subcomparisons (732 participants) compared two approaches to SLT. In general, the trials randomised small numbers of participants across a range of characteristics (age, time since stroke and severity profiles), interventions and outcomes. Suitable statistical data were unavailable for several measures. AUTHORS' CONCLUSIONS: This review shows some indication of the effectiveness of SLT for people with aphasia following stroke. We also observed a consistency in the direction of results which favoured intensive SLT over conventional SLT, though significantly more people withdrew from intensive SLT than conventional SLT. SLT facilitated by a therapist-trained and supervised volunteer appears to be as effective as the provision of SLT by a professional. There was insufficient evidence to draw any conclusions in relation to the effectiveness of one SLT approach over another. SN - 1469-493X UR - https://www.unboundmedicine.com/medline/citation/20464716/Speech_and_language_therapy_for_aphasia_following_stroke_ L2 - https://doi.org/10.1002/14651858.CD000425.pub2 DB - PRIME DP - Unbound Medicine ER -