Distributed Aphasia Therapy Superior to Intensive

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For adults suffering from chronic aphasia after stroke, distributed therapy has better clinical outcomes than intensive therapy, according to a study published in Stroke.

Although previous studies have compared different levels of aphasia treatment intensity, they did not control the dosage of therapy provided. In this study, the researchers wanted to determine the true effect of treatment intensity on aphasia rehabilitation.

The study included 34 adults with chronic, post-stroke aphasia were randomized to either an intensive therapy program (16 hours per week for 3 weeks) or a distributed therapy program (6 hours per week for 8 weeks). The program, called Aphasia Language Impairment and Functioning Therapy, included 48 hours of impairment, functional, computer, and group-based therapy. The researchers looked at communication outcomes to see which treatment schedule was more effective.

Compared with intensive therapy, distributive therapy resulted in significantly greater improvements on the Boston Naming Test both immediately post therapy (P=0.04) and after one month (P=0.002). The researchers found that the results were similar for measures of participants’ communicative effectiveness, communication confidence, and communication-related quality of life both immediately post therapy and at one-month follow-up.

The researchers believe their results have important implications for how to best deliver aphasia treatment to patients.

Distributed Aphasia Therapy Superior to Intensive
Distributed Aphasia Therapy Superior to Intensive 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.

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