PMID- 24588906
OWN - NLM
STAT- MEDLINE
DCOM- 20141108
LR  - 20161125
IS  - 1460-6984 (Electronic)
IS  - 1368-2822 (Linking)
VI  - 49
IP  - 2
DP  - 2014 Mar-Apr
TI  - A comparison of aphasia therapy outcomes before and after a Very Early 
      Rehabilitation programme following stroke.
PG  - 149-61
LID - 10.1111/1460-6984.12074 [doi]
AB  - BACKGROUND: Very early aphasia rehabilitation studies have shown mixed results. 
      Differences in therapy intensity and therapy type contribute significantly to the 
      equivocal results. AIMS: To compare a standardized, prescribed very early aphasia 
      therapy regimen with a historical usual care control group at therapy completion 
      (4-5 weeks post-stroke) and again at follow-up (6 months). METHODS & PROCEDURES: 
      This study compared two cohorts from successive studies conducted in four 
      Australian acute/sub-acute hospitals. The studies had near identical recruitment, 
      blinded assessment and data-collection protocols. The Very Early Rehabilitation 
      (VER) cohort (N = 20) had mild-severe aphasia and received up to 20 1-h sessions 
      of impairment-based aphasia therapy, up to 5 weeks. The control cohort (n = 27) 
      also had mild-severe aphasia and received usual care (UC) therapy for up to 4 
      weeks post-stroke. The primary outcome measure was the Aphasia Quotient (AQ) and 
      a measure of communicative efficiency (DA) at therapy completion. Outcomes were 
      measured at baseline, therapy completion and 6 months post-stroke and were 
      compared using Generalised Estimating Equations (GEE) models. OUTCOMES & RESULTS: 
      After controlling for initial aphasia and stroke disability, the GEE models 
      demonstrated that at the primary end-point participants receiving VER achieved 
      18% greater recovery on the AQ and 1.5% higher DA scores than those in the 
      control cohort. At 6 months, the VER participants maintained a 16% advantage in 
      recovery on the AQ and 0.6% more on DA scores over the control cohort 
      participants. CONCLUSIONS & IMPLICATIONS: A prescribed, impairment-based aphasia 
      therapy regimen, provided daily in very early post-stroke recovery, resulted in 
      significantly greater communication gains in people with mild-severe aphasia at 
      completion of therapy and at 6 months, when compared with a historical control 
      cohort. Further research is required to demonstrate large-scale and long-term 
      efficacy.
CI  - (c) 2014 Royal College of Speech and Language Therapists.
FAU - Godecke, Erin
AU  - Godecke E
AD  - Faculty of Health, Engineering and Science, Edith Cowan University, Joondalup, 
      WA, Australia; Clinical Centre of Research Excellence in Aphasia Rehabilitation, 
      Brisbane, QLD, Australia.
FAU - Ciccone, Natalie A
AU  - Ciccone NA
FAU - Granger, Andrew S
AU  - Granger AS
FAU - Rai, Tapan
AU  - Rai T
FAU - West, Deborah
AU  - West D
FAU - Cream, Angela
AU  - Cream A
FAU - Cartwright, Jade
AU  - Cartwright J
FAU - Hankey, Graeme J
AU  - Hankey GJ
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Int J Lang Commun Disord
JT  - International journal of language & communication disorders
JID - 9803709
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Aphasia/*rehabilitation/therapy
MH  - Brain Ischemia/rehabilitation/therapy
MH  - Cerebral Hemorrhage/rehabilitation/therapy
MH  - Cohort Studies
MH  - Disability Evaluation
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Language Therapy/*methods
MH  - Male
MH  - Middle Aged
MH  - Speech Therapy/*methods
MH  - Stroke/therapy
MH  - *Stroke Rehabilitation
MH  - Time-to-Treatment
MH  - Treatment Outcome
OTO - NOTNLM
OT  - Very Early Rehabilitation
OT  - aphasia
OT  - stroke
EDAT- 2014/03/05 06:00
MHDA- 2014/11/09 06:00
CRDT- 2014/03/05 06:00
PHST- 2014/03/05 06:00 [entrez]
PHST- 2014/03/05 06:00 [pubmed]
PHST- 2014/11/09 06:00 [medline]
AID - 10.1111/1460-6984.12074 [doi]
PST - ppublish
SO  - Int J Lang Commun Disord. 2014 Mar-Apr;49(2):149-61. doi: 
      10.1111/1460-6984.12074.