PMID- 33019888
OWN - NLM
STAT- MEDLINE
DCOM- 20211025
LR  - 20211025
IS  - 1747-4949 (Electronic)
IS  - 1747-4930 (Print)
IS  - 1747-4930 (Linking)
VI  - 16
IP  - 5
DP  - 2021 Jul
TI  - A randomized control trial of intensive aphasia therapy after acute stroke: The 
      Very Early Rehabilitation for SpEech (VERSE) study.
PG  - 556-572
LID - 10.1177/1747493020961926 [doi]
AB  - BACKGROUND: Effectiveness of early intensive aphasia rehabilitation after stroke 
      is unknown. The Very Early Rehabilitation for SpEech trial (VERSE) aimed to 
      determine whether intensive aphasia therapy, beginning within 14 days after 
      stroke, improved communication recovery compared to usual care. METHODS: 
      Prospective, randomized, single-blinded trial conducted at 17 acute-care 
      hospitals across Australia/New Zealand from 2014 to 2018. Participants with 
      aphasia following acute stroke were randomized to receive usual care (direct 
      usual care aphasia therapy), or one of two higher intensity regimens (20 sessions 
      of either non-prescribed (usual care-plus or prescribed (VERSE) direct aphasia 
      therapy). The primary outcome was improvement of communication on the Western 
      Aphasia Battery-Revised Aphasia Quotient (AQ) at 12 weeks after stroke. Our 
      pre-planned intention to treat analysis combined high intensity groups for the 
      primary outcome. FINDINGS: Among 13,654 acute stroke patients screened, 25% 
      (3477) had aphasia, of whom 25% (866) were eligible and 246 randomized to usual 
      care (n = 81; 33%), usual care-plus (n = 82; 33%) or VERSE (n = 83; 34%). At 12 
      weeks after stroke, the primary outcome was assessed in 217 participants (88%); 
      14 had died, 9 had withdrawn, and 6 were too unwell for assessment. Communication 
      recovery was 50.3% (95% CI 45.7-54.8) in the high intensity group (n = 147) and 
      52.1% (95% CI 46.1-58.1) in the usual care group (n = 70; difference -1.8, 95% CI 
      -8.7-5.0). There was no difference between groups in non-fatal or fatal adverse 
      events (p = 0.72). INTERPRETATION: Early, intensive aphasia therapy did not 
      improve communication recovery within 12 weeks post stroke compared to usual 
      care.
FAU - Godecke, Erin
AU  - Godecke E
AUID- ORCID: 0000-0002-7210-1295
AD  - School of Medical and Health Sciences, Edith Cowan University, Joondalup, 
      Australia.
AD  - Speech Pathology Department, Sir Charles Gairdner Hospital, Perth, Australia.
FAU - Armstrong, Elizabeth
AU  - Armstrong E
AUID- ORCID: 0000-0003-4469-1117
AD  - School of Medical and Health Sciences, Edith Cowan University, Joondalup, 
      Australia.
FAU - Rai, Tapan
AU  - Rai T
AD  - School of Mathematical and Physical Sciences, University of Technology NSW, 
      Broadway, Australia.
FAU - Ciccone, Natalie
AU  - Ciccone N
AUID- ORCID: 0000-0002-1822-7217
AD  - School of Medical and Health Sciences, Edith Cowan University, Joondalup, 
      Australia.
FAU - Rose, Miranda L
AU  - Rose ML
AUID- ORCID: 0000-0002-8892-0965
AD  - School of Allied Health, Human Services and Sport, La Trobe University, 
      Melbourne, Australia.
FAU - Middleton, Sandy
AU  - Middleton S
AUID- ORCID: 0000-0002-7201-4394
AD  - St Vincent's Health Australia, Sydney and Australian Catholic University, 
      Darlinghurst, Australia.
FAU - Whitworth, Anne
AU  - Whitworth A
AD  - Faculty of Health Sciences, Curtin University, Bentley, Australia.
FAU - Holland, Audrey
AU  - Holland A
AD  - Speech Language Pathology, University of Arizona, Tucson, AZ, USA.
FAU - Ellery, Fiona
AU  - Ellery F
AD  - Florey Institute of Neuroscience and Mental Health, The University of Melbourne, 
      Melbourne, Australia.
FAU - Hankey, Graeme J
AU  - Hankey GJ
AD  - Medical School, The University of Western Australia, Perth, Australia.
FAU - Cadilhac, Dominique A
AU  - Cadilhac DA
AUID- ORCID: 0000-0001-8162-682X
AD  - Stroke and Ageing Research, School of Clinical Science at Monash Health, Monash 
      University, Clayton, Australia.
FAU - Bernhardt, Julie
AU  - Bernhardt J
AUID- ORCID: 0000-0002-2787-8484
AD  - Florey Institute of Neuroscience and Mental Health, The University of Melbourne, 
      Melbourne, Australia.
CN  - VERSE Collaborative Group
LA  - eng
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
DEP - 20201006
PL  - United States
TA  - Int J Stroke
JT  - International journal of stroke : official journal of the International Stroke 
      Society
JID - 101274068
SB  - IM
MH  - *Aphasia/etiology
MH  - Humans
MH  - Prospective Studies
MH  - Speech
MH  - Speech Therapy
MH  - *Stroke/complications
MH  - *Stroke Rehabilitation
MH  - Treatment Outcome
PMC - PMC8267088
OTO - NOTNLM
OT  - Aphasia
OT  - communication
OT  - early
OT  - rehabilitation
OT  - stroke
OT  - therapy fidelity
EDAT- 2020/10/07 06:00
MHDA- 2021/10/26 06:00
PMCR- 2021/07/09
CRDT- 2020/10/06 05:23
PHST- 2020/10/07 06:00 [pubmed]
PHST- 2021/10/26 06:00 [medline]
PHST- 2020/10/06 05:23 [entrez]
PHST- 2021/07/09 00:00 [pmc-release]
AID - 10.1177_1747493020961926 [pii]
AID - 10.1177/1747493020961926 [doi]
PST - ppublish
SO  - Int J Stroke. 2021 Jul;16(5):556-572. doi: 10.1177/1747493020961926. Epub 2020 
      Oct 6.