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  Efficacy of intensive aphasia therapy in patients with chronic stroke: A randomised controlled trial

Stahl, B., Mohr, B., Büscher, V., Dreyer, F. R., Lucchese, G., & Pulvermüller, F. (2018). Efficacy of intensive aphasia therapy in patients with chronic stroke: A randomised controlled trial. Journal of Neurology, Neurosurgery & Psychiatry, 89(6), 586-592. doi:10.1136/jnnp-2017-315962.

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Item Permalink: http://hdl.handle.net/11858/00-001M-0000-002E-30BA-6 Version Permalink: http://hdl.handle.net/21.11116/0000-0003-9DB8-D
Genre: Journal Article

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 Creators:
Stahl, Benjamin1, 2, 3, 4, Author              
Mohr, Bettina5, Author
Büscher, Verena6, Author
Dreyer, Felix R.6, Author
Lucchese, Guglielmo2, 6, Author
Pulvermüller, Friedemann6, 7, Author
Affiliations:
1Department of Neurology, Charité University Medicine Berlin, Germany, ou_persistent22              
2Department of Neurology, University Medicine of Greifswald, Germany, ou_persistent22              
3Department Neurophysics (Weiskopf), MPI for Human Cognitive and Brain Sciences, Max Planck Society, Leipzig, DE, ou_2205649              
4Psychologische Hochschule Berlin, Germany, ou_persistent22              
5Department Psychiatry, Charité University Medicine Berlin, Germany, ou_persistent22              
6Brain Language Laboratory, Department of Philosophy and Humanities, FU Berlin, Germany, ou_persistent22              
7Berlin School of Mind and Brain, Humboldt University Berlin, Germany, ou_persistent22              

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Free keywords: Aphasia; Stroke; Treatment Intensity; Intensive Language-Action Therapy (ILAT); Constraint-Induced Aphasia Therapy (CIAT)
 Abstract: Objective. Recent evidence has fuelled the debate on the role of massed practice in the rehabilitation of chronic post-stroke aphasia. Here, we further determined the optimal daily dosage and total duration of intensive speech-language therapy. Methods. Individuals with chronic aphasia more than 1 year post-stroke received Intensive Language-Action Therapy in a randomised, parallel-group, blinded-assessment, controlled trial. Participants were randomly assigned to one of two outpatient groups who engaged in either highly-intensive practice (Group I: 4 hours daily) or moderately-intensive practice (Group II: 2 hours daily). Both groups went through an initial waiting period and two successive training intervals. Each phase lasted 2 weeks. Co-primary endpoints were defined after each training interval. Results. Thirty patients—15 per group—completed the study. A primary outcome measure (Aachen Aphasia Test) revealed no gains in language performance after the waiting period, but indicated significant progress after each training interval (gradual 2-week t-score change [CI]: 1.7 [±0.4]; 0.6 [±0.5]), independent of the intensity level applied (4-week change in Group I: 2.4 [±1.2]; in Group II: 2.2 [±0.8]). A secondary outcome measure (Action Communication Test) confirmed these findings in the waiting period and in the first training interval. In the second training interval, however, only patients with moderately-intensive practice continued to make progress (Time-by-Group interaction: P=0.009, η2=0.13). Conclusions. Our results suggest no added value from more than 2 hours of daily speech-language therapy within 4 weeks. Instead, these results demonstrate that even a small 2-week increase in treatment duration contributes substantially to recovery from chronic post-stroke aphasia.

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Language(s): eng - English
 Dates: 2017-11-132017-03-012017-11-142017-12-222018-06-01
 Publication Status: Published in print
 Pages: -
 Publishing info: -
 Table of Contents: -
 Rev. Type: Peer
 Identifiers: DOI: 10.1136/jnnp-2017-315962
PMID: 29273692
PMC: PMC6031278
Other: Epub 2017
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Project name : -
Grant ID : PU 97/15-1
Funding program : -
Funding organization : Deutsche Forschungsgemeinschaft (DFG)
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Grant ID : -
Funding program : -
Funding organization : Deutscher Akademischer Austauschdienst e.V.

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Title: Journal of Neurology, Neurosurgery & Psychiatry
Source Genre: Journal
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Affiliations:
Publ. Info: London : British Medical Association
Pages: - Volume / Issue: 89 (6) Sequence Number: - Start / End Page: 586 - 592 Identifier: ISSN: 0022-3050
CoNE: https://pure.mpg.de/cone/journals/resource/111085522793000