MedWire News: In stroke patients with moderate to severe aphasia, daily speech therapy begun very soon after the stroke event can improve communication to a greater degree than usual care, suggest study results.
Almost half of all stroke patients experience some degree of speech impairment, or aphasia, which can be persistent and debilitating and has a serious negative impact on the social and emotional well being of stroke survivors and their families.
Due to a lack of "high-quality" evidence, there is still some debate about the best way and optimum time period in which to treat aphasia, although evidence suggests that there may be an early "window of opportunity" for such treatment.
Writing in the International Journal of Stroke, Erin Godecke (Edith Cowan University, Joondalup Campus, Western Australia) and colleagues report the results of a study carried out to assess whether very early speech therapy (from a median of 3 days post stroke) can positively impact communication outcomes in patients with moderate to severe aphasia.
In total, 32 patients were randomly assigned to daily speech therapy (mean session time of 45.0 minutes), and 27 to usual care (one speech therapy session per week of approximately 10.5 minutes) during their time in hospital (median 19 days). The speech therapy included lexical-semantic therapy, mapping therapy, and semantic feature analysis, and followed general principles of neurorehabilitation.
The patients were aged 69.1 years on average and 90% had ischemic strokes. The researchers measured the aphasia quotient and functional communication profile of all the patients at a primary endpoint of hospital discharge, or 4-weeks post stroke, depending on which came first.
They found that the patients who underwent daily speech therapy (mean of 331 minutes of therapy in total) scored significantly more points on the aphasia quotient and functional communication profile at the primary endpoint than those receiving usual care, at a mean of 15.1 and 11.3 more points, respectively.
"Our study established that two and a half-hours of aphasia therapy per week, when commenced within the first-week poststroke is both feasible and beneficial for people with moderate-severe aphasia," write Godecke and team.
"This finding has important implications considering the general lack of aphasia services to people in the early recovery phase," they add.
"Now, the challenge is to find the right type of therapy provided in the right amount at the right time for the right person."
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