Summary of the Systematic Review

Article Citation

Speech and Language Therapy for Aphasia Following Stroke

Brady, M. C., Kelly, H., et al. (2016).
Cochrane Database of Systematic Reviews(6), CD000425.
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Sponsoring Body

The Cochrane Collaboration; Nursing, Midwifery and Allied Health Professions Research Unit (United Kingdom); Chief Scientist Office Scotland (United Kingdom)

Article Quality Ratings

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Indicators of Review Quality

  • Yes The review states a clearly focused question/aim.
  • Yes Criteria for inclusion of studies are provided.
  • Yes Search strategy described in sufficient detail for replication.
  • Yes Included studies are assessed for study quality.
  • Yes Quality assessments are reproducible.
  • Yes Characteristics of the included studies are provided.

Article Details

Description

This is an update of an original systematic review by Greener et al. (1999) and subsequent reviews by Kelly et al. (2010) and Brady et al. (2012). This is a review of randomized controlled trials investigating the effects of speech and language therapy intervention in adults with stroke-induced aphasia.

Questions/Aims Addressed

  1. Is speech and language treatment more effective than no speech and language treatment?
  2. Is speech and language treatment more effective than social support and stimulation?
  3. Is one speech and language treatment more effective than another speech and language treatment?

Population

Adults with aphasia as a result of stroke

Intervention/Assessment

Any speech-language therapy designed to improve language and communication

Number of Studies Included

57

Years Included

Up to September 2015


Conclusions from This Systematic Review

What are Conclusions?

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Treatment

A meta-analysis of nine randomized controlled trials found no difference in functional communication when comparing conventional speech and language treatment to speech and language treatment with social support and stimulation (e.g., adjunctive emotional, psychosocial support groups).

Keywords: Stroke, Aphasia

The findings from 38 randomized controlled trials comparing frequency and intensity concluded that functional communication was significantly better when patients received "therapy at a high intensity, high dose, or over a long duration compared to those that received therapy at a lower intensity, lower dose, or over a shorter period of time" (p. 2). However, further research is warranted due to confounding dropout rates and small number of participants.

Keywords: Stroke, Dosage (e.g. Frequency/Intensity), Dosage (e.g. Frequency/Intensity), Aphasia

The findings from 27 randomized controlled trials revealed that speech and language treatment was more effective than no treatment. Speech and language treatment "resulted in clinically and statistically significant benefits to patients' functional communication (standardised mean difference (SMD) 0.28, 95% confidence interval (CI) 0.06 to 0.49, P = 0.01), reading, writing, and expressive language" (p. 2). Further research is needed to determine if benefits are maintained at follow-up.

Keywords: Stroke, Aphasia

Service Delivery

The findings from 38 randomized controlled trials comparing frequency and intensity concluded that functional communication was significantly better when patients received "therapy at a high intensity, high dose, or over a long duration compared to those that received therapy at a lower intensity, lower dose, or over a shorter period of time" (p. 2). However, further research is warranted due to confounding dropout rates and small number of participants.

Keywords: Stroke, Dosage (e.g. Frequency/Intensity), Dosage (e.g. Frequency/Intensity), Aphasia

Go to Map

Treatment

A meta-analysis of nine randomized controlled trials found no difference in functional communication when comparing conventional speech and language treatment to speech and language treatment with social support and stimulation (e.g., adjunctive emotional, psychosocial support groups).

Keywords: Stroke, Aphasia

The findings from 38 randomized controlled trials comparing frequency and intensity concluded that functional communication was significantly better when patients received "therapy at a high intensity, high dose, or over a long duration compared to those that received therapy at a lower intensity, lower dose, or over a shorter period of time" (p. 2). However, further research is warranted due to confounding dropout rates and small number of participants.

Keywords: Stroke, Dosage (e.g. Frequency/Intensity), Dosage (e.g. Frequency/Intensity), Aphasia

The findings from 27 randomized controlled trials revealed that speech and language treatment was more effective than no treatment. Speech and language treatment "resulted in clinically and statistically significant benefits to patients' functional communication (standardised mean difference (SMD) 0.28, 95% confidence interval (CI) 0.06 to 0.49, P = 0.01), reading, writing, and expressive language" (p. 2). Further research is needed to determine if benefits are maintained at follow-up.

Keywords: Stroke, Aphasia

Service Delivery

The findings from 38 randomized controlled trials comparing frequency and intensity concluded that functional communication was significantly better when patients received "therapy at a high intensity, high dose, or over a long duration compared to those that received therapy at a lower intensity, lower dose, or over a shorter period of time" (p. 2). However, further research is warranted due to confounding dropout rates and small number of participants.

Keywords: Stroke, Dosage (e.g. Frequency/Intensity), Dosage (e.g. Frequency/Intensity), Aphasia

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