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Semin Speech Lang 2013; 34(03): 129-141
DOI: 10.1055/s-0033-1358369
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Amount of Therapy Matters in Very Early Aphasia Rehabilitation after Stroke: A Clinical Prognostic Model

Erin Godecke
1   Faculty of Health, Engineering and Science, Edith Cowan University, Joondalup, Western Australia, Australia
2   Stroke Unit, Royal Perth Hospital, Perth, Western Australia, Australia
3   Clinical Centre of Research Excellence in Aphasia Rehabilitation, Queensland, Australia
,
Tapan Rai
4   School of Mathematical Sciences, University of Technology Sydney, Sydney, New South Wales, Australia
,
Natalie Ciccone
1   Faculty of Health, Engineering and Science, Edith Cowan University, Joondalup, Western Australia, Australia
3   Clinical Centre of Research Excellence in Aphasia Rehabilitation, Queensland, Australia
,
Elizabeth Armstrong
1   Faculty of Health, Engineering and Science, Edith Cowan University, Joondalup, Western Australia, Australia
3   Clinical Centre of Research Excellence in Aphasia Rehabilitation, Queensland, Australia
,
Andrew Granger
5   Osborne Park Hospital, North Metropolitan Health Service, Osborne Park, Western Australia, Australia
,
Graeme J. Hankey
6   School of Medicine and Pharmacology, University of Western Australia, Perth, Western Australia, Australia
› Author Affiliations
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Publication History

Publication Date:
28 October 2013 (online)

Also available atMedOne
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Abstract

Background and Aim The effects of very early aphasia therapy on recovery are equivocal. This article examines predictors of very early aphasia recovery through statistical modeling.

Methods This study involved a secondary analysis of merged data from two randomized, single-blind trials conducted in Australian acute and subacute hospitals. Study 1 (n = 59) compared daily therapy to usual ward care for up to 4 weeks poststroke in patients with moderate to severe aphasia. Study 2 (n = 20) compared daily group therapy to daily individual therapy for 20 1-hour sessions over 5 weeks, in patients with mild to severe aphasia. The primary outcome measure was the Western Aphasia Battery Aphasia Quotient (AQ) at therapy completion. This analysis used regression modeling to examine the effects of age, baseline AQ and baseline modified Rankin Scale (mRS), average therapy amount, therapy intensity, and number of therapy sessions on aphasia recovery.

Results Baseline AQ (p = 0.047), average therapy amount (p = 0.030), and baseline mRS (p = 0.043) were significant predictors in the final regression model, which explained 30% (p < 0.001) of variance in aphasia recovery.

Conclusion The amount of very early aphasia therapy could significantly affect communication outcomes at 4 to 5 weeks poststroke. Further studies should include amount of therapy provided to enhance reliability of prognostic modeling in aphasia recovery.

Keywords

Very early rehabilitation - aphasia - stroke