Aphasia rehabilitation: a Cochrane Systematic Review of the evidence for Speech and Language Therapy (SLT) compared with no SLT

M. C. Brady, H. Kelly, P. Enderby

Research output: Chapter in Book/Report/Conference proceedingConference contribution

Abstract

Background: Each year more than 1 million Europeans experience a stroke. A third acquire aphasia, a language impairment affecting the expression and understanding of speech, reading and writing. The original Cochrane Review of SLT for aphasia after stroke (Greener et al., 1999) reviewed 12 trials but a lack of available data meant that the evidence was inconclusive. In this review update we identified and synthesised current evidence from 30 trials that compared SLT with a) no SLT, b) social support and stimulation, and c) different approaches to SLT. Here we report the evidence from (a). Methods: We searched the Cochrane Stroke Group Trials Register, MEDLINE and CINAHL, hand searched key journals, screened reference lists of relevant articles and contacted researchers to identify other published, unpublished and ongoing randomised controlled trials (RCTs) that compared SLT with no SLT. Two review authors independently extracted the data and assessed the quality of included trials. We sought missing data from trialists. Results: We included 14 randomised SLT versus no SLT comparisons (n = 1064). Approaches evaluated included “conventional”, computer-mediated, group, functional, intensive, operant training and volunteer-facilitated SLT. Outcomes measured included functional communication, receptive and expressive language, severity of impairment, psychosocial impact, number of drop-outs, compliance with allocated intervention and economic outcomes. A meta-analysis of four comparisons found that participants that received SLT had better receptive language scores than those that did not have SLT (MD 8.04, 95% CI [1.55, 14.52]) P = 0.02. We found no other evidence of between-group differences, though we noticed a promising consistency in the direction of the Results which favoured the provision of SLT. Conclusion: More data are required to inform this comparison. Improved design and reporting of trials in this field will further contribute to the evidence for SLT for aphasia following stroke.
Original languageEnglish
Title of host publicationCerebrovascular Diseases
Volume31
Edition2
DOIs
Publication statusPublished - May 2011

Keywords

  • Cochrane systematic reviews
  • aphasia
  • rehabiliation

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