The National Center for Evidence-Based Practice
in Communication Disorders
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Summary of Systematic Review

Rehabilitation of Aphasia: More Is Better
Bhogal, S. K., Teasell, R. W., et al. (2003).
Topics in Stroke Rehabilitation, 10(2), 66-76.  
Indicators of Review Quality:
The review states a clearly focused question or aim No
Criteria for inclusion of studies are provided No
Search strategy is described in sufficient detail for replication Yes
Included studies are assessed for study quality No
Quality assessments are reproducible No
Characteristics of the included studies are provided No

Description:
This is a review of studies investigating the effects of aphasia speech and language therapy on individuals post-stroke.

Question(s)/Aim(s) Addressed:
Question not specifically stated.

Population:
Persons with aphasia post-stroke.

Intervention/Assessment:
Constraint-induced language therapy (CILT) was examined separately from other treatment approaches, as was volunteer-delivered treatment.

Number of Studies Included:
Not stated.

Years Included:
1970 to June 2002

Conclusions:
Aphasia
  • Treatment
    • Language
      • Constraint-Induced Language Therapy (CILT) - Moderate evidence suggests that forced-use aphasia treatment is beneficial for improving speech and language outcomes in individuals with chronic aphasia.  
      • Writing Treatment - Moderate evidences suggests that group aphasia treatment for writing is less beneficial compared to individual treatment.  
  • Service Delivery
    • Dosage
      • Strong evidence supports intensive aphasia treatment over a short period of time to improve speech and language outcomes.
      • The authors found that studies demonstrating a significant treatment effect "provided an average of 8.8 hours of therapy per week for 11.2 weeks compared with the 4 negative studies that only provided two 1-hour sessions per week for 22.9 weeks" (p. 991).
    • Format
      • Moderate evidences suggests that group aphasia treatment for writing is less beneficial compared to individual treatment.
    • Provider
      • Strong evidence suggests that use of trained volunteers is beneficial when providing aphasia therapy and is equivalent to treatment provided by speech-language pathologists.

Sponsoring Body:
Ontario Ministry of Health and Long-Term Care; the Heart and Stroke Foundation of Ontario; Canadian Stroke Network

Keywords: Aphasia, Stroke, Service Delivery Models

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