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Summary of Systematic Review

Updated Evidence-Based Systematic Review: Effects of Intensity of Treatment and Constraint-Induced Language Therapy for Individuals with Stroke-Induced Aphasia
Cherney, L. R., Patterson, J. P., et al. (2010).
Rockville (MD): American Speech-Language-Hearing Association, 36 pages.  
 
This review meets the criteria for a high-quality evidence-based systematic review.
Indicators of Review Quality:
The review states a clearly focused question or aim Yes
Criteria for inclusion of studies are provided Yes
Search strategy is 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 Yes
Reviewed with the original review:
Cherney, L. R., Patterson, J. P., et al. (2008). Evidence-Based Systematic Review: Effects of Intensity of Treatment and Constraint-Induced Language Therapy for Individuals with Stroke-Induced Aphasia. Journal of Speech, Language, and Hearing Research, 51(5), 1282-1299.

Description:
This is an update of the Cherney et al. 2008 review of peer-reviewed studies investigating the effects of constraint-induced language therapy (CILT) and intensity of treatment for individuals with stroke-induced aphasia.

Question(s)/Aim(s) Addressed:
  1. What is the influence of treatment intensity on measures of language impairment and communication activity/participation for individuals with stroke-induced chronic and acute aphasia?
  2. What is the influence of constraint-induced language therapy on measures of language impairment and communication activity/participation for individuals with stroke-induced chronic and acute aphasia?
  3. What treatment outcomes are maintained following intensive language treatment of individuals with stroke-induced chronic aphasia?
  4. What treatment outcomes are maintained following constraint-induced language therapy for individuals with stroke-induced chronic aphasia?

Population:
Adults with stroke-induced aphasia.

Intervention/Assessment:
Intensive aphasia interventions and constraint-induced language therapy.

Number of Studies Included:
10 studies from the original review and 16 additional studies from the 2010 update

Years Included:
1990 to 2010

Conclusions:
Aphasia
  • Treatment
    • Language
      • Constraint-Induced Language Therapy (CILT)
        • This updated review identified 13 new studies pertaining to CILT, all contributing data to examine the effects of CILT on measures of language impairment. Six studies also examined the effects of CILT on measures of communication activity/participation and four examined treatment maintenance effects.
        • Findings from two efficacy studies favored CILT on various measures of language impairment and communication activity/participation, while findings from exploratory studies were mixed.
        • The conclusions from the updated review remains unchanged. Modest evidence supports the use of CILT for adults with stroke-induced aphasia. However given the small number of studies, range of methodological quality and range of participant characteristics and outcomes, these results are considered preliminary.
  • Service Delivery
    • Dosage
      • In the original review, modest treatment effects were found supporting more intensive language treatment for individuals with stroke-induced aphasia. However given the small number of studies, range of methodological quality and range of participant characteristics and outcomes, these results were considered preliminary.
      • The results from the updated review reported mixed findings on measures of language impairment. "These findings differ from the original review in which the majority of studies found increased treatment intensity to be associated with positive changes in outcome measures of language impairment" (p. 3-4).

Sponsoring Body:
American Speech-Language-Hearing Association

Keywords: Aphasia, Stroke, Constraint-Induced Language Treatment

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