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J Speech Lang Hear Res. 2008 Oct;51(5):1282-99. doi: 10.1044/1092-4388(2008/07-0206).

Evidence-based systematic review: effects of intensity of treatment and constraint-induced language therapy for individuals with stroke-induced aphasia.

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1
National Center for Evidence-Based Practice in Communication Disorders, American Speech-Language-Hearing Association, 2200 Research Boulevard, Rockville, MD 20850, USA. tfrymark@asha.org

Abstract

PURPOSE:

This systematic review summarizes evidence for intensity of treatment and constraint-induced language therapy (CILT) on measures of language impairment and communication activity/participation in individuals with stroke-induced aphasia.

METHOD:

A systematic search of the aphasia literature using 15 electronic databases (e.g., PubMed, CINAHL) identified 10 studies meeting inclusion/exclusion criteria. A review panel evaluated studies for methodological quality. Studies were characterized by research stage (i.e., discovery, efficacy, effectiveness, cost-benefit/public policy research), and effect sizes (ESs) were calculated wherever possible.

RESULTS:

In chronic aphasia, studies provided modest evidence for more intensive treatment and the positive effects of CILT. In acute aphasia, 1 study evaluated high-intensity treatment positively; no studies examined CILT. Four studies reported discovery research, with quality scores ranging from 3 to 6 of 8 possible markers. Five treatment efficacy studies had quality scores ranging from 5 to 7 of 9 possible markers. One study of treatment effectiveness received a score of 4 of 8 possible markers.

CONCLUSION:

Although modest evidence exists for more intensive treatment and CILT for individuals with stroke-induced aphasia, the results of this review should be considered preliminary and, when making treatment decisions, should be used in conjunction with clinical expertise and the client's individual values.

PMID:
18812489
DOI:
10.1044/1092-4388(2008/07-0206)
[Indexed for MEDLINE]
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