Aphasia therapy in the acute hospital setting: Is it justified?

Introduction: Robey (1998) reported that people who receive intense aphasia therapy in the acute phase have more than twofold the improvement of those treated in the chronic phase. Despite such evidence, conjecture regarding the optimum timing, intensity and duration of rehabilitation persists (Kwakkel et al., 2004). Method: A prospective randomised, open labelled, single blinded study was conducted to determine the impact of daily aphasia therapy in the acute setting on communication outcomes at discharge and at 6 months post stroke. Participants (N = 59) were randomised to either daily or weekly therapy while in hospital (χ = 22 days). Results: A principal component analysis identified three clusters of outcome measures that displayed a significant between group difference at acute discharge and at 6 months. When stroke severity, initial aphasia severity and gender were controlled, patients who received daily therapy, showed significantly better outcomes than those who received weekly therapy. Results of a longitudinal random-effects regression analysis to determine prognostic factors influencing communication status at 6 months post stroke will be discussed. Conclusions: This study showed that despite large inter-subject variability, people with moderate-severe aphasia who received daily therapy in the acute hospital setting made significantly positive gains in effective communication skills at hospital discharge and that these gains were maintained at 6 months. This study showed that aphasia therapy in the acute hospital setting is beneficial and appropriate for people with moderate-severe aphasia. Discussion will focus on addressing who benefits from therapy and how much therapy is appropriate in the very early recovery phase. Godecke, E., Hird, K., & Lalor, E. (2008). Aphasia therapy in the acute hospital setting: Is it justified? Internal Medicine Journal, 38(Suppl 4), A88