Article  |   October 2008
Evidence-Based Systematic Review: Effects of Intensity of Treatment and Constraint-Induced Language Therapy for Individuals With Stroke-Induced Aphasia
Author Affiliations & Notes
  • Leora R. Cherney
    Rehabilitation Institute of Chicago, IL
  • Janet P. Patterson
    California State University, East Bay, Hayward, CA
  • Anastasia Raymer
    Old Dominion University, Norfolk, VA
  • Tobi Frymark
    American Speech-Language-Hearing Association, Rockville, MD
  • Tracy Schooling
    American Speech-Language-Hearing Association, Rockville, MD
  • Contact author: Tobi Frymark, National Center for Evidence-Based Practice in Communication Disorders, American Speech-Language-Hearing Association, 2200 Research Boulevard, Rockville, MD 20850. E-mail: tfrymark@asha.org.
Special Populations / Research Issues, Methods & Evidence-Based Practice / Language Disorders / Aphasia / Language
Article   |   October 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 October 2008, Vol.51, 1282-1299. doi:10.1044/1092-4388(2008/07-0206)
History: Accepted 24 Feb 2008 , Received 04 Sep 2007
Journal of Speech, Language, and Hearing Research October 2008, Vol.51, 1282-1299. doi:10.1044/1092-4388(2008/07-0206)
History: Accepted 24 Feb 2008 , Received 04 Sep 2007

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.

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