Evidence-Based Systematic Review: Effects of Intensity of Treatment and Constraint-Induced Language Therapy for Individuals With Stroke-Induced Aphasia 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 ... Research Article
Research Article  |   October 01, 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.
Article Information
Special Populations / Language Disorders / Aphasia / Language / Research Articles
Research Article   |   October 01, 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: Received September 4, 2007 , Accepted February 24, 2008
 
Journal of Speech, Language, and Hearing Research, October 2008, Vol. 51, 1282-1299. doi:10.1044/1092-4388(2008/07-0206)
History: Received September 4, 2007; Accepted February 24, 2008
Web of Science® Times Cited: 126

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.

Acknowledgments
This EBSR was supported by ASHA’s National Center for Evidence-Based Practice in Communication Disorders (N-CEP), the Advisory Committee on Evidence-Based Practice in Communication Disorders, and ASHA’s Special Interest Division 2: Neurophysiology and Neurogenic Speech and Language Disorders. We thank the following individuals who contributed to the preparation of this article: Rob Mullen, N-CEP Director; Beverly Wang, N-CEP Information Manager; and Floyd Roye, N-CEP Project Administrator. All members of this evidence-based review panel agreed to declare no competing interests in relation to this article. No author had any paid consultancy or any other conflict of interest with this document. The first three authors contributed equally to the preparation of this article, and the order does not reflect any differences in contribution.
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