Clinical Effectiveness of the Queen Square Intensive Comprehensive Aphasia Service for Patients With Poststroke Aphasia
Year: 2021
Type: article
Abstract: Background and Purpose: Poststroke aphasia has a major impact on peoples’ quality of life. Speech and language therapy interventions work, especially in high doses, but these doses are rarely achieved outside of research studies. Intensive Comprehensive Aphasia Programs (ICAPs) are an option to deliver high doses of therapy to people with aphasia over a short period of time. Methods: Forty-six people with aphasia in the chronic stage poststroke completed the ICAP over a 3-week period, attending for 15 days and averaging 6 hours of therapy per day. Outcome measures included the Comprehensive Aphasia Test, an impairment-based test of the 4 main domains of language (speaking, writing, auditory comprehension, and reading) which was measured at 3 time points (baseline, immediately posttreatment at 3 weeks and follow-up at 12-week post-ICAP); and, the Communicative Effectiveness Index, a carer-reported measure of functional communication skills collected at baseline and 12 weeks. Results: A 2-way repeated measures multivariate ANOVA was conducted. We found a significant domain-by-time interaction, F=12.7, P<0.0005, indicating that the ICAP improved people with aphasia’s language scores across all 4 domains, with the largest gains in speaking (Cohen’s d=1.3). All gains were maintained or significantly improved further at 12-week post-ICAP. Importantly, patients’ functional communication, as indexed by changes on the Communicative Effectiveness Index, also significantly improved at 12-week post-ICAP, t=5.4, P<0.0005, also with a large effect size (Cohen’s d=0.9). Conclusions: People with aphasia who participated in the Queen Square ICAP made large and clinically meaningful gains on both impairment-based and functional measures of language. Gains were sustained and in some cases improved further over the subsequent 12 weeks.
Source: Stroke
Authors: Alexander P. Leff, Sarah Nightingale, Beth Gooding, Jean Rutter, Nicola Craven, Makena Peart, Alice Dunstan, Amy Sherman, Andrew Paget, Morvwen Duncan, Jonathan Davidson, Naveen Kumar, Claire Farrington-Douglas, Camille Julien, Jennifer T. Crinion
Institutions: University College London Hospitals NHS Foundation Trust, UCL Queen Square Institute of Neurology, University College London, Barts Health NHS Trust, Royal London Hospital, City, University of London, City St George's, University of London, Homerton University Hospital NHS Foundation Trust, Great Ormond Street Hospital for Children NHS Foundation Trust
Language: English
Subfield: Cognitive Neuroscience
Field: Neuroscience
Domain: Life Sciences
Open Access status: hybrid
Awards: Mechanisms underlying spoken language production: facilitating frontal brain networks following aphasic stroke. ., Mechanisms underlying spoken language production: facilitating frontal brain networks following aphasic stroke. ., Digital neuro-interventions to enhance re-learning in patients with acquired and degenerative brain diseases
OpenAlex ID: W3171947979