Success rates of intensive aphasia therapy: real-world data from 448 patients between 2003 and 2020.

IF 4.8 2区 医学 Q1 CLINICAL NEUROLOGY Journal of Neurology Pub Date : 2024-11-01 Epub Date: 2024-05-20 DOI:10.1007/s00415-024-12429-7
Dorothea Peitz, Beate Schumann-Werner, Katja Hussmann, João Pinho, Hong Chen, Ferdinand Binkofski, Walter Huber, Klaus Willmes, Stefan Heim, Jörg B Schulz, Bruno Fimm, Cornelius J Werner
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Abstract

Background: Aphasia is a devastating consequence after stroke, affecting millions of patients each year. Studies have shown that intensive speech and language therapy (SLT) is effective in the chronic phase of aphasia. Leveraging a large single-center cohort of persons with aphasia (PWA) including patients also in the subacute phase, we assessed treatment effects of intensive aphasia therapy in a real-world setting.

Methods: Data were collected at the Aachen aphasia ward in Germany between 2003 and 2020. Immediate treatment responses across different language domains were assessed with the Aachen Aphasia Test (AAT) using single-case psychometrics, conducted before and after 6-7 weeks of intensive SLT (10 h per week, median (IQR) dosage = 68 (61-76)). We adjusted for spontaneous recovery in subacute patients. Differential treatment effects between subgroups of chronicity and predictors of therapy response were investigated.

Results: A total of 448 PWA were included (29% female, median (IQR) age = 54 (46-62) years, median (IQR) time post-onset = 11 (6-20) months) with 12% in the early subacute, 15% in the late subacute and 74% in the chronic phase of aphasia. The immediate responder rate was 59%. Significant improvements in all AAT subtests und subscales were observed hinting at broad effectiveness across language domains. The degree of therapy-induced improvement did not differ between the chronicity groups. Time post-onset, dosage of therapy and aphasia severity at the beginning of treatment were predictors of immediate treatment response.

Discussion: Intensive therapy protocols for aphasia after stroke are yielding substantial responder rates in a routine clinical setting including a wide range of patients.

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失语症强化治疗的成功率:2003 年至 2020 年间 448 名患者的真实数据。
背景:失语症是中风后的一种严重后果,每年影响数百万患者。研究表明,强化言语和语言治疗(SLT)对慢性阶段的失语症有效。我们利用一个大型单中心失语症患者(PWA)队列(包括处于亚急性阶段的患者),评估了在真实世界环境中强化失语症治疗的效果:2003年至2020年期间在德国亚琛失语症病房收集的数据。在接受 6-7 周强化 SLT(每周 10 小时,剂量中位数(IQR)= 68 (61-76))治疗前后,使用亚琛失语症测试(AAT)进行单病例心理测量,评估不同语言领域的即时治疗反应。我们对亚急性患者的自发恢复情况进行了调整。我们还调查了慢性亚组之间的治疗效果差异以及治疗反应的预测因素:共纳入 448 名 PWA(29% 为女性,年龄中位数(IQR)= 54(46-62)岁,发病后时间中位数(IQR)= 11(6-20)个月),其中 12% 属于亚急性早期,15% 属于亚急性晚期,74% 属于失语症慢性期。即时应答率为 59%。所有 AAT 分项测试和分量表都有显著改善,这表明该疗法在各个语言领域都有广泛的疗效。不同慢性期组的治疗改善程度并无差异。发病后的时间、治疗剂量和治疗开始时的失语严重程度是预测即时治疗反应的因素:讨论:针对中风后失语症的强化治疗方案在常规临床环境中产生了可观的应答率,包括广泛的患者。
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来源期刊
Journal of Neurology
Journal of Neurology 医学-临床神经学
CiteScore
10.00
自引率
5.00%
发文量
558
审稿时长
1 months
期刊介绍: The Journal of Neurology is an international peer-reviewed journal which provides a source for publishing original communications and reviews on clinical neurology covering the whole field. In addition, Letters to the Editors serve as a forum for clinical cases and the exchange of ideas which highlight important new findings. A section on Neurological progress serves to summarise the major findings in certain fields of neurology. Commentaries on new developments in clinical neuroscience, which may be commissioned or submitted, are published as editorials. Every neurologist interested in the current diagnosis and treatment of neurological disorders needs access to the information contained in this valuable journal.
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