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Computerised speech and language therapy or attention control added to usual care for people with long-term post-stroke aphasia: the Big CACTUS three-arm RCT Computerised speech and language therapy or attention control added to usual care for people with long-term post-stroke aphasia: the Big CACTUS three-arm RCT Journals Library An error occurred retrieving content to display, please try again. >> >> >> Page Not Found Page not found (404) Sorry - the page you requested could not be found
Computerised speech and language therapy can help people with aphasia find words following a stroke. The studyPalmer R, Dimairo M, Cooper C, et al. Self-managed, computerised speech and language therapy for patients with chronic aphasia post-stroke compared with usual care or attention control (Big CACTUS): a multicentre, single-blinded, randomised controlled trial. Lancet Neurol 2019;18:821-33.This project was funded by the NIHR Health Technology Assessment Programme (project number 12/21/01
Transcranial direct current stimulation (tDCS) for improving aphasia in adults with aphasia after stroke. Stroke is one of the leading causes of disability worldwide and aphasia among survivors is common. Current speech and language therapy (SLT) strategies have only limited effectiveness in improving aphasia. A possible adjunct to SLT for improving SLT outcomes might be non-invasive brain stimulation by transcranial direct current stimulation (tDCS) to modulate cortical excitability and hence (...) to improve aphasia.To assess the effects of tDCS for improving aphasia in people who have had a stroke.We searched the Cochrane Stroke Group Trials Register (June 2018), CENTRAL (Cochrane Library, June 2018), MEDLINE (1948 to June 2018), Embase (1980 to June 2018), CINAHL (1982 to June 2018), AMED (1985 to June 2018), Science Citation Index (1899 to June 2018), and seven additional databases. We also searched trial registers and reference lists, handsearched conference proceedings and contacted authors
Transcranial Direct Current Stimulation Does Not Improve Language Outcome in Subacute Poststroke Aphasia The aim of the present study is to investigate the effect of transcranial direct current stimulation on word-finding treatment outcome in subacute poststroke aphasia.In this multi-center, double-blind, randomized controlled trial with 6-month follow-up, we included 58 patients with subacute aphasia (<3 months poststroke), who were enrolled in a stroke rehabilitation program. Patients
Effects of multimodal communication program on patients with chronic aphasia: a single-subject A-B-A design study Aphasia as a common consequence of stroke, is an acquired neurologic communication disorder that can affect symbol language processing. Different types of intervention approaches have been introduced. Multimodal Communication Program (MCP) is a new augmentative alternative communication approach in chronic aphasia. The aim of this study was to investigate the effect of MCP (...) on communication skills of patients with chronic aphasia.This prospective, single subject, A-B-A design study was done during 2016 in Semnan, Iran. Participants were two patients with severe aphasia with a single left-hemisphere stroke. Three phases, including baseline, intervention and follow-up were administered. The patients received nine-hour intervention, over 10 working days.Three different scores were calculated for each patient: verbal efforts, the frequency of each modality and the accuracy
â€˜I felt pain. Deep painâ€¦â€™: Experiences of primary caregivers of stroke survivors with aphasia in a South African township Aphasia is an acquired impairment in language and in the cognitive processes that underlie language. Aphasia affects the quality of life of the person with aphasia (PWA) and his or her families in various ways in diverse contexts and cultures. It is therefore important that speech language therapists understand how different contextual and cultural factors may mediate (...) were analysed according to the principles of thematic analysis.Findings indicated that caregivers are unfamiliar with aphasia and the support available to them. Participants experienced frustration and found communication to be challenging owing to their lack of communication strategies. The participants' experiences reflected their context-specific experiences, such as feminisation of caregiving, barriers to healthcare, the influence of low health literacy and contextual perspectives on stroke
Efficacy of intensive aphasia therapy in patients with chronic stroke: a randomised controlled trial Recent evidence has fuelled the debate on the role of massed practice in the rehabilitation of chronic post-stroke aphasia. Here, we further determined the optimal daily dosage and total duration of intensive speech-language therapy.Individuals with chronic aphasia more than 1 year post-stroke received Intensive Language-Action Therapy in a randomised, parallel-group, blinded-assessment (...) , controlled trial. Participants were randomly assigned to one of two outpatient groups who engaged in either highly-intensive practice (Group I: 4 hours daily) or moderately-intensive practice (Group II: 2 hours daily). Both groups went through an initial waiting period and two successive training intervals. Each phase lasted 2 weeks. Co-primary endpoints were defined after each training interval.Thirty patients-15 per group-completed the study. A primary outcome measure (Aachen Aphasia Test) revealed
in the brain. However, because fluency is a multi-dimensional term based on factors that can dissociate (grammatical accuracy, rate of speech, prosody, effort, articulatory precision, hesitations), it is often difficult to judge. A patient can be fluent on one dimension and non-fluent on another. Therefore, there is often disagreement between two people in judging fluency of an aphasic individual. Fluent aphasias are typically due to lesions posterior to the central sulcus: Wernicke aphasia with fluent (...) /17431404?tool=bestpractice.com Saur D, Kreher BW, Schnell S, et al. Ventral and dorsal pathways for language. Proc Natl Acad Sci U S A. 2008 Nov 18;105(46):18035-40. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2584675/ http://www.ncbi.nlm.nih.gov/pubmed/19004769?tool=bestpractice.com Follow-up treatment After identifying and treating the underlying cause of aphasia, such as acute stroke or herpes encephalitis, patients may have a residual aphasia. Such aphasic individuals benefit from referral
Combined Dextroamphetamine and Transcranial Direct Current Stimulation in Poststroke Aphasia. There is a growing need for various effective adjunctive treatment options for speech recovery after stroke. A pharmacological agent combined with noninvasive brain stimulation has not been previously reported for poststroke aphasia recovery. In this "proof of concept" study, we aimed to test the safety of a combined intervention consisting of dextroamphetamine, transcranial direct current stimulation (...) , and speech and language therapy in subjects with nonfluent aphasia. Ten subjects with chronic nonfluent aphasia underwent two experiments where they received dextroamphetamine or placebo along with transcranial direct current stimulation and speech and language therapy on two separate days. The Western Aphasia Battery-Revised was used to monitor changes in speech performance. No serious adverse events were observed. There was no significant increase in blood pressure with amphetamine or deterioration
The Consequences of the Consequences: The Impact of the Environment on People With Aphasia Over Time Understanding the impact of the environment on the participation of people with aphasia depends on one's perspective. A long-term perspective provides a unique insight into the myriad of ways in which the environment can influence the participation of people living with aphasia over decades. In this article, the authors present the real-life story of "Hank," who has lived with aphasia for more (...) than 15 years. The authors consider how 2 different conceptual frameworks-the International Classification of Functioning, Disability and Health and the Social Determinants of Health-account for Hank's experience. The International Classification of Functioning, Disability and Health is useful to conceptualize the range of factors that influence living with aphasia at a particular point in time. In contrast, the Social Determinants of Health is useful to conceptualize the cumulative impact
Speech therapy for treatment of adults with primary progressive aphasia Speech therapy for treatment of adults with primary progressive aphasia Speech therapy for treatment of adults with primary progressive aphasia HAYES, Inc. Record Status This is a bibliographic record of a published health technology assessment. No evaluation of the quality of this assessment has been made for the HTA database. Citation HAYES, Inc.. Speech therapy for treatment of adults with primary progressive aphasia (...) . Lansdale: HAYES, Inc.. Healthcare Technology Brief Publication. 2016 Authors' conclusions Description of Technology: Speech therapy is effective for patients with acquired aphasia (e.g., after a stroke). Speech therapy in patients with primary progressive aphasia (PPA) and other forms of aphasia should be tailored to the needs of the patient, the caregiver, and the progression of the patient's underlying disease. Speech therapy is necessarily subjective, and the selection of activities during therapy
Aphasia rehabilitation best practice statements Aphasia Rehabilitation Best Practice Statements 2014 Comprehensive supplement to the Australian Aphasia Rehabilitation Pathway www.aphasiapathway.com.au 2 Aphasia Rehabilitation Best Practice Statements 2014 ComprehensivesupplementtotheAustralianAphasiaRehabilitationPathway Contents :: PART 1 - INTRODUCTION 3 DEVELOPMENT OF THE BEST PRACTICE STATEMENTS 3 UNDERSTANDING THE PRESENTATION OF THE STATEMENTS 4 ACKNOWLEDGEMENTS 6 PART 2 - APHASIA (...) :: REFERENCE LIST 44 3 Aphasia Rehabilitation Best Practice Statements 2014 ComprehensivesupplementtotheAustralianAphasiaRehabilitationPathway PART 1 - INTRODUCTION DEVELOPMENT OF THE BEST PRACTICE STATEMENTS This document presents best practice statements for aphasia rehabilitation developed by the National Health and Medical Research Council (NHMRC) funded Centre for Clinical Research Excellence (CCRE) in Aphasia Rehabilitation. The CCRE in Aphasia Rehabilitation is an Australian research group that has
recruited from hospital wards, community rehabilitation, speech and language therapy services and stroke groups.Of 511 people with aphasia identified, 105 had low mood and were recruited.Behavioural therapy was offered for up to three months. Outcomes were assessed three and six months after random allocation.Stroke Aphasic Depression Questionnaire, Visual Analog Mood Scales 'sad' item, and Visual Analogue Self-Esteem Scale.Participants were aged 29 to 94 years (mean 67.0, SD 13.5) and 66 (63%) were men (...) Stroke Aphasic Depression Questionnaire 10-item hospital version scores decreased from baseline to six months by six points in the intervention group as compared with an increase of 1.9 points in the control group.Behavioural therapy seemed to improve the mood of people with aphasia.
A systematic review of gesture treatments for post-stroke aphasia A systematic review of gesture treatments for post-stroke aphasia A systematic review of gesture treatments for post-stroke aphasia Rose ML, Raymer AM, Lanyon LE, Attard MC CRD summary The authors concluded that there was some evidence of a benefit from combined gesture plus verbal treatment for some individuals with aphasia after a stroke. It was unclear whether this benefit was greater than that produced by verbal treatment (...) alone. The authors' cautious conclusions reflect the quality and amount of evidence presented. Authors' objectives To evaluate the effects of gesture training for patients with aphasia after a stroke. Searching MEDLINE, CINAHL, PsycINFO, EMBASE, Cochrane Database of Systematic Reviews, and Clinical Aphasiology Conference archives were searched to September 2012; search terms were reported. Google Scholar was used to search the Internet. Reference lists of retrieved studies were checked. Study
Effectiveness of enhanced communication therapy in the first four months after stroke for aphasia and dysarthria: a randomised controlled trial. To assess the effectiveness of enhanced communication therapy in the first four months after stroke compared with an attention control (unstructured social contact).Externally randomised, pragmatic, parallel, superiority trial with blinded outcome assessment.Twelve UK hospital and community stroke services.170 adults (mean age 70 years) randomised (...) within two weeks of admission to hospital with stroke (December 2006 to January 2010) whom speech and language therapists deemed eligible, and 135 carers.Enhanced, agreed best practice, communication therapy specific to aphasia or dysarthria, offered by speech and language therapists according to participants' needs for up to four months, with continuity from hospital to community. Comparison was with similarly resourced social contact (without communication therapy) from employed visitors.Primary
Therapeutic interventions for aphasia initiated more than six months post stroke: a review of the evidence Therapeutic interventions for aphasia initiated more than six months post stroke: a review of the evidence Therapeutic interventions for aphasia initiated more than six months post stroke: a review of the evidence Allen L, Mehta S, McClure JA, Teasell R CRD summary The authors concluded that there was evidence to support the use of several treatments for chronic aphasia post-stroke (...) , but further research was required. Most individual interventions were assessed by only one small study, reducing the reliability of the results, but the authors' overall conclusion is supported by the limited evidence available. Authors' objectives To assess the effectiveness of therapeutic interventions for aphasia, initiated more than six months post-stroke. Searching Multiple databases were searched for English language studies, including MEDLINE, EMBASE, CINAHL and Scopus; search terms were reported
Efficacy of early cognitive-linguistic treatment and communicative treatment in aphasia after stroke: a randomised controlled trial (RATS-2) The two main approaches in aphasia treatment are cognitive-linguistic treatment (CLT), aimed at restoring the linguistic levels affected, semantics, phonology or syntax, and communicative treatment, aimed at optimising information transfer by training compensatory strategies and use of residual language skills. The hypothesis that CLT is more effective (...) than communicative treatment in the early stages after stroke was tested in this study.In this multicentre, randomised, parallel group trial with blinded outcome assessment, 80 patients with aphasia after stroke were included within 3 weeks post-stroke. Patients received 6 months of CLT, comprising semantic and/or phonological training, or communicative treatment for at least 2 h per week. They were assessed before treatment and at 3 and 6 months with the Amsterdam-Nijmegen Everyday Language Test
Memantine and constraint-induced aphasia therapy in chronic poststroke aphasia We conducted a randomized, double-blind, placebo-controlled, parallel-group study of both memantine and constraint-induced aphasia therapy (CIAT) on chronic poststroke aphasia followed by an open-label extension phase.Patients were randomized to memantine (20 mg/day) or placebo alone during 16 weeks, followed by combined drug treatment with CIAT (weeks 16-18), drug treatment alone (weeks 18-20), and washout (weeks 20 (...) -24), and finally, an open-label extension phase of memantine (weeks 24-48). After baseline evaluations, clinical assessments were done at two end points (weeks 16 and 18), and at weeks 20, 24, and 48. Outcome measures were changes in the Western Aphasia Battery-Aphasia Quotient and the Communicative Activity Log.Twenty-eight patients were included, and 27 completed both treatment phases. The memantine group showed significantly better improvement on Western Aphasia Battery-Aphasia Quotient