Predicting Outcomes of Language Rehabilitation: Prognostic Factors for Immediate and Long-Term Outcomes After Aphasia Therapy.
Sigfus Kristinsson, Alexandra Basilakos, Dirk B den Ouden and 11 others
PMID 36827514WHAT IT FOUND
People with mild or moderate aphasia improved naming after 30 hours of therapy and kept those gains for six months.
Those with severe or very severe aphasia showed no significant naming improvement. Baseline severity predicted response better than age, education, or cognitive reserve.
Key findings
01Participants with mild and moderate aphasia showed significant improvements in naming that were maintained at 1 and 6 months, while those with severe and very severe aphasia did not.
02The study models had poor predictive accuracy for individual therapy response, with the best model accounting for only 12% of variability in naming outcomes.
03Average naming performance improved significantly from baseline at all post-therapy time points, but this was an ancillary analysis as the trial was not designed to test efficacy.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The trial was not designed to test therapy efficacy, so the observed improvements cannot be definitively attributed to the therapy itself. Participants with the most severe speech and comprehension deficits were excluded, so findings do not apply to the most severely affected individuals. The models used to predict individual therapy response were inaccurate, meaning clinicians cannot reliably use these factors to forecast how a specific patient will do. Only naming was measured as the primary outcome, which may not reflect broader communication abilities.
Declared interests
The study was supported by the National Institute on Deafness and Other Communication Disorders. No commercial conflicts of interest were reported.
The easy way to misread this
Do not conclude that severe aphasia is untreatable or that this therapy is ineffective for everyone. The lack of naming gains in severe groups may reflect the specific outcome measure or dosage used, and the study was not designed to prove therapy efficacy.