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Kelly H, Brady MC, Enderby P
Plain Language Summary
Speech and language therapy for aphasia following stroke
Language problems following a stroke are called aphasia (or dysphasia). About one-third of all
people who experience stroke develop aphasia, which can affect one or more areas of
communication (speaking, understanding spoken words, reading and writing). Speech and
language therapists are involved in the assessment, diagnosis and treatment of aphasia at all
stages of recovery, and work closely with the person with aphasia and their carers. There is no
universally accepted treatment that can be applied to every person with aphasia. We identified 30
trials involving 1840 randomised participants that were suitable for inclusion in this review.
Overall, the review shows evidence from randomised trials to suggest there may be a benefit
from speech and language therapy but there was insufficient evidence to indicate the best
approach to delivering speech and language therapy.
This is a Cochrane review abstract and plain language summary, prepared and maintained by
The Cochrane Collaboration, currently published in The Cochrane Database of Systematic
Reviews 2011 Issue 9, Copyright © 2011 The Cochrane Collaboration. Published by John Wiley
and Sons, Ltd.. The full text of the review is available in The Cochrane Library (ISSN 1464-
780X).
This record should be cited as: Kelly H, Brady MC, Enderby P. Speech and language therapy for
aphasia following stroke. Cochrane Database of Systematic Reviews 2010, Issue 5. Art. No.:
CD000425. DOI: 10.1002/14651858.CD000425.pub2
Editorial Group: Stroke Group
This version first published online: October 25. 1999
Last assessed as up-to-date: November 9. 2009
Abstract
Background
Aphasia is an acquired language impairment following brain damage which affects some or all
language modalities: expression and understanding of speech, reading and writing.
Approximately one-third of people who have a stroke experience aphasia.
Objectives
To assess the effectiveness of speech and language therapy (SLT) for aphasia following stroke.
Search strategy
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We searched the Cochrane Stroke Group Trials Register (last searched April 2009), MEDLINE
(1966 to April 2009) and CINAHL (1982 to April 2009). In an effort to identify further
published, unpublished and ongoing trials we handsearched the International Journal of
Language and Communication Disorders, searched reference lists of relevant articles and
contacted other researchers and authors.
Selection criteria
Randomised controlled trials comparing SLT versus no SLT, SLT versus social support or
stimulation, and one SLT intervention versus another SLT intervention. SLT refers to a formal
speech and language therapy intervention that aims to improve language and communication
abilities and in turn levels of communicative activity and participation. Social support and
stimulation refers to an intervention which provides social support or communication stimulation
but does not include targeted therapeutic interventions. Direct comparisons of different SLT
interventions refers to SLT interventions that differ in terms of duration, intensity, frequency or
method of intervention or in the theoretical basis for the SLT approach.
Data collection and analysis
Two review authors independently extracted the data and assessed the quality of included trials.
We sought missing data from study investigators if necessary.
Main results
We included 30 trials (41 paired comparisons) in the review: 14 subcomparisons (1064
participants) compared SLT with no SLT; six subcomparisons (279 participants) compared SLT
with social support and stimulation; and 21 subcomparisons (732 participants) compared two
approaches to SLT. In general, the trials randomised small numbers of participants across a range
of characteristics (age, time since stroke and severity profiles), interventions and outcomes.
Suitable statistical data were unavailable for several measures.
Authors' conclusions
This review shows some indication of the effectiveness of SLT for people with aphasia following
stroke. We also observed a consistency in the direction of results which favoured intensive SLT
over conventional SLT, though significantly more people withdrew from intensive SLT than
conventional SLT. SLT facilitated by a therapist-trained and supervised volunteer appears to be
as effective as the provision of SLT by a professional. There was insufficient evidence to draw
any conclusions in relation to the effectiveness of one SLT approach over another.

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Kelly H, Brady MC, Enderby P Plain Language Summary Speech and language therapy for aphasia following stroke Language problems following a stroke are called aphasia (or dysphasia). About one-third of all people who experience stroke develop aphasia, which can affect one or more areas of communication (speaking, understanding spoken words, reading and writing). Speech and language therapists are involved in the assessment, diagnosis and treatment of aphasia at all stages of recovery, and work closely with the person with aphasia and their carers. There is no universally accepted treatment that can be applied to every person with aphasia. We identified 30 trials involving 1840 randomised participants that were suitable for inclusion in this review. Overall, the review shows evidence from randomised trials to suggest there may be a benefit from speech and language therapy but there was insufficient evidence to indicate the best approach to delivering speech and language therapy. This is a Cochrane review abstract and plain language summary, prepared and maintained by The Cochrane Collaboration, currently published in The Cochrane Database of Systematic Reviews 2011 Issue 9, Copyright © 2011 The Cochrane Collaboration. Published by John Wiley and Sons, Ltd.. The full text of the review is available in The Cochrane Library (ISSN 1464780X). This record should be cited as: Kelly H, Brady MC, Enderby P. Speech and language therapy for aphasia following stroke. Cochrane Database of Systematic Reviews 2010, Issue 5. Art. No.: CD000425. DOI: 10.1002/14651858.CD000425.pub2 Editorial Group: Stroke Group This version first published online: October 25. 1999 Last assessed as up-to-date: November 9. 2009 Abstract Background Aphasia is an acquired language impairment following brain damage which affects some or all language modalities: expression and understanding of speech, reading and writing. Approximately one-third of people who have a stroke experience aphasia. Objectives To assess the effectiveness of speech and language therapy (SLT) for aphasia following stroke. Search strategy We searched the Cochrane Stroke Group Trials Register (last searched April 2009), MEDLINE (1966 to April 2009) and CINAHL (1982 to April 2009). In an effort to identify further published, unpublished and ongoing trials we handsearched the International Journal of Language and Communication Disorders, searched reference lists of relevant articles and contacted other researchers and authors. Selection criteria Randomised controlled trials comparing SLT versus no SLT, SLT versus social support or stimulation, and one SLT intervention versus another SLT intervention. SLT refers to a formal speech and language therapy intervention that aims to improve language and communication abilities and in turn levels of communicative activity and participation. Social support and stimulation refers to an intervention which provides social support or communication stimulation but does not include targeted therapeutic interventions. Direct comparisons of different SLT interventions refers to SLT interventions that differ in terms of duration, intensity, frequency or method of intervention or in the theoretical basis for the SLT approach. Data collection and analysis Two review authors independently extracted the data and assessed the quality of included trials. We sought missing data from study investigators if necessary. Main results We included 30 trials (41 paired comparisons) in the review: 14 subcomparisons (1064 participants) compared SLT with no SLT; six subcomparisons (279 participants) compared SLT with social support and stimulation; and 21 subcomparisons (732 participants) compared two approaches to SLT. In general, the trials randomised small numbers of participants across a range of characteristics (age, time since stroke and severity profiles), interventions and outcomes. Suitable statistical data were unavailable for several measures. Authors' conclusions This review shows some indication of the effectiveness of SLT for people with aphasia following stroke. We also observed a consistency in the direction of results which favoured intensive SLT over conventional SLT, though significantly more people withdrew from intensive SLT than conventional SLT. SLT facilitated by a therapist-trained and supervised volunteer appears to be as effective as the provision of SLT by a professional. There was insufficient evidence to draw any conclusions in relation to the effectiveness of one SLT approach over another. Name: Description: ...
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