Intensive aphasia therapy is effective when measured at group level, but many individuals do not respond significantly, and even fewer individuals maintain their initial gains.

Maya Menahemi-Falkov, Caterina Breitenstein, John E. Pierce, Anne J. Hill, Robyn O'Halloran & Miranda L. Rose

doi.org/10.1080/09638288.2021.1955303

We analysed 44 studies of intensive aphasia intervention (n=670 participants with post-stroke aphasia) by calculating individual-level statistics. Only about one-third improved significantly immediately after intervention and only two-third of these maintained their improvements at follow-up. Thus, only 22% of all participants improved significantly and maintained their therapy gains. This demonstrates the importance of maintenance activities.

Video summary

Implications for rehabilitation

Only a small proportion (about one fifth in this review) of intensive aphasia treatment program participants respond and maintain their therapy gains, a fact that is obscured by traditional p-value group analysis.

A simple clinical decision-making method is presented for evaluating individual therapy gains and their maintenance.

For some immediate treatment responders (about one third in this review), gains from intensive therapy programs are unlikely to be maintained in the long-term without additional, ongoing practice.

Clinicians should consider the possibility of individual clients losing some of their therapy gains and take proactive steps to support long-term maintenance.