Researchers working at Universities in Australia and Germany have published a systematic review of outcome improvements and maintenance patterns in persons with chronic aphasia following completion of intensive aphasia therapy programs. The primary goals of review were to:  investigate individual response patterns and rates across six common outcome measures upon program completion; and  to determine whether and how these therapeutic gains hold up over time following program completion.
The investigators searched four leading data bases to identify articles that met five criteria: (i) published in peer-reviewed English-language journals; (ii) reported on adults with chronic, stroke-induced aphasia; (iii) presented original quantitative research data; (iv) involved intensive behavioral therapy interventions; and (v) included at least one follow-up assessment. Of approximately 1200 initial candidate articles, forty four (~ 4%) ultimately met criteria for inclusion in their review.
To probe impairment-level changes, data from the 3 outcome measures were analyzed – the Aphasia Quotient of the Western Aphasia Battery, Boston Naming Test scores, and Aachen Aphasia Test profile; for participation/activity – the Amsterdam-Nijmegen Everyday Language Test A-scores and the Communicative Effectiveness Index; and for Quality of Life – the Stroke and Aphasia Quality of Life Scale-39. To identify clinically meaningful improvements following program participation, Minimal Detectable Change and Standard Error of Measurement were calculated and compared for individuals. Content analyses of articles were conducted to determine intervention dosages, intensities, and durations, as well as demographic characteristics of participants.
From their analyses, the authors conclude that intensive group therapy programs may register as effective when analyzed at the group level, but that analyses of individual responses show only about one in three participants made significant gains from program engagement; and that of those not all maintained their gains over the longer term. In consequence, the proportion of persons in chronic aphasia who both made gains and kept them after participation in an intensive language therapy program was approximately two in nine (~ 22%).
The authors conclude that future research should attempt to identify those factors that predict both positive treatment response at the individual level, coupled with longer-term maintenance following program completion.
For further reading: M. Menahemi-Falkov, C. Breitenstein, J. Pierce et al., 2021. A systematic review of maintenance following intensive therapy programs in chronic post-stoke aphasia: importance of individual response analysis. Disability and Rehabilitation, 43, 15 pp. https://doi.org/10.1080/09638288.2021.1955303