Predictors of Therapy Outcome After Intensive Treatment in Post-Acute and Chronic Aphasia

EasyChair Preprint 6509

Abstract

There is good evidence that intensive speech and language therapy (SLT) is effective but it is still not clear who benefits most. A recent meta-analysis has shown greatest improvements for younger age and earlier treatment enrollment (Ali et al., 2021). This retrospective study extends these findings with a large single-center database and some additional variables such as Handedness, Education and Hours of SLT. The database contains all patients who received intensive SLT at the RWTH Aachen University hospital between 2003-2020. We included inpatients with an ischemic or hemorrhagic stroke in the post-acute (>6 weeks post-onset, n=278) or chronic stage (>12 months post-onset, n=456) of aphasia. The Aachen Aphasia Test (AAT) was used as primary outcome measure at the end of each treatment cycle of 6-8 weeks. Each individual was classified as a responder to treatment if at least one of the AAT subscales, subtests or the profile level showed significant improvement between the latest pre-treatment and the outcome assessment (Poeck et al.,1989). In the overall group of 734 patients 56% responded to treatment. Significant predictors of the multivariate logistic regression analysis were Time post-onset (p=.006), Age (p=.012; both negatively associated with good response) and Hours of SLT (p=.047; positively associated with good response). Neither Handedness nor Education were predictors. The multivariate analyses within the subgroups of post-acute and chronic patients showed different predictors depending on the chronicity of aphasia: In the post-acute stage of aphasia, 63% of patients were responders and only Time post-onset was a significant predictor. In contrast, in the chronic stage 52% of patients improved significantly in the outcome AAT. The only significant predictor here was Age. Large unexplained variances of these analyses indicate that further studies are required considering additional potential predictors, for example based on brain imaging.

Keyphrases: Aachen Aphasia Test, Intensive therapy, Predictors, Treatment Outcome, aphasia

@booklet{EasyChair:6509,
  author    = {Dorothea Peitz and Beate Schumann-Werner and Katja Hussmann and Hong Chen and Irmgard Radermacher and Ferdinand Binkofski and Walter Huber and Klaus Willmes and Stefan Heim and Jörg B. Schulz and Bruno Fimm and Cornelius J. Werner},
  title     = {Predictors of Therapy Outcome After Intensive Treatment in Post-Acute and Chronic Aphasia},
  howpublished = {EasyChair Preprint 6509},
  year      = {EasyChair, 2021}}