Oral Presentation Smart Strokes Annual Scientific Meeting 2024

Predicting Treatment Response to Intensive, Comprehensive Aphasia Treatment (106359)

Jade Dignam 1 2 , Penni Burfein 1 3 , Adele Coleman 1 2 , Caitlin Fraser 2 4 , Jessica Hickey 2 4 , Annie Hill 1 5 , Kate O'Brien 1 2 , Emma O'Neill 2 4 , Katherine Roxas 2 4 , Kylie Short 2 4 , Kirstine Shrubsole 1 2 , Hannah Wedley 1 2 , David Copland 1 2
  1. Queensland Aphasia Research Centre, The University of Queensland, Brisbane, QLD, Australia
  2. Surgical Treatment and Rehabilitation Service (STARS) Education and Research Alliance, The University of Queensland and Metro North Health, Brisbane, QLD, Australia
  3. Speech Pathology Department, Royal Brisbane & Women's Hospital, Herston, Queensland, Australia
  4. Speech Pathology Department, Surgical, Treatment and Rehabilitation Service, Metro North Health, Herston, Queensland, Australia
  5. Centre of Research Excellence in Aphasia Rehabilitation and Recovery, La Trobe University, Melbourne, VIC, Australia

Introduction: Intensive, Comprehensive Aphasia Programs (ICAPs) are an innovative service delivery model with demonstrated cognitive-linguistic and psycho-social benefits for people with post-stroke aphasia (Rose et al., 2021). However, there is limited evidence to guide decision-making regarding program candidacy. A greater understanding of who may benefit from ICAPs is required to inform service provision. This study aimed to identify demographic and baseline neuropsychological predictors of ICAP treatment response.

Methods: Sixty-seven adults (48M, 19F; mean age =65.6, SD=13.3) with post-stroke aphasia (mean time post-onset =27.7 months, SD=61.1) participated in the Comprehensive, High-dose Aphasia Treatment (CHAT). CHAT includes 50 hours of evidence-based aphasia therapy delivered over 8 weeks. Linear Mixed Modelling (LMM) was used to evaluate changes on outcome measures, including the Comprehensive Aphasia Test modality mean (CAT), Communicative Effectiveness Index (CETI), Communication Confidence Rating Scale for Aphasia (CCRSA) and the Stroke and Aphasia Quality of Life Scale-39 (SaQOL-39), at post-therapy and 3-month follow-up. Multiple regression modelling was used to determine the relationship between baseline demographic and neuropsychological variables and improvements on outcome measures.  

Results: There were significant improvements across all outcome measures at post-therapy and 3-month follow-up (p<.05). Baseline performance on the CCRSA and SaQOL-39 significantly predicted domain specific treatment response at post-therapy (CCRSA p<.001, SaQOL-39 p =.001), and 3-month follow-up (CCRSA p=.001, SaQOL-39, p=.022). There were no other significant predictors of treatment response.

Conclusion: For tailored, Comprehensive, High-dose Aphasia Treatment, common demographic and neuropsychological variables, including age, years of education, time post-onset, aphasia severity, lexical-semantic processing, and cognitive ability, did not affect treatment response. Low communication confidence and quality-of-life at baseline resulted in greater gains for these domains.

Relevance to clinical practice or patient experience: Patients with post-stroke aphasia may benefit from Comprehensive, High-dose Aphasia Treatment, regardless of age, time post-onset, baseline aphasia severity, or cognitive ability.

  1. Rose, M., Pierce, J. E., Scharp, V. L., Off, C. A., Babbitt, E. M., Griffin-Musick, J. R., & Cherney, L. R. (2021). Developments in the application of Intensive Comprehensive Aphasia Programs: An international survey of practice. Disability and Rehabilitation, 1-15. doi:10.1080/09638288.2021.1948621