The Benefits of Conversation Group Treatment for Individuals With Chronic Aphasia: Updated Evidence From a Multisite Randomized Controlled Trial on Measures of Language and Communication.

IF 2.3 3区 医学 Q1 AUDIOLOGY & SPEECH-LANGUAGE PATHOLOGY
Elizabeth Hoover, Gretchen Szabo, Francine Kohen, Sarah Vitale, Nicholas McCloskey, Edwin Maas, Varsha Kulkarni, Gayle DeDe
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引用次数: 0

Abstract

Purpose: Aphasia is a communication disorder that affects up to 30% of stroke survivors. Insufficient access to communication services creates personal, social, and financial costs to people with aphasia (PwA), care partners, and the community. Group conversation treatment has the potential to improve communication and reduce social isolation in a cost-effective manner, but little is known about its critical ingredients. This multicenter randomized controlled trial examined the effects of conversation treatment and whether the pattern of changes on outcome measures differed when treatment was delivered in large groups compared to dyads.

Method: One hundred four PwA were randomly assigned to a dyad, large group, or delayed control condition. Conversation group treatment was 1 hr, twice weekly, over 10 weeks. Individual communication goals were addressed within thematically oriented conversation treatment. To evaluate treatment effects, primary (Aphasia Communication Outcome Measure [ACOM]) and secondary outcome measures were examined at pretreatment, posttreatment, and 6 weeks posttreatment.

Results: The ACOM did not show significant changes in the planned omnibus analyses. Post hoc analyses suggested that the large group, but not dyad, treatment condition showed a treatment effect on the ACOM from pre- to posttreatment. Both treatment conditions showed changes on a measure of naming, and the dyads also showed improvement on a measure of repetition.

Conclusions: The study failed to show the effects of conversation treatment in the omnibus analysis, but there was evidence that conversation group treatment, delivered in a large group, is effective for people with chronic aphasia. This study also illustrated how manipulating the size of the group may alter the outcomes for individuals. The results of this study offer support for a cost-effective treatment option for PwA across the continuum of care.

Supplemental material: https://doi.org/10.23641/asha.28719578.

会话小组治疗慢性失语症患者的益处:来自语言和交流测量的多地点随机对照试验的最新证据。
目的:失语症是一种交流障碍,影响着高达30%的中风幸存者。通信服务获取不足会给失语症患者、护理伙伴和社区带来个人、社会和经济成本。集体谈话治疗有可能以一种具有成本效益的方式改善沟通和减少社会孤立,但对其关键成分知之甚少。这项多中心随机对照试验检查了谈话治疗的效果,以及在大群体治疗与双组治疗时,结果测量的变化模式是否有所不同。方法:104例PwA随机分为二组、大组和延迟对照组。对话组治疗1小时,每周2次,持续10周。在主题导向的谈话治疗中解决了个人的沟通目标。为了评估治疗效果,在治疗前、治疗后和治疗后6周检查主要(失语交流结果测量[ACOM])和次要结果测量。结果:在计划的综合分析中,ACOM没有显示出明显的变化。事后分析表明,大组而非双组治疗条件对ACOM从治疗前到治疗后都有治疗效果。两种治疗条件都显示出命名能力的变化,而二联体也显示出重复能力的改善。结论:该研究未能在综合分析中显示会话治疗的效果,但有证据表明,在大群体中进行的会话组治疗对慢性失语症患者有效。这项研究还说明了如何操纵群体的规模可能会改变个人的结果。本研究的结果为PwA的持续治疗提供了一种经济有效的治疗选择。补充资料:https://doi.org/10.23641/asha.28719578。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
American Journal of Speech-Language Pathology
American Journal of Speech-Language Pathology AUDIOLOGY & SPEECH-LANGUAGE PATHOLOGY-REHABILITATION
CiteScore
4.30
自引率
11.50%
发文量
353
审稿时长
>12 weeks
期刊介绍: Mission: AJSLP publishes peer-reviewed research and other scholarly articles on all aspects of clinical practice in speech-language pathology. The journal is an international outlet for clinical research pertaining to screening, detection, diagnosis, management, and outcomes of communication and swallowing disorders across the lifespan as well as the etiologies and characteristics of these disorders. Because of its clinical orientation, the journal disseminates research findings applicable to diverse aspects of clinical practice in speech-language pathology. AJSLP seeks to advance evidence-based practice by disseminating the results of new studies as well as providing a forum for critical reviews and meta-analyses of previously published work. Scope: The broad field of speech-language pathology, including aphasia; apraxia of speech and childhood apraxia of speech; aural rehabilitation; augmentative and alternative communication; cognitive impairment; craniofacial disorders; dysarthria; fluency disorders; language disorders in children; speech sound disorders; swallowing, dysphagia, and feeding disorders; and voice disorders.
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