Speech and language therapy for aphasia following stroke

Why the study was done

About a third of people who have a stroke develop aphasia, a language problem that can affect speaking, understanding, reading and writing. Cochrane reviews bring together all the randomized trials on a question to give the most reliable answer available.

What the researchers did

The review included 57 randomized controlled trials with 3,002 participants, covering research up to September 2015. It compared speech and language therapy with no therapy, with social support and stimulation, and with other forms of therapy that differed in intensity, length, delivery or approach.

What they found

• Compared with no therapy, speech and language therapy led to clinically and statistically significant improvements in everyday (functional) communication.
• It also improved reading, writing and expressive language.
• Therapy at higher intensity, higher dose or over a longer period gave better functional communication than less intensive therapy, although more people dropped out of the intensive programs.
• Whether the benefits lasted at follow-up was unclear, because fewer people were followed up.

What this means for families

Speech and language therapy helps people communicate again after a stroke, and more practice tends to bring more benefit. Therapy at home can make regular, frequent sessions easier to manage, and lets practice focus on the conversations that matter most in daily life.

Limits of the study

Many of the trials were small and differed in who took part and how therapy was given, and the authors rated much of the evidence as weak. Intensive schedules may not suit everyone.