Benchmarks of Significant Change After Aphasia Rehabilitation

• Published in: Archives of physical medicine and rehabilitation Vol. 100; no. 6; pp. 1131 - 1139.e87
• Main Authors: Gilmore, Natalie, Dwyer, Michaela, Kiran, Swathi
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.06.2019
• Subjects: Aphasia; Aphasia - rehabilitation; Benchmarking; Humans; Language Tests; Outcome; Outcome Assessment, Health Care - methods; Rehabilitation; Severity of Illness Index; Speech therapy; Stroke; Treatment Outcome; Stroke; CI; COS; CETI; BNT; PRISMA; WAB-AQ; ES; QOL; ASHA; Outcome; Aphasia; SEM; Rehabilitation; Speech therapy
• ISSN: 0003-9993; 1532-821X; 1532-821X
• DOI: 10.1016/j.apmr.2018.08.177

To establish benchmarks of significant change for aphasia rehabilitation outcome measures (ie, Western Aphasia Battery-Aphasia Quotient [WAB-AQ], Communicative Effectiveness Index [CETI], Boston Naming Test [BNT]) and assess if those benchmarks significantly differ across subgroups (ie, time post onset, dose frequency, treatment type). A comprehensive literature search of 12 databases, reference lists of previous reviews, and evidence-based practice materials was conducted. Randomized controlled trials, quasi-experimental studies, single-subject design, and case studies that used a standardized outcome measure to assess change were included. Titles and full-text articles were screened using a dual review process. Seventy-eight studies met criteria for inclusion. Data were extracted independently, and 25% of extractions were checked for reliability. All included studies were assigned quality indicator ratings and an evidence level. Random-effects meta-analyses were conducted separately for each study design group (ie, within-/between-group comparisons). For within-group designs, the summary effect size after aphasia rehabilitation was 5.03 points (95% confidence interval, 3.95-6.10, P<.001) on the WAB-AQ, 10.37 points (6.08-14.66, P<.001) on the CETI, and 3.30 points (2.43-4.18, P<.001) on the BNT. For between-group designs, the summary effect size was 5.05 points (1.64-8.46, P=.004) on the WAB-AQ and 0.55 points (-1.33 to 2.43, P=.564) on the BNT, the latter of which was not significant. Subgroup analyses for the within-group designs showed no significant differences in the summary effect size as a function of dose frequency or treatment type. This study established benchmarks of significant change on 3 standardized outcome measures used in aphasia rehabilitation.