Intensity of Aphasia Therapy, Impact on Recovery
Abstract
Background— It has been speculated that the conflicting results demonstrated across poststroke aphasia therapy studies might be related to differences in intensity of therapy provided across studies. The aim of this study is to investigate the relationship between intensity of aphasia therapy and aphasia recovery. Methods— A MEDLINE literature search was conducted to retrieve clinical trials investigating aphasia therapy after stroke. Changes in mean scores from each study were recorded. Intensity of therapy was recorded in terms of length of therapy, hours of therapy provided per week, and total hours of therapy provided. Pearson correlation was used to assess the relationship between changes in mean scores of outcome measures and intensity of therapy. Results— Studies that demonstrated a significant treatment effect provided 8.8 hours of therapy per week for 11.2 weeks versus the negative studies that only provided ≈2 hours per week for 22.9 weeks. On average, positive studies provided a total of 98.4 hours of therapy, whereas negative studies provided 43.6 hours of therapy. Total length of therapy time was found to be inversely correlated with hours of therapy provided per week ( P =0.003) and total hours of therapy provided ( P =0.001). Total length of therapy was significantly inversely correlated with mean change in Porch Index of Communicative Abilities (PICA) scores ( P =0.0001). The number of hours of therapy provided in a week was significantly correlated to greater improvement on the PICA ( P =0.001) and the Token Test ( P =0.027). Total number of hours of therapy was significantly correlated with greater improvement on the PICA ( P <0.001) and the Token Test ( P <0.001). Conclusions— Intense therapy over a short amount of time can improve outcomes of speech and language therapy for stroke patients with aphasia.
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Bhogal's meta-analysis is entitled 'Intensity of aphasia therapy, impact on recovery' but its high-intensity studies are also high-dose studies (average 8.8 h/week, 98 h vs 2 h/week, 44 h).
“It is entitled, ‘Intensity of aphasia therapy, impact on recovery’ [13], yet in table 3 the authors clearly make the point that high-intensity studies (with an average 8.8 h of therapy per week, compared to 2 h for the low intensity studies) are also the high dose studies (98 vs. 44 h).”
From Aphasia Recovery: When, How and Who to Treat? (2018) · cites this paper as [13]
Mobile app-based therapies can increase the intensity of treatment or rehabilitation.
“These apps can increase the intensity of treatment and have resulted in meaningful outcomes across several domains.”
Greater intensity of rehabilitation is associated with greater long-term recovery.
“Such apps have the potential to increase the intensity of rehabilitation, a factor that is associated with greater long-term recovery [10-12].”
The dosage of speech-language therapy plays a crucial role in its effectiveness.
“The dosage of speech-language therapy plays a crucial role in its effectiveness (Bhogal et al., 2003).”
From Improving lexical retrieval with LingoTalk: an app-based, self-administered treatment for clients with aphasia (2023) · cites this paper as Bhogal et al., 2003
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Efficacy of Digital Speech Therapy for Poststroke Dysarthria: Randomized Noninferiority Trial
Kim, Y., Kim, M., Kim, S., Kim, J., Shin, J.-H., Chang, Y., Na, J. Y., Kim, J., & Song, T.-J. (2026) · Journal of Medical Internet Research · doi:10.2196/81938
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- Authors
- Bhogal, S. K., Teasell, R., & Speechley, M.
- Affiliations
- Western University (CA)
- Venue
- Stroke
- Published
- 2003-04
- Volume
- 34
- Issue
- 4
- Pages
- 987-993
- ISSN
- 0039-2499 (ISSN-L)
- 1524-4628
- OpenAlex
- W1894429194
- Cited by
- 719
- References
- 21
- Citations by year
- 2026: 21 · 2025: 18 · 2024: 21 · 2023: 28 · 2022: 23 · 2021: 43 · 2020: 47 · 2019: 26 · 2018: 34 · 2017: 38 · 2016: 54 · 2015: 36 · 2014: 40 · 2013: 34 · 2012: 43
- FWCI
- 8.65
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Stroke (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Life Sciences › Neuroscience › Cognitive Neuroscience › Neurobiology of Language and Bilingualism
- Health Sciences › Medicine › Rehabilitation › Stroke Rehabilitation and Recovery
- Social Sciences › Psychology › Developmental and Educational Psychology › Language Development and Disorders
- Keywords
- aphasia rehabilitation, treatment intensity, aphasia recovery, speech therapy, Token Test, treatment effects, treatment duration
- MeSH terms
- Aphasia, Humans, Time Factors, Treatment Outcome, Stroke
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