When it comes to stroke therapy and rehabilitation, the general acceptance is that sooner is better. Take the treatment of aphasia (the speech difficulties that often follow a stroke), for example. Guidelines recommend intensive speech and language therapy for chronic aphasia (aphasia lasting more than 6 months). However, there is a long-held belief that these patients have limited chances of improvement. As a direct result, many patients with chronic aphasia are frequently denied access to speech and language therapy.
Lucky for us, German researchers are daring to challenge convention. Lucky for them, having their research published in The Lancet (one of the most prestigious journals in the world) lends a lot of credibility to that challenge.
Results from the study
The researchers set themselves a relatively simple goal. They wanted to determine whether 3 weeks of intensive speech therapy has clear value for patients with chronic language problems. The researchers used a relatively conventional, but intense, treatment program. Individual and group therapy sessions and self-guided training were all core to the treatment program. The group treated patients between the ages of 18 and 70. All of the patients had suffered a stroke more than 6 months ago. Many wouldn’t have usually been considered as candidates for intensive therapy due to the chronic nature of their condition. Once patients hit a particular stage, treatment usually ends.
As it turns out, the researchers were onto something! Based on standardized tests and feedback from friends and family, patients reported experiencing improvements in their ability to communicate verbally. They also noticed improvements in their overall quality of life. While there is room for further research to optimize treatment intensity and to determine whether improvements can be ongoing, this convention-defying study shows that there is no need to limit treatment options based on how much time has passed since a stroke occurred.
The first author of this study is Dr. Breitenstein from the Department of General Neurology of the University of Münster, Münster, Germany.