Laska A C, Kahan T, Hellblom A, Murray V, von Arbin M
Karolinska Institutet, Department of Clinical Sciences, Danderyd Hospital, Division of Internal Medicine, Stockholm, Sweden.
Top Stroke Rehabil. 2008 May-Jun;15(3):256-61. doi: 10.1310/tsr1503-256.
Most clinicians would recommend speech and language therapy (SLT) for aphasic patients. The question of when and for how long SLT should be administered still remains controversial. The aim of this trial is to evaluate the efficacy of early SLT in patients with acute stroke and aphasia in a randomized controlled trial. This report will present design and methods and discuss feasibility.
Consecutive patients with first ever ischemic stroke and aphasia are assessed by the Amsterdam-Nijmegen Everyday Language Test (ANELT) and a short version of the Norsk Grunntest for Afasi. The treatment is language enrichment therapy, and the therapy is given 45 min/day for 15 weekdays. The primary outcome is the difference in the degree of aphasia between the SLT treated group and the control group measured by ANELT at 3 weeks.
Around 10% of acute consecutive patients with aphasia are included. Of the first 79 included patients, 86% have completed the study according to protocol. We intend to include 125 patients, which provide sufficient statistical power to detect a clinically significant difference in the degree of aphasia.
It is feasible to conduct a randomized controlled study on very early SLT for acute aphasic patients.
大多数临床医生会建议为失语症患者提供言语和语言治疗（SLT）。关于何时以及进行多长时间的SLT治疗仍存在争议。本试验的目的是在一项随机对照试验中评估早期SLT对急性中风和失语症患者的疗效。本报告将介绍设计和方法并讨论可行性。
通过阿姆斯特丹-奈梅亨日常语言测试（ANELT）和挪威失语症基础测试简版对首次发生缺血性中风和失语症的连续患者进行评估。治疗方法为语言强化治疗，每周5天，每天45分钟。主要结局是SLT治疗组和对照组在3周时通过ANELT测量的失语症程度差异。
纳入了约10%的急性连续性失语症患者。在前79名纳入患者中，86%已按方案完成研究。我们打算纳入125名患者，这将提供足够的统计效力以检测失语症程度上的临床显著差异。
对急性失语症患者进行极早期SLT的随机对照研究是可行的。
