Discipline of Speech Pathology, School of Allied Health, Human Services and Sport, College of Science, Health and Engineering, La Trobe University, Bundoora, Australia.
Centre of Research Excellence in Aphasia Recovery and Rehabilitation, Bundoora, Australia.
Neuropsychol Rehabil. 2021 Dec;31(10):1629-1660. doi: 10.1080/09602011.2020.1786412. Epub 2020 Jul 7.
Little is known about how the amount of treatment a person with aphasia receives impacts aphasia recovery following stroke, yet this information is vital to ensure effective treatments are delivered efficiently. Furthermore, there is no standard dose terminology in the stroke rehabilitation or aphasia literature. This scoping review aims to systematically map the evidence regarding dose in treatments for post-stroke aphasia and to explore how treatment dose is conceptualized, measured and reported in the literature. A comprehensive search was undertaken in June 2019. One hundred and twelve intervention studies were reviewed. Treatment dose (amount of treatment) has been conceptualized as both a measure of time and a count of discrete therapeutic elements. Doses ranged from one to 100 hours, while some studies reported session doses of up to 420 therapeutic inputs per session. Studies employ a wide variety of treatment schedules (i.e., session dose, session frequency, and intervention duration) and the interaction of dose parameters may impact the dose-response relationship. High dose interventions delivered over short periods may improve treatment efficiency while maintaining efficacy. Person- and treatment-level factors that mediate tolerance of high dose interventions require further investigation. Systematic exploration of dose-response relationships in post-stroke aphasia treatment is required.
关于一个患有失语症的人接受的治疗量如何影响中风后的失语症康复，目前知之甚少，但这些信息对于确保有效治疗的高效实施至关重要。此外，中风康复或失语症文献中没有标准的剂量术语。本范围综述旨在系统地绘制关于中风后失语症治疗中剂量的证据，并探讨文献中如何概念化、测量和报告治疗剂量。在 2019 年 6 月进行了全面检索。综述了 112 项干预研究。治疗剂量（治疗量）既被概念化为时间的度量，也被概念化为离散治疗元素的计数。剂量范围从 1 到 100 小时，而一些研究报告每次治疗高达 420 个治疗输入的治疗剂量。研究采用了各种各样的治疗方案（即治疗剂量、治疗频率和干预持续时间），剂量参数的相互作用可能会影响剂量反应关系。在短时间内给予高剂量的干预措施可能会提高治疗效率，同时保持疗效。需要进一步研究介导高剂量干预耐受性的个体和治疗水平因素。需要系统地探索中风后失语症治疗中的剂量反应关系。
