School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia.
Centre of Research Excellence in Aphasia Recovery and Rehabilitation, Bundoora, Australia.
Disabil Rehabil. 2022 Jun;44(12):2548-2559. doi: 10.1080/09638288.2020.1843079. Epub 2020 Nov 9.
Aphasia is a debilitating chronic acquired language disorder that impacts heavily on a person's life. Behavioural treatments aim to remediate language processing skills or to enhance communication between the person with aphasia and others, and a number of different treatments are efficacious. However, it is unclear how much of a particular treatment a person needs in order to optimise recovery of language and communication skills following stroke.
Systematic search for and meta-analysis of experimental studies that directly compared different amounts of the same behavioural aphasia treatment, following PRISMA guidelines.
Treatment dose research in aphasia is an emerging area. Just six studies comparing different doses of the same intervention met all criteria for inclusion. Evidence from these studies was synthesised and meta-analysed, where possible. Meta-analyses were inconclusive due to limited data; however, there are indications that suggest increased dose may confer greater improvement on language and communication measures, but with diminishing returns over time. Aphasia severity and chronicity may affect dose-response relationships.
There is currently insufficient evidence to determine the effect of dose on treatment response. A dedicated and coordinated research agenda is required to systematically explore dose-response relationships in post-stroke aphasia interventions.A video abstract is available in the Supplementary Material.Implications for rehabilitationThe investigation of the effect of dose on treatment outcomes in post-stroke aphasia is an emerging research area with few studies reporting comparison of different amounts of the same intervention.In the acute phase of recovery following stroke, higher doses of treatment provided over short periods may not be preferable, tolerable, or superior to lower doses of the same treatment.In the chronic phase, providing additional blocks of treatment may confer additional benefit for some people with aphasia but with diminishing returns.People with chronic aphasia can achieve and maintain significant gains in picture naming after a relatively brief period of high-dose treatment.
失语症是一种使人衰弱的慢性后天语言障碍，对人的生活影响很大。行为疗法旨在矫正语言处理技能，或增进失语症患者与他人之间的交流，有许多不同的疗法是有效的。但是，尚不清楚一个人需要接受特定治疗的程度，才能使中风后语言和交流技能得到最佳恢复。
按照 PRISMA 指南，系统地搜索并进行了比较相同行为性失语症治疗的不同剂量的实验研究的荟萃分析。
失语症的治疗剂量研究是一个新兴领域。只有六项研究比较了相同干预措施的不同剂量，符合所有纳入标准。对这些研究进行了综合分析和荟萃分析，如果可能的话。由于数据有限，荟萃分析的结果并不确定；但是，有迹象表明，增加剂量可能会使语言和交流测量的改善更大，但随着时间的推移，回报会减少。失语症的严重程度和慢性可能会影响剂量反应关系。
目前尚无足够的证据确定剂量对治疗反应的影响。需要一个专门的、协调一致的研究议程，以系统地探讨中风后失语症干预措施的剂量反应关系。视频摘要见补充材料。
在中风后失语症中，研究剂量对治疗效果的影响是一个新兴的研究领域，只有少数研究报告了比较相同干预措施的不同剂量的情况。在中风后恢复的急性期，提供短时间内更高剂量的治疗可能不是首选，也不能耐受或优于相同治疗的低剂量。在慢性期，为一些失语症患者提供额外的治疗块可能会带来额外的益处，但回报会减少。慢性失语症患者在接受相对短暂的高剂量治疗后，可在图片命名方面取得并保持显著的进步。
