Benchmarks of significant change after aphasia rehabilitation

Publication date: Available online 18 September 2018

Source: Archives of Physical Medicine and Rehabilitation

Author(s): Natalie Gilmore, Michaela Dwyer, Swathi Kiran

Abstract

Objective

To establish benchmarks of significant change for aphasia rehabilitation outcome measures (i.e., Western Aphasia Battery-Aphasia Quotient [WAB-AQ], Communicative Effectiveness Index [CETI], Boston Naming Test [BNT]) and assess if those benchmarks significantly differed across subgroups (i.e., time post onset, dose frequency, treatment type).

Data Sources

A comprehensive literature search of 12 databases, reference lists of previous reviews, and evidence-based practice materials was conducted.

Study Selection

Randomized-controlled trials, quasi-experimental studies, single-subject design, and case studies that used a standardized outcome measure to assess change were included. Titles and full-text articles were screened using a dual review process. 78 studies met criteria for inclusion.

Data Extraction

Data were extracted independently and 25% of extractions were checked for reliability. All included studies were assigned quality indicator ratings and an evidence level.

Data Synthesis

Random-effects meta-analyses were conducted separately for each study design group (i.e., within/between group comparisons). For within group designs, the summary effect size after aphasia rehabilitation was 5.03 points (95% confidence interval: 3.95-6.10, p < .001) on the WAB-AQ, 10.37 points (6.08-14.66, p < .001) on the CETI and 3.30 points (2.43-4.18, p < .001) on the BNT. For between group designs, the summary effect size was 5.05 points (1.64-8.46, p = .004) on the WAB-AQ, and .55 points (-1.33, 2.43, p = .564) on the BNT, the latter of which was not significant. Subgroup analyses for the within group designs showed no significant differences in the summary effect size as a function of dose frequency, or treatment type.

Conclusions

This study established benchmarks of significant change on three standardized outcome measures used in aphasia rehabilitation.

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