Clinical Effectiveness of the Queen Square Intensive Comprehensive Aphasia Service for Patients With Poststroke...

Area of Science:

• Neuroscience
• Speech and Language Therapy
• Rehabilitation Medicine

Background:

• Poststroke aphasia significantly impacts quality of life.
• High-dose speech and language therapy is effective but difficult to achieve.
• Intensive Comprehensive Aphasia Programs (ICAPs) offer a solution for delivering intensive therapy.

Purpose of the Study:

• To evaluate the effectiveness of an Intensive Comprehensive Aphasia Program (ICAP) for chronic poststroke aphasia.
• To assess both impairment-based language skills and functional communication outcomes.

Main Methods:

• Forty-six individuals with chronic poststroke aphasia participated in a 3-week ICAP (15 days, 6 hours/day).
• Language abilities were assessed using the Comprehensive Aphasia Test (speaking, writing, auditory comprehension, reading) at baseline, 3 weeks, and 12 weeks post-ICAP.
• Functional communication was measured by the carer-reported Communicative Effectiveness Index at baseline and 12 weeks post-ICAP.

Main Results:

• A significant improvement in language scores across all four domains was observed (p<0.0005).
• Speaking showed the largest gains (Cohen's d=1.3), with improvements sustained or enhanced at 12 weeks.
• Functional communication also significantly improved (t=5.4, p<0.0005, Cohen's d=0.9) and was maintained at 12 weeks.

Conclusions:

• The Queen Square ICAP led to large, clinically meaningful improvements in language for people with aphasia.
• Both impairment-level and functional communication measures showed significant gains.
• Therapeutic benefits were sustained and further improved over the 12 weeks following the program.