title: Therapeutic interventions for aphasia initiated more than six months post stroke: a review of the evidence.
abstract: BACKGROUND
  Aphasia effects up to 38% of acute stroke patients. For many of these individuals, this condition persists far beyond the acute phase. The purpose of this review is to evaluate the effectiveness of therapeutic interventions for aphasia initiated more than 6 months post stroke.
  
  
  METHODS
  A literature search was conducted for articles in which aphasia treatments were initiated more than 6 months post stroke. Searches were conducted in multiple databases including MEDLINE, Scopus, CINAHL, and EMBASE.
  
  
  RESULTS
  A total of 21 randomized controlled trials (RCTs) met the inclusion criteria. There is good evidence to suggest that the use of computer-based treatments, constraint-induced therapy, intensity of therapy, group language therapies, and training conversation/communication partners are effective treatments for chronic aphasia. Repetitive transcranial magnetic stimulation, transcranial direct current stimulation, and the use of the drugs piracetam, donepezil, memantime, and galantamine have also demonstrated evidence that they are effective treatments of aphasia 6 months or more post stroke onset. Neither filmed language instruction nor the drug bromocriptine has been shown to be effective in treating chronic aphasia.
  
  
  CONCLUSIONS
  There is evidence to support the use of a number of treatments for chronic aphasia post stroke. Further research is required to fully support the use of these interventions and to explore the effectiveness of other aphasia interventions in the chronic stage.
authors.affiliation: Lawson Health Research Institute, London, Ontario, Canada.
authors.forename: Laura
authors.initials: L
authors.lastname: Allen
authors.forename: Swati
authors.initials: S
authors.lastname: Mehta
authors.forename: J Andrew
authors.initials: JA
authors.lastname: McClure
authors.forename: Robert
authors.initials: R
authors.lastname: Teasell
mesh_terms: D000328:Adult; D000368:Aged; D001037:Aphasia / Q000209:etiology* / Q000628:therapy*; D016208:Databases, Factual / Q000706:statistics & numerical data; D004599:Electric Stimulation Therapy; D005260:Female; D006801:Humans; D007808:Language Therapy; D008297:Male; D008875:Middle Aged; D026741:Physical Therapy Modalities; D016032:Randomized Controlled Trials as Topic; D020521:Stroke / Q000150:complications*; D050781:Transcranial Magnetic Stimulation