title: A randomized, rater-blinded, parallel trial of intensive speech therapy in sub-acute post-stroke aphasia: the SP-I-R-IT study.
abstract: BACKGROUND
  There is conflicting evidence regarding the benefits of intensive speech and language therapy (SLT), particularly because intensity is often confounded with total SLT provided.
  
  
  OBJECTIVE
  A two-centre, randomized, rater-blinded, parallel study was conducted to compare the efficacy of 100 h of SLT in a regular (RT) versus intensive (IT) treatment in sub-acute post-stroke aphasia.
  
  
  METHODS
  Consecutive patients with aphasia, within 3 months of a left hemisphere ischemic stroke, were randomized to IT (2 h per day × 5 days per week, 10 weeks) or RT (2 h per week × 50 weeks). Evaluations took place at 10, 50 and 62 weeks. Primary outcome was the frequency of responders, defined by 15% increase of Aphasia Quotient (AQ) from the baseline to 50 weeks. Secondary outcomes were changes from the baseline in AQ and functional communication profile (FCP) at 50 and 62 weeks and improvement stability between 50 and 62 weeks.
  
  
  RESULTS
  Thirty patients were randomized and 18 completed the study. No significant differences were found between groups in primary or secondary outcomes, although IT patients (N = 9) obtained higher scores in language measures between 10 and 62 weeks in per protocol analysis. The number of non-completions was identical between groups.
  
  
  CONCLUSIONS
  This study suggests that, in the sub-acute period following stroke and controlling for the number of hours of SLT provided, there is a trend for a greater improvement in language and functional communication measures with IT compared with RT. The lack of statistical significance in results was probably due to the small sample size.
authors.affiliation: Language Research Laboratory, Department of Neurosciences, Lisbon Faculty of Medicine, Instituto de Medicina Molecular, Hospital de Sta Maria, Lisbon, Portugal. Isabel_Martins@fm.ul.pt
authors.forename: Isabel Pavão
authors.initials: IP
authors.lastname: Martins
authors.forename: Gabriela
authors.initials: G
authors.lastname: Leal
authors.forename: Isabel
authors.initials: I
authors.lastname: Fonseca
authors.forename: Luísa
authors.initials: L
authors.lastname: Farrajota
authors.forename: Marta
authors.initials: M
authors.lastname: Aguiar
authors.forename: José
authors.initials: J
authors.lastname: Fonseca
authors.forename: Martin
authors.initials: M
authors.lastname: Lauterbach
authors.forename: Luís
authors.initials: L
authors.lastname: Gonçalves
authors.forename: M Carmo
authors.initials: MC
authors.lastname: Cary
authors.forename: Joaquim J
authors.initials: JJ
authors.lastname: Ferreira
authors.forename: Jose M
authors.initials: JM
authors.lastname: Ferro
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D001037:Aphasia / Q000534:rehabilitation*; D002545:Brain Ischemia / Q000534:rehabilitation; D003142:Communication; D003147:Communication Disorders / Q000534:rehabilitation*; D005260:Female; D006801:Humans; D020244:Infarction, Middle Cerebral Artery / Q000534:rehabilitation*; D008297:Male; D008875:Middle Aged; D016037:Single-Blind Method; D013070:Speech Therapy / Q000379:methods*; D016896:Treatment Outcome
keywords: aphasia; clinical trial; intensive speech therapy; speech and language therapy; stroke rehabilitation