Systematic review of the quality of clinical guidelines for aphasia in stroke management

Rohde, Alexia; Worrall, Linda; Dorze, Guylaine Le

doi:10.1111/jep.12023

Cited by 50 publications

(49 citation statements)

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“…Aphasia affects up to 38% of stroke survivors. [1] Aphasia causes major limitations in social participation and quality of life and can be associated with unemployable and social isolation. A range of patient-related (gender, handedness, age, education, socioeconomic status, and intelligence) and stroke-related indices (initial severity, lesion site, and lesion size) were identified as potentially influential factors in poststroke aphasia recovery.…”

Section: Introductionmentioning

confidence: 99%

“…Japan in 2004, Australian in 2010 and New Zealand in 2010, respectively, drew up the Clinical Guidelines for Stroke Management in this century. [1] In Germany, to address the increasing complexity and continuously changing needs and demands in the health-care system, the researchers identified the need to strengthen knowledge translation, evidence-based practice, and the conduct of clinical trials in the field of allied health professions. On August 6, 2015, the first symposium of linguistic disability and the science of the brain was held in Beijing, China.…”

Section: Introductionmentioning

confidence: 99%

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Study on Language Rehabilitation for Aphasia

Zhang

Jiang

Jia

et al. 2017

Chinese Medical Journal

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Objective:The aim is to update our clinical recommendations for evidence-based language rehabilitation of people with aphasia, based on a systematic review of the literature from 1999 to 2015.Data Sources:Articles referred to in this systematic review of the Medline and PubMed published in English language literatures were from 1998 to 2015. The terms used in the literature searches were aphasia and evidenced-based.Study Selection:The task force initially identified citations for 51 published articles. Of the 51 articles, 44 studies were selected after further detailed review. Six articles, which were not written in English, and one study related to laryngectomy rehabilitation interventions, were excluded from the study. This study referred to all the important and English literature in full.Results:Aphasia is the linguistic disability, which usually results from injuries to the dominant hemisphere of the brain. The rehabilitation of aphasia is until in the process of being debated and researched. Evidence-based medicine (EBM), EBM based on the clinical evidence, promotes the practice of combining the clinicians’ first-hand experience and the existing objective and scientific evidence encouraging making decisions based on both empirical evidence and the scientific evidence. Currently, EBM is being gradually implemented in the clinical practice as the aim of the development of modern medicine.Conclusions:At present, the research for the aphasia rehabilitation mainly focuses on the cognitive language rehabilitation and the intensive treatment and the precise treatment, etc. There is now sufficient information to support evidence-based protocols and implement empirically-supported treatments for linguistic disability after traumatic brain injury and stroke, which can be used to develop linguistic rehabilitation guidelines for patients with aphasia.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Study on Language Rehabilitation for Aphasia

Zhang

Jiang

Jia

et al. 2017

Chinese Medical Journal

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“…In general, the field of stroke rehabilitation tends to promote early initiation of treatment [4][5][6][7][8][9]. Well-known, often expert-based, statements about rehabilitation advocate 'The earlier, the better' and 'Use it or lose it'.…”

mentioning

confidence: 99%

Optimal timing of speech and language therapy for aphasia after stroke: more evidence needed

Nouwens

Sandt-Koenderman

et al. 2015

Expert Review of Neurotherapeutics

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Aphasia due to stroke affects communication and quality of life. Most stroke survivors with aphasia receive speech and language therapy. Although an early start of treatment is advocated in clinical practice, evidence for "The earlier, the better" in aphasia rehabilitation is weak. Hence, clinicians are faced with the dilemma of when to initiate intensive treatment: as early as possible, when most of the spontaneous recovery occurs but when patients are often ill, or later, when the patients' condition is more stabilized. Here we discuss whether aphasia outcome is affected by timing of treatment in relation to stroke onset and whether there is evidence for an optimal window of time during which language therapy should be provided. Findings from various rehabilitation research fields are discussed and combined to provide principles for future research.

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“…A recent systematic review of the quality of clinical guidelines for aphasia in stroke management reported significant variability in both the scope of coverage of recommendations for aphasia management provided within the guidelines and in the methodological rigour of the guideline development processes (Rohde, Worrall, & Le Dorze, 2013 Salter, Teasell, Bhogal, Zettler, & Foley, 2011). They cover topics including aphasia management, and they reflect the complexity and diversity of speech pathology practice in acute aphasia management and stroke care in general.…”

Section: Clinical Guidelines For the Management Of Acute Aphasiamentioning

confidence: 99%

“…These guidelines represent the breadth of speech pathologists' practice in the management of aphasia in the acute hospital setting, and across the continuum of care. A systematic evaluation of the quality of guidelines exploring aphasia management available at the time has suggested significant variability in the guideline development process, and also in the scope of the recommendations provided within the guidelines (Rohde et al, 2013). While the majority of synthesised research included in current guidelines garners only a low-level grading for the aphasia-related recommendations, it is important to acknowledge that the strength of this grading is not necessarily reflective of the clinical importance of the recommendation, but rather a reflection of research design and the stage of research development in the area (Scottish Intercollegiate Guidelines Network, 2008).…”

Section: Recommendations For Best Practice In the Management Of Aphasmentioning

confidence: 99%

“Communication is taking a back seat”: An exploration of aphasia management in acute hospital settings

Foster¹

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While in the past the focus of speech pathologists working in the acute hospital setting has been service provision to people with communication disorders and their families, their primary role is now in dysphagia. In the limited literature regarding aphasia management in acute hospital settings, there is a lack of consistency regarding the type and amount of intervention being provided to people with aphasia; however, there is consensus that current practice is inconsistent with bestpractice recommendations. Given that aphasia intervention has been identified as being central to improved communicative outcomes, an increased capacity to effectively communicate healthcare needs, a decrease in hospital negative events, and an increased sense of satisfaction for people with aphasia, this is of concern. Little is known about the reasons underlying this evidence-practice gap.The overall aim of this thesis was to provide an understanding of current acute aphasia management practice and the factors that influence it. Specifically, the research aimed to: (a) provide an in-depth understanding of the current aphasia management pathway in the acute hospital setting; (b) explore acute speech-language pathologists' conceptualisation, experiences, and perceptions of post-stroke aphasia management, and provide a greater understanding of the factors that influence their practice; and, (c) understand the factors that influence acute aphasia management from the perspectives of speech pathologists, people with aphasia, and their close others, through a cultural lens.In order to address the research aims, the empirical aspects of this research were conducted in two Phases. Phase One, an interpretative phenomenological investigation, aimed to provide a deep understanding of aphasia management from the perspective of acute speech pathologists. Semistructured, in-depth interviews were undertaken with 15 Australian speech pathologists working with people with aphasia (one of which was later excluded resulting in a total n=14). Interviews were transcribed verbatim, and data were analysed using a thematic analysis. Key themes identified included: role perception; competing priorities; the de-prioritisation of aphasia; and, the sense of disempowerment experienced by speech pathologists as a result of their relationship with evidencebased practice for acute aphasia management. In addition, a qualitative content analysis was undertaken to describe the current aphasia management pathway. Grounded within the guiding construct, First contact with the profession, the findings represented the significant diversity in the ii pathways of care for people with aphasia and their families in the acute hospital setting. Overall, analysis revealed the complex, diverse, and multi-faceted nature of the phenomenon.Phase Two was designed based on the findings of Phase One. It examined the culture of acute aphasia management by speech pathologists in depth, through the use of focused ethnography in a single acute stroke unit. Three participant triads...

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Systematic review of the quality of clinical guidelines for aphasia in stroke management

Abstract: Improvement is needed in the quality of methodological rigour in development and reporting within clinical guidelines, and in aphasia-specific recommendations within stroke multidisciplinary clinical guidelines.

Cited by 50 publications

References 24 publications

Study on Language Rehabilitation for Aphasia

Study on Language Rehabilitation for Aphasia

Optimal timing of speech and language therapy for aphasia after stroke: more evidence needed

“Communication is taking a back seat”: An exploration of aphasia management in acute hospital settings

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