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Title: | A randomized control trial of intensive aphasia therapy after acute stroke: The Very Early Rehabilitation for SpEech (VERSE) study. | Authors: | Godecke E.;Armstrong E.;Rai T.;Ciccone N.;Rose M.L.;Middleton S.;Whitworth A.;Holland A.;Ellery F.;Hankey G.J.;Cadilhac D.A.;Bernhardt J. | Monash Health Department(s): | Monash University - School of Clinical Sciences at Monash Health | Institution: | (Godecke, Armstrong, Ciccone) School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia (Godecke) Speech Pathology Department, Sir Charles Gairdner Hospital, Perth, Australia (Rai) School of Mathematical and Physical Sciences, University of Technology NSW, Broadway, Australia (Rose) School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia (Middleton) St Vincent's Health Australia, Sydney and Australian Catholic University, Darlinghurst, Australia (Whitworth) Faculty of Health Sciences, Curtin University, Bentley, Australia (Holland) Speech Language Pathology, University of Arizona, Tucson, AZ, United States (Ellery, Bernhardt) Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Melbourne, Australia (Hankey) Medical School, The University of Western Australia, Perth, Australia (Cadilhac) Stroke and Ageing Research, School of Clinical Science at Monash Health, Monash University, Clayton, Australia |
Issue Date: | 23-Jan-2022 | Copyright year: | 2021 | Publisher: | SAGE Publications Inc. | Place of publication: | United Kingdom | Publication information: | International Journal of Stroke. 16(5) (pp 556-572), 2021. Date of Publication: July 2021. | Journal: | International Journal of Stroke | Abstract: | Background: Effectiveness of early intensive aphasia rehabilitation after stroke is unknown. The Very Early Rehabilitation for SpEech trial (VERSE) aimed to determine whether intensive aphasia therapy, beginning within 14 days after stroke, improved communication recovery compared to usual care. Method(s): Prospective, randomized, single-blinded trial conducted at 17 acute-care hospitals across Australia/New Zealand from 2014 to 2018. Participants with aphasia following acute stroke were randomized to receive usual care (direct usual care aphasia therapy), or one of two higher intensity regimens (20 sessions of either non-prescribed (usual care-plus or prescribed (VERSE) direct aphasia therapy). The primary outcome was improvement of communication on the Western Aphasia Battery-Revised Aphasia Quotient (AQ) at 12 weeks after stroke. Our pre-planned intention to treat analysis combined high intensity groups for the primary outcome. Finding(s): Among 13,654 acute stroke patients screened, 25% (3477) had aphasia, of whom 25% (866) were eligible and 246 randomized to usual care (n = 81; 33%), usual care-plus (n = 82; 33%) or VERSE (n = 83; 34%). At 12 weeks after stroke, the primary outcome was assessed in 217 participants (88%); 14 had died, 9 had withdrawn, and 6 were too unwell for assessment. Communication recovery was 50.3% (95% CI 45.7-54.8) in the high intensity group (n = 147) and 52.1% (95% CI 46.1-58.1) in the usual care group (n = 70; difference -1.8, 95% CI -8.7-5.0). There was no difference between groups in non-fatal or fatal adverse events (p = 0.72). Interpretation(s): Early, intensive aphasia therapy did not improve communication recovery within 12 weeks post stroke compared to usual care.Copyright © 2020 World Stroke Organization. | DOI: | http://monash.idm.oclc.org/login?url=https://dx.doi.org/10.1177/1747493020961926 | PubMed URL: | 33019888 [https://www.ncbi.nlm.nih.gov/pubmed/?term=33019888] | URI: | https://repository.monashhealth.org/monashhealthjspui/handle/1/47082 | Type: | Article | Subjects: | atrial fibrillation behavior change drug fatality dysarthria Glasgow coma scale head and neck cancer intensive care unit lacunar stroke National Institutes of Health Stroke Scale nuclear magnetic resonance imaging quality of life Rankin scale training Western aphasia battery |
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