Therapy within the first month

5.2 People with aphasia should be offered therapy commencing within the first month post stroke onset to gain benefits in receptive and expressive language and communication in everyday environments.

Reference: The RELEASE collaborators, 2021: Meta-analysis of 174 studies (5,928 IPD)

NHMRC level of Evidence: I

Rationale: A meta-analysis of individual participant data from 174 studies (47 RCTs, 18 non-RCTs, 5 registries and 104 case-series/cohort studies) investigated predictors of language recovery by modality (auditory comprehension, naming and functional communication), and overall language recovery (The RELEASE collaborators, 2021). The effects of age, aphasia chronicity and sex were included in the analyses.

Treatment provided within one month of stroke onset was associated with the greatest mean absolute change in overall language ability, more correct responses in auditory comprehension and naming tasks, and greatest absolute gain in functional communication. The meta-analysis results were unable to account for the role of spontaneous recovery and this needs to be taken into consideration when interpreting these data.

References:

1. The RELEASE Collaborators (2021). Predictors of Poststroke Aphasia Recovery: A Systematic Review-Informed Individual Participant Data Meta-Analysis. Stroke, 52(5):1778-1787. doi: 10.1161/STROKEAHA.120.031162.