Strategies to promote long-tern maintenance of gains

5.8 Aphasia rehabilitation can focus on strategies to promote long-term maintenance of gains, including promoting independent communication practice and use, and maximising communication opportunities.

Reference: Menahemi-Falkov et al., 2022: Systematic review of 44 studies (6 RCTs, 4 pseudo-RCTs, 3 non-RCTs, 11 SCEDs, 12 case series, 7 pre-post single case, 1 interrupted time series with a control group)

NHMRC Level of Evidence: I

Rationale: It has been found that many people with aphasia (~80%) who undergo intensive language interventions do not maintain gains in the long-term without ongoing treatment or communication use (Menahemi-Falkov et al., 2022). In light of these findings, speech pathologists should be aware, realistic, and transparent about the potential long-term benefits of high intensity intervention for their clients. Focusing on raising awareness and embedding proactive, long-term strategies (e.g., how to integrate real life communication practice in daily settings, maximising usage opportunities in the long term) may be considered as an explicit target in speech and language therapy (Menahemi-Falkov et al., 2022). If possible, tapering of treatment through ongoing, more distributed practice can be considered after the initial, more intensive phase of therapy, which may help to maintain treatment effects (Menahemi- Falkov et al., 2022). Less evidence is available on maintenance of gains following lower intensity interventions, but the same strategies are likely to be necessary to maintain therapy gains for the longterm.

References: 

1. Menahemi-Falkov, M., Breitenstein, C., Pierce, J.E., Hill, A.J., O’Halloran, R., & Rose, M. (2022). A systematic review of maintenance following intensive therapy programs in chronic post-stroke aphasia: Importance of individual response analysis. Disability and Rehabilitation 44(20), 5811-5826. DOI: 10.1080/09638288.2021.1955303