High-Intensity Aphasia Intervention Is Minimally Fatiguing in Chronic Aphasia: An Analysis of Participant Self-Ratings From a Large Randomized Controlled Trial-Reference-Cited by-同舟云学术

High-Intensity Aphasia Intervention Is Minimally Fatiguing in Chronic Aphasia: An Analysis of Participant Self-Ratings From a Large Randomized Controlled Trial

Published:2024-07 Issue:7 Volume:55 Page:1877-1885
ISSN:0039-2499
Container-title:Stroke
language:en
Short-container-title:Stroke

Author:

Pierce John E.¹²^ORCID,Cavanaugh Robert³^ORCID,Harvey Sam¹⁴^ORCID,Dickey Michael Walsh⁵^ORCID,Nickels Lyndsey¹⁶^ORCID,Copland David¹⁴⁷^ORCID,Togher Leanne¹⁸^ORCID,Godecke Erin¹⁹^ORCID,Meinzer Marcus¹⁰^ORCID,Rai Tapan¹¹^ORCID,Cadilhac Dominique A.¹¹²¹³^ORCID,Kim Joosup¹²^ORCID,Hurley Melanie¹^ORCID,Foster Abby M.¹²¹⁴¹⁵^ORCID,Carragher Marcella¹²^ORCID,Wilcox Cassie¹²,Rose Miranda L.¹²^ORCID

Affiliation:

1. Centre of Research Excellence in Aphasia Recovery and Rehabilitation (J.E.P., L.N., M.H., A.M.F., M.C., C.W., M.L.R., S.H., L.T., E.G., D.A.C., D.C.), Melbourne, VIC, Australia.

2. La Trobe University, and School of Allied Health, Human Services and Sport (A.M.F., J.E.P., M.L.R., M.C., C.W.), Melbourne, VIC, Australia.

3. Observational Health Data Sciences and Informatics Center, Roux Institute, Northeastern University, Boston, MA (R.C.).

4. Queensland Aphasia Research Centre (D.C. S.H.), School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia.

5. Communication Science and Disorders, University of Pittsburgh, and Geriatric Research Education and Clinical Center, VA Pittsburgh Healthcare System, PA (M.W.D.).

6. School of Psychological Sciences, Macquarie University, Sydney, NSW, Australia (L.N.).

7. Surgical Treatment and Rehabilitation Service Education and Research Alliance, The University of Queensland and Metro North Health, Brisbane, Australia (D.C.).

8. Faculty of Medicine and Health, The University of Sydney, NSW, Australia (L.T.).

9. School of Medical and Health Sciences, Edith Cowan University and Sir Charles Gairdner Osborne Park Health Care Group, Perth, WA, Australia (E.G.).

10. Department of Neurology, Healthy Aging and Prevention of Dementia Group, University Medicine Greifswald, Germany (M.M.).

11. School of Mathematical and Physical Sciences, University of Technology Sydney, Ultimo, NSW, Australia (T.R.).

12. Stroke and Ageing Research, Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, VIC, Australia (D.A.C., J.K.).

13. Stroke Team, Florey Institute, The University of Melbourne, VIC, Australia (D.A.C.).

14. Monash Health, Melbourne, VIC, Australia (A.M.F.).

15. School of Primary and Allied Health Care, Monash University, Melbourne, VIC, Australia (A.M.F.).

Abstract

BACKGROUND: High-intensity therapy is recommended in current treatment guidelines for chronic poststroke aphasia. Yet, little is known about fatigue levels induced by treatment, which could interfere with rehabilitation outcomes. We analyzed fatigue experienced by people with chronic aphasia (>6 months) during high-dose interventions at 2 intensities. METHODS: A retrospective observational analysis was conducted on self-rated fatigue levels of people with chronic aphasia (N=173) collected during a previously published large randomized controlled trial of 2 treatments: constraint-induced aphasia therapy plus and multi-modality aphasia therapy. Interventions were administered at a higher intensity (30 hours over 2 weeks) or lower intensity (30 hours over 5 weeks). Participants rated their fatigue on an 11-point scale before and after each day of therapy. Data were analyzed using Bayesian ordinal multilevel models. Specifically, we considered changes in self-rated participant fatigue across a therapy day and over the intervention period. RESULTS: Data from 144 participants was analyzed. Participants were English speakers from Australia or New Zealand (mean age, 62 [range, 18–88] years) with 102 men and 42 women. Most had mild (n=115) or moderate (n=52) poststroke aphasia. Median ratings of the level of fatigue by people with aphasia were low (1 on a 0–10-point scale) at the beginning of the day. Ratings increased slightly (+1.0) each day after intervention, with marginally lower increases in the lower intensity schedule. There was no evidence of accumulating fatigue over the 2- or 5-week interventions. CONCLUSIONS: Findings suggest that intensive intervention was not associated with large increases in fatigue for people with chronic aphasia enrolled in the COMPARE trial (Constraint-Induced or Multimodality Personalised Aphasia Rehabilitation). Fatigue did not change across the course of the intervention. This study provides evidence that intensive treatment was minimally fatiguing for stroke survivors with chronic aphasia, suggesting that fatigue is not a barrier to high-intensity treatment.

Publisher

Ovid Technologies (Wolters Kluwer Health)

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