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Prognosis and Predictors Research

 

 

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At present there is limited understanding of the factors which indicate the degree of natural recovery from aphasia following stroke.

An understanding of which individuals with aphasia are likely to respond well to rehabilitation and which people are more likely to benefit from a communication management approach is lacking. Combining pre-existing datasets would permit investigation and analyses of these issues.

 

Systematic review of the factors predicting language recovery in individuals with post-stroke aphasia

There are numerous papers dealing with various individual factors that may be predictive for language recovery in post-stroke aphasic patients. Some of them have provided even conflicting results; e.g. some studies have shown that gender has a significant effect on incidence, severity or fluency of the aphasia, while there are some other studies that have shown that gender has little or no effect. However, studies done so far have been conducted mainly on small samples and only a small number of factors was investigated. For that reason there is a need to reanalyze all patient-related and stroke-related factors of language recovery from previous studies. Work on the systematic review paper is ongoing within WG3 in collaboration between Serbian and Swedish teams and as a part of a joint COST activity. 


The main aim is to identify the most influential factors that affect language recovery in individuals suffering from aphasia taking into consideration interdisciplinary approaches. 

REhabilitation and recovery of peopLE with Aphasia after StrokE (RELEASE)

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Background: Aphasia, a language problem associated with stroke-related damage to the brain, occurs in approximately 50,600 people in the UK every year.  People with aphasia have difficulty speaking, understanding speech, reading and writing. Speech and language therapy for aphasia after stroke has benefit. However, therapists need better information to inform their choice of the best treatment option for specific patients. Therapy could be even more effective if it could be tailored to individual patients’ needs. Therapists often asked to advise on recovery, have little high quality information to support them in providing such guidance. 

Aim: This study aims to explore the contribution the characteristics of therapy, the individuals themselves, their stroke and aphasia makes to their rehabilitation and prognosis.

Benefits: A recent James Lind Alliance partnership between stroke survivors, carers and healthcare professionals listed aphasia twice in the ‘top 10’ research priorities for life after stroke. A better understanding of what makes aphasia rehabilitation work, would allow treatments to be tailored to specific individuals resulting in more effective and efficient therapy. 

Research Activities: We are gathering pre-existing data from clinical trials and studies of aphasia treatments after stroke. We are pooling these data in a large database and use them to answer new research questions about aphasia. This is a highly efficient method to explore our research questions (the high quality data has already been collected). We are bringing these separate databases together to allow us to generate new information about aphasia after stroke and identify future research questions. This will offer benefit, inform our understanding of what kind of patients we should be approaching to participate in our study, and when. 

Outcomes: We will produce information on:



  1. The components of aphasia therapy that best facilitate recovery (in general and for different types of people, stroke and aphasia)
  2. The optimum therapy (timing, intensity, frequency, duration, repetition) and home practice routine (in general and for different types of people, stroke and aphasia)
  3. The usual patterns of recovery from aphasia (with and without therapy)
  4. What aspects indicate someone will make a good (or not so good) recovery from aphasia

International Population Registry of AphasIa after StrokE (I-PRAISE)

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Those with aphasia who are included in RCTs represent only a small proportion of those who are affected by post-stroke aphasia in the wider clinical population. the evidence base for therapy which is generated from these participants may not be applicable to all of those with aphasia who are typically seen in clinics and hospitals. We seek to address gaps in knowledge by examining recovery and service provision for aphasia across Europe. 

Aims

1.      Describe the clinical aphasia population across Europe

2.      Describe the clinical treatments for aphasia after stroke in the general population across Europe

3.      Examine the outcomes after clinical intervention for aphasia, across different countries


Aphasia telerehabilitation early post stroke [PhD Fellowship]

Team: Hege Prag Øra, Frank Becker, Melanie Kirmess, Marian Brady 

Funder: Regional Health Trust South East Norway, full time grant for equivalent of 3 years FTE. Start: 1st Aug 2015 End 31st July 2019 (over 4 years)

Transforming access to cost effective aphasia services: the Australian Aphasia Centre for Research Excellence

Team: Linda Worrall, Miranda Rose, Leanne Togher, Tim Shaw, David Copland, Lyndsey Nickels, Erin Godecke, Marian Brady, Julie Bernhardt, Geoffrey Donnan, Dominic Cadillac, Anne Hill, Emma Power, Nina Simmons-Mackie, Deborah Hersh, Robyn O’Halloran

Funder: Australian Government National Health and Medical Research Council. Submission Jan 2016 

 

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