Aphasietherapie – Wirksamkeit und Evidenzbasierung

Zusammenfassung

Wie andere Therapien auch muss die Aphasietherapie Wirksamkeit und Wirtschaftlichkeit nachweisen. Der übliche Goldstandard der randomisierten kontrollierten Interventionsstudie greift für die auf die individuellen Störungsmuster und Teilhabebeeinträchtigungen ausgerichtete Behandlung erworbener Sprachstörungen zu kurz. Es werden Vorschläge gemacht, wie aus unter definierten Bedingungen durchgeführten Interventionsstudien valide Evidenz für Metaanalysen generiert werden kann.

Abstract

Like other treatments, aphasia therapy is required to prove its effectiveness and efficiency. Randomised, controlled studies, the gold standard of evidence-based medicine, are not well compatible with treatments that have to take into account individual deficit profiles and acquired speech participation impairments. We propose that conditions for therapeutic interventions be defined that allow for the conduction of meta-analyses on the basis of other methodologies than randomised controlled trials.

Schlüsselwörter

Aphasietherapie - Wirksamkeit - Evidenzbasierung

Keywords

aphasia therapy - effectiveness - evidence base

Literatur

• 1 Huber W, Poeck K, Springer L. Klinik und Rehabilitation der Aphasie. Stuttgart; Thieme 2006
• 2 Ziegler W, Ackermann H, Goldenberg G. et al .Rehabilitation aphasischer Störungen nach Schlaganfall. http://uni-duesseldorf.de/AWMF/11/030-090.htm . 2008
• 3 Greener J, Enderby P, Whurr R. Speech and language therapy for aphasia following stroke.  Cochrane Database Syst Rev. 2000;  (2) , CD000425
• 4 Kelly H, Brady M C, Enderby P. Speech and language therapy for aphasia follwoing stroke.  Cochrane Database. 2010;  (5) , CD000425
• 5 Besson P M, Robey R R. Evaluating single-subject treatment research: Lessons learned from the aphasia literature.  Neuropsychol Rev. 2006;  16 161-169
• 6 Best W, Greenwood A, Grassly J. et al . Bridging the gap: can impairment-based therapy for anomia have an impact on the psycho-social level?.  Int J Lang Comm Disord. 2008;  43 390-407
• 7 Robey R R. A meta-analysis of clinical outcomes in the treatment of aphasia.  J Speech Lang Hear Res. 1998;  41 172-187
• 8 Basso A, Carporali A. Aphasia therapy or the importance of being earnest.  Aphasiology. 2001;  15 307-332
• 9 Wallesch C W, Johannsen-Horbach H. Computers in aphasia therapy – effects and side-effects.  Aphasiology. 2004;  18 223-228
• 10 Cherney L R, Patterson J P, Raymer A. et al . Evidence-based systematic review: effects of intensity of treatment and constraint-induced language therapy for individuals with stroke-induced aphasia.  J Speech Lang Hear Res. 2008;  51 1282-1299
• 11 Carlomagno S, Pandolfi M, Labruna L. et al . Recovery from moderate aphasia in the first year poststroke: effect of type of therapy.  Arch Phys Med Rehabil. 2001;  82 1073-1080
• 12 Springer L, Glindemann R, Huber W. et al . How efficacious is PACE therapy when „Language Systematic Training” is incorporated?.  Aphasiology. 1991;  5 391-399
• 13 Katz R C, Wertz R T. The efficacy of computer-provided reading treatment for chronic aphasic adults.  J Speech Hear Res. 1997;  40 493-507
• 14 Springer L, Huber W, Schlenck K J. et al . Agrammatism: deficit or compensation? Consequences for aphasia therapy.  Neurospych Rehab. 2000;  10 279-309
• 15 Springer L, Willmes K, Haag E. Training in the use of wh-questions and propositions in dialogues: a comparison of two different approaches in aphasia therapy.  Aphasiology. 1993;  7 251-270
• 16 Doesborgh S JC, van de Sandt-Koenderman M W, Dippel D W. et al . Effects of semantic treatment on verbal communication and linguistic processing in aphasia after stroke: a randomized controlled trial.  Stroke. 2004;  35 141-146
• 17 Brendel B, Ziegler W. Effectiveness of metrical pacing in the treatment of apraxia of speech.  Aphasiology. 2008;  22 77-102
• 18 Albert M L, Sparks R W, Helm N A. Melodic intonation therapy for aphasia.  Arch Neurol. 1993;  29 130-131
• 19 Benson D F, Dobkin B H, Gonzalez Rothi L J. et al . Assessment: melodic intonation therapy.  Neurology. 1994;  44 566-568
• 20 Schlenck C, Schlenck K J, Springer L. Die Behandlung des schweren Agrammatismus: Reduzierte Syntax-Therapie REST. Stuttgart; Thieme 1995
• 21 Davis G A, Wilcox M J. Adult Aphasia Rehabilitation: Applied Pragmatics. San Diego; College-Hill Press 1985
• 22 Barlow D H, Hersen M. Single case experimental designs: Strategies for studying behavior change. Boston; Alan & Bacon 1984
• 23 Huber W, Poeck K, Weniger D. et al .Der Aachener Aphasie Test – AAT. Göttingen; Hogrefe 1983
• 24 Glueckauf R L, Blonder L X, Ecklund-Johnon E. et al . Functional outcome questionnaire: overview and preliminary psychometric evaluation.  NeuroRehabilitation. 2003;  18 281-290
• 25 Long A, Hesketh A, Bowen A. ACT NoW Research Study . Communication outcome after stroke: a new measure of the carer’s perspective.  Clin Rehabil. 2009;  23 846-856
• 26 Hilari K, Byng S, Lamping D L. et al . Stroke and aphasia Quality of Life Scale-39 (SAQOL-39): Evalution of acceptability, reliability, and validity.  Stroke. 2003;  34 1944-1950