A randomized control trial of intensive aphasia therapy after acute stroke: The Very Early Rehabilitation for SpEech (VERSE) study.

Godecke, E; Armstrong, E; Rai, T; Ciccone, N; Rose, ML; Middleton, S; Whitworth, A; Holland, A; Ellery, F; Hankey, GJ; Cadilhac, DA; Bernhardt, J; VERSE Collaborative Group

A randomized control trial of intensive aphasia therapy after acute stroke: The Very Early Rehabilitation for SpEech (VERSE) study.

Godecke, E Armstrong, E Rai, T

Ciccone, N Rose, ML Middleton, S Whitworth, A Holland, A Ellery, F Hankey, GJ Cadilhac, DA Bernhardt, J VERSE Collaborative Group

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Publisher:: SAGE Publications
Publication Type:: Journal Article
Citation:: International journal of stroke : official journal of the International Stroke Society, 2020, pp. 1747493020961926
Issue Date:: 2020-10-06

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Field	Value	Language
dc.contributor.author	Godecke, E
dc.contributor.author	Armstrong, E
dc.contributor.author	Rai, T https://orcid.org/0000-0003-1610-8983
dc.contributor.author	Ciccone, N
dc.contributor.author	Rose, ML
dc.contributor.author	Middleton, S
dc.contributor.author	Whitworth, A
dc.contributor.author	Holland, A
dc.contributor.author	Ellery, F
dc.contributor.author	Hankey, GJ
dc.contributor.author	Cadilhac, DA
dc.contributor.author	Bernhardt, J
dc.contributor.author	VERSE Collaborative Group
dc.date.accessioned	2020-10-19T19:23:46Z
dc.date.available	2020-10-19T19:23:46Z
dc.date.issued	2020-10-06
dc.identifier.citation	International journal of stroke : official journal of the International Stroke Society, 2020, pp. 1747493020961926
dc.identifier.issn	1747-4930
dc.identifier.issn	1747-4949
dc.identifier.uri	http://hdl.handle.net/10453/143378
dc.description.abstract	BACKGROUND:Effectiveness of early intensive aphasia rehabilitation after stroke is unknown. The Very Early Rehabilitation for SpEech trial (VERSE) aimed to determine whether intensive aphasia therapy, beginning within 14 days after stroke, improved communication recovery compared to usual care. METHODS:Prospective, randomized, single-blinded trial conducted at 17 acute-care hospitals across Australia/New Zealand from 2014 to 2018. Participants with aphasia following acute stroke were randomized to receive usual care (direct usual care aphasia therapy), or one of two higher intensity regimens (20 sessions of either non-prescribed (usual care-plus or prescribed (VERSE) direct aphasia therapy). The primary outcome was improvement of communication on the Western Aphasia Battery-Revised Aphasia Quotient (AQ) at 12 weeks after stroke. Our pre-planned intention to treat analysis combined high intensity groups for the primary outcome. FINDINGS:Among 13,654 acute stroke patients screened, 25% (3477) had aphasia, of whom 25% (866) were eligible and 246 randomized to usual care (n = 81; 33%), usual care-plus (n = 82; 33%) or VERSE (n = 83; 34%). At 12 weeks after stroke, the primary outcome was assessed in 217 participants (88%); 14 had died, 9 had withdrawn, and 6 were too unwell for assessment. Communication recovery was 50.3% (95% CI 45.7-54.8) in the high intensity group (n = 147) and 52.1% (95% CI 46.1-58.1) in the usual care group (n = 70; difference -1.8, 95% CI -8.7-5.0). There was no difference between groups in non-fatal or fatal adverse events (p = 0.72). INTERPRETATION:Early, intensive aphasia therapy did not improve communication recovery within 12 weeks post stroke compared to usual care.
dc.format	Print-Electronic
dc.language	eng
dc.publisher	SAGE Publications
dc.relation.ispartof	International journal of stroke : official journal of the International Stroke Society
dc.relation.isbasedon	10.1177/1747493020961926
dc.rights	info:eu-repo/semantics/openAccess
dc.rights	International journal of stroke : official journal of the International Stroke Society, 2020, pp. 1747493020961926. Copyright © 2020 SAGE Publications. DOI: https://dx.doi.org/10.1177/1747493020961926	en_US
dc.subject	1103 Clinical Sciences, 1109 Neurosciences
dc.subject.classification	Neurology & Neurosurgery
dc.title	A randomized control trial of intensive aphasia therapy after acute stroke: The Very Early Rehabilitation for SpEech (VERSE) study.
dc.type	Journal Article
utslib.location.activity	United States
utslib.for	1103 Clinical Sciences
utslib.for	1109 Neurosciences
pubs.organisational-group	/University of Technology Sydney/DVC (Research)
pubs.organisational-group	/University of Technology Sydney/DVC (Research)/Graduate Research School
pubs.organisational-group	/University of Technology Sydney
utslib.copyright.status	open_access	*
dc.date.updated	2020-10-19T19:23:33Z
pubs.publication-status	Published

Abstract:

BACKGROUND:Effectiveness of early intensive aphasia rehabilitation after stroke is unknown. The Very Early Rehabilitation for SpEech trial (VERSE) aimed to determine whether intensive aphasia therapy, beginning within 14 days after stroke, improved communication recovery compared to usual care. METHODS:Prospective, randomized, single-blinded trial conducted at 17 acute-care hospitals across Australia/New Zealand from 2014 to 2018. Participants with aphasia following acute stroke were randomized to receive usual care (direct usual care aphasia therapy), or one of two higher intensity regimens (20 sessions of either non-prescribed (usual care-plus or prescribed (VERSE) direct aphasia therapy). The primary outcome was improvement of communication on the Western Aphasia Battery-Revised Aphasia Quotient (AQ) at 12 weeks after stroke. Our pre-planned intention to treat analysis combined high intensity groups for the primary outcome. FINDINGS:Among 13,654 acute stroke patients screened, 25% (3477) had aphasia, of whom 25% (866) were eligible and 246 randomized to usual care (n = 81; 33%), usual care-plus (n = 82; 33%) or VERSE (n = 83; 34%). At 12 weeks after stroke, the primary outcome was assessed in 217 participants (88%); 14 had died, 9 had withdrawn, and 6 were too unwell for assessment. Communication recovery was 50.3% (95% CI 45.7-54.8) in the high intensity group (n = 147) and 52.1% (95% CI 46.1-58.1) in the usual care group (n = 70; difference -1.8, 95% CI -8.7-5.0). There was no difference between groups in non-fatal or fatal adverse events (p = 0.72). INTERPRETATION:Early, intensive aphasia therapy did not improve communication recovery within 12 weeks post stroke compared to usual care.

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http://hdl.handle.net/10453/143378