Results of the COMPARE trial of Constraint-induced or Multimodality Aphasia Therapy compared with usual care in chronic post-stroke aphasia.

Rose, ML; Nickels, L; Copland, D; Togher, L; Godecke, E; Meinzer, M; Rai, T; Cadilhac, DA; Kim, J; Hurley, M; Foster, A; Carragher, M; Wilcox, C; Pierce, JE; Steel, G

Results of the COMPARE trial of Constraint-induced or Multimodality Aphasia Therapy compared with usual care in chronic post-stroke aphasia.

Rose, ML Nickels, L Copland, D Togher, L Godecke, E Meinzer, M Rai, T

Cadilhac, DA Kim, J Hurley, M Foster, A Carragher, M Wilcox, C Pierce, JE Steel, G

Permalink

Publisher:: BMJ PUBLISHING GROUP
Publication Type:: Journal Article
Citation:: J Neurol Neurosurg Psychiatry, 2022, 93, (6), pp. 573-581
Issue Date:: 2022-06

Open Access

Copyright Clearance Process

Recently Added
In Progress
Open Access

This item is open access.

Adobe PDF

Download Published versionAdobe PDF (1.41 MB)

View on publisher's site

View statistics

Full metadata record

Field	Value	Language
dc.contributor.author	Rose, ML
dc.contributor.author	Nickels, L
dc.contributor.author	Copland, D
dc.contributor.author	Togher, L
dc.contributor.author	Godecke, E
dc.contributor.author	Meinzer, M
dc.contributor.author	Rai, T https://orcid.org/0000-0003-1610-8983
dc.contributor.author	Cadilhac, DA
dc.contributor.author	Kim, J
dc.contributor.author	Hurley, M
dc.contributor.author	Foster, A
dc.contributor.author	Carragher, M
dc.contributor.author	Wilcox, C
dc.contributor.author	Pierce, JE
dc.contributor.author	Steel, G
dc.date.accessioned	2022-11-19T22:58:21Z
dc.date.available	2022-03-09
dc.date.available	2022-11-19T22:58:21Z
dc.date.issued	2022-06
dc.identifier.citation	J Neurol Neurosurg Psychiatry, 2022, 93, (6), pp. 573-581
dc.identifier.issn	0022-3050
dc.identifier.issn	1468-330X
dc.identifier.uri	http://hdl.handle.net/10453/163599
dc.description.abstract	BACKGROUND: While meta-analyses confirm treatment for chronic post-stroke aphasia is effective, a lack of comparative evidence for different interventions limits prescription accuracy. We investigated whether Constraint-Induced Aphasia Therapy Plus (CIAT-plus) and/or Multimodality Aphasia Therapy (M-MAT) provided greater therapeutic benefit compared with usual community care and were differentially effective according to baseline aphasia severity. METHODS: We conducted a three-arm, multicentre, parallel group, open-label, blinded endpoint, phase III, randomised-controlled trial. We stratified eligible participants by baseline aphasia on the Western Aphasia Battery-Revised Aphasia Quotient (WAB-R-AQ). Groups of three participants were randomly assigned (1:1:1) to 30 hours of CIAT-Plus or M-MAT or to usual care (UC). Primary outcome was change in aphasia severity (WAB-R-AQ) from baseline to therapy completion analysed in the intention-to-treat population. Secondary outcomes included word retrieval, connected speech, functional communication, multimodal communication, quality of life and costs. RESULTS: We analysed 201 participants (70 in CIAT-Plus, 70 in M-MAT and 61 in UC). Aphasia severity was not significantly different between groups at postintervention: 1.05 points (95% CI -0.78 to 2.88; p=0.36) UC group vs CIAT-Plus; 1.06 points (95% CI -0.78 to 2.89; p=0.36) UC group vs M-MAT; 0.004 points (95% CI -1.76 to 1.77; p=1.00) CIAT-Plus vs M-MAT. Word retrieval, functional communication and communication-related quality of life were significantly improved following CIAT-Plus and M-MAT. Word retrieval benefits were maintained at 12-week follow-up. CONCLUSIONS: CIAT-Plus and M-MAT were effective for word retrieval, functional communication, and quality of life, while UC was not. Future studies should explore predictive characteristics of responders and impacts of maintenance doses. TRIAL REGISTRATION NUMBER: ACTRN 2615000618550.
dc.format	Print-Electronic
dc.language	eng
dc.publisher	BMJ PUBLISHING GROUP
dc.relation	http://purl.org/au-research/grants/nhmrc/1083010
dc.relation	http://purl.org/au-research/grants/nhmrc/GNT1083010
dc.relation.ispartof	J Neurol Neurosurg Psychiatry
dc.relation.isbasedon	10.1136/jnnp-2021-328422
dc.rights	info:eu-repo/semantics/openAccess
dc.subject	11 Medical and Health Sciences, 17 Psychology and Cognitive Sciences
dc.subject.classification	Neurology & Neurosurgery
dc.subject.mesh	Aphasia
dc.subject.mesh	Humans
dc.subject.mesh	Language Therapy
dc.subject.mesh	Quality of Life
dc.subject.mesh	Stroke Rehabilitation
dc.subject.mesh	Treatment Outcome
dc.subject.mesh	Humans
dc.subject.mesh	Aphasia
dc.subject.mesh	Treatment Outcome
dc.subject.mesh	Language Therapy
dc.subject.mesh	Quality of Life
dc.subject.mesh	Stroke Rehabilitation
dc.title	Results of the COMPARE trial of Constraint-induced or Multimodality Aphasia Therapy compared with usual care in chronic post-stroke aphasia.
dc.type	Journal Article
utslib.citation.volume	93
utslib.location.activity	England
utslib.for	11 Medical and Health Sciences
utslib.for	17 Psychology and Cognitive Sciences
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/DVC (Research)
utslib.copyright.status	open_access	*
dc.date.updated	2022-11-19T22:58:17Z
pubs.issue	6
pubs.publication-status	Published
pubs.volume	93
utslib.citation.issue	6

Abstract:

BACKGROUND: While meta-analyses confirm treatment for chronic post-stroke aphasia is effective, a lack of comparative evidence for different interventions limits prescription accuracy. We investigated whether Constraint-Induced Aphasia Therapy Plus (CIAT-plus) and/or Multimodality Aphasia Therapy (M-MAT) provided greater therapeutic benefit compared with usual community care and were differentially effective according to baseline aphasia severity. METHODS: We conducted a three-arm, multicentre, parallel group, open-label, blinded endpoint, phase III, randomised-controlled trial. We stratified eligible participants by baseline aphasia on the Western Aphasia Battery-Revised Aphasia Quotient (WAB-R-AQ). Groups of three participants were randomly assigned (1:1:1) to 30 hours of CIAT-Plus or M-MAT or to usual care (UC). Primary outcome was change in aphasia severity (WAB-R-AQ) from baseline to therapy completion analysed in the intention-to-treat population. Secondary outcomes included word retrieval, connected speech, functional communication, multimodal communication, quality of life and costs. RESULTS: We analysed 201 participants (70 in CIAT-Plus, 70 in M-MAT and 61 in UC). Aphasia severity was not significantly different between groups at postintervention: 1.05 points (95% CI -0.78 to 2.88; p=0.36) UC group vs CIAT-Plus; 1.06 points (95% CI -0.78 to 2.89; p=0.36) UC group vs M-MAT; 0.004 points (95% CI -1.76 to 1.77; p=1.00) CIAT-Plus vs M-MAT. Word retrieval, functional communication and communication-related quality of life were significantly improved following CIAT-Plus and M-MAT. Word retrieval benefits were maintained at 12-week follow-up. CONCLUSIONS: CIAT-Plus and M-MAT were effective for word retrieval, functional communication, and quality of life, while UC was not. Future studies should explore predictive characteristics of responders and impacts of maintenance doses. TRIAL REGISTRATION NUMBER: ACTRN 2615000618550.

Please use this identifier to cite or link to this item:

http://hdl.handle.net/10453/163599