Attention control comparisons with SLT for people with aphasia following stroke: methodological concerns raised following a systematic review

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dc.contributor.author Brady, Marian C.
dc.contributor.author Godwin, Jon
dc.contributor.author Kelly, Helen
dc.contributor.author Enderby, Pam
dc.contributor.author Elders, Andrew
dc.contributor.author Campbell, Pauline
dc.date.accessioned 2019-01-22T11:10:41Z
dc.date.available 2019-01-22T11:10:41Z
dc.date.issued 2018-06-17
dc.identifier.citation Brady, M. C., Godwin, J., Kelly, H., Enderby, P., Elders, A. and Campbell, P. (2018) 'Attention control comparisons with SLT for people with aphasia following stroke: methodological concerns raised following a systematic review', Clinical Rehabilitation, 32(10), pp. 1383-1395. doi:10.1177/0269215518780487 en
dc.identifier.volume 32 en
dc.identifier.issued 10 en
dc.identifier.startpage 1383 en
dc.identifier.endpage 1395 en
dc.identifier.issn 0269-2155
dc.identifier.issn 1477-0873
dc.identifier.uri http://hdl.handle.net/10468/7337
dc.identifier.doi 10.1177/0269215518780487
dc.description.abstract Objective: Attention control comparisons in trials of stroke rehabilitation require care to minimize the risk of comparison choice bias. We compared the similarities and differences in SLT and social support control interventions for people with aphasia. Data sources: Trial data from the 2016 Cochrane systematic review of SLT for aphasia after stroke. Methods: Direct and indirect comparisons between SLT, social support and no therapy controls. We double-data extracted intervention details using the template for intervention description and replication. Standardized mean differences and risk ratios (95% confidence intervals (CIs)) were calculated. Results: Seven trials compared SLT with social support (n  =  447). Interventions were matched in format, frequency, intensity, duration and dose. Procedures and materials were often shared across interventions. Social support providers received specialist training and support. Targeted language rehabilitation was only described in therapy interventions. Higher drop-out (P  =  0.005, odds ratio (OR) 0.51, 95% CI 0.32–0.81) and non-adherence to social support interventions (P  <  0.00001, OR 0.18, 95% CI 0.09–0.37) indicated an imbalance in completion rates increasing the risk of control comparison bias. Conclusion: Distinctions between social support and therapy interventions were eroded. Theoretically based language rehabilitation was the remaining difference in therapy interventions. Social support is an important adjunct to formal language rehabilitation. Therapists should continue to enable those close to the person with aphasia to provide tailored communication support, functional language stimulation and opportunities to apply rehabilitation gains. Systematic group differences in completion rates is a design-related risk of bias in outcomes observed. en
dc.format.mimetype application/pdf en
dc.language.iso en en
dc.publisher SAGE Publications en
dc.rights © 2018, the Authors. This is an Accepted Manuscript of an article published by SAGE Publications in Clinical Rehabilitation on 17 June 2018, available online: https://journals.sagepub.com/doi/abs/10.1177/0269215518780487 en
dc.subject Aphasia en
dc.subject Meta-analysis en
dc.subject Social support en
dc.subject Rehabilitation en
dc.subject Stroke en
dc.title Attention control comparisons with SLT for people with aphasia following stroke: methodological concerns raised following a systematic review en
dc.type Article (peer-reviewed) en
dc.internal.authorcontactother Helen Kelly, Speech And Hearing Sciences, University College Cork, Cork, Ireland. +353-21-490-3000 Email: helen.kelly@ucc.ie en
dc.internal.availability Full text available en
dc.check.info Access to this article is restricted until 12 months after publication by request of the publisher. en
dc.check.date 2019-06-17
dc.date.updated 2019-01-22T10:05:11Z
dc.description.version Accepted Version en
dc.internal.rssid 442168538
dc.contributor.funder Chief Scientist Office en
dc.contributor.funder Scottish Government Health and Social Care Directorate en
dc.description.status Peer reviewed en
dc.identifier.journaltitle Clinical Rehabilitation en
dc.internal.copyrightchecked Yes en
dc.internal.licenseacceptance Yes en
dc.internal.IRISemailaddress helen.kelly@ucc.ie en


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