Is it better to have a lot of aphasia therapy in a shorter time, or spread it out?

The researchers wanted to find out how often therapy should happen each week for people with long-term aphasia.

They compared studies with:

• More sessions each week (high intensity)

• Fewer sessions each week (low intensity)

Both groups got the same amount of therapy.

It was just spread out differently.

They wanted to see if doing therapy more often in a short time helps more, or if it is better to spread therapy out over more weeks.

A systematic review and meta-analysis.

In other words:
The researchers looked at all past studies on how often therapy is given each week.

They compared the results together to see if more often or less often works better.

Main message:
Both ways of giving therapy can work.
We still need bigger, better studies to know if one is best.

• The researchers found only a small number of good studies on this topic.

• Both higher-intensity (more therapy each week) and lower-intensity (less therapy each week) helped people with aphasia improve.

• There was no clear evidence that one way (more often or less often) was better.

• At the end of therapy, lower-intensity sometimes looked a little better, but this was not strong evidence.

• One month later, there was no difference between the two.

  📺 Video summary

The research was done to find out how often therapy should happen each week.

People with aphasia, families, and speech pathologists need clear answers.

Knowing the best way could make therapy more helpful and also save time and money.

• There is no strong proof that one way is always better.

• This means you can still make progress even if you spread out your therapy hours to a small number each week.

• If you have the chance to do more therapy in a short time, that might also help — but it is not the only way.

• The most important thing is that you get therapy that is regular and right for you.

The researchers looked at many past studies.

They chose the good ones that compared more therapy each week vs less each week.

They checked how strong each study was and then added the results together to see the bigger picture.

Talk with your speech pathologist about what therapy schedule works best for you. 

We don’t know the best way to give therapy:

• More hours each week (intensive), or

• Less hours each week, spread out (distributed).

Scientists and speech pathologists want to know which way helps most.

More therapy each week can:

• Make you tired

• Be hard to travel to

• Put pressure on your family or carer

• Feel frustrating if progress is slow

Less therapy each week can:

• Mean fewer chances to practise

• Risk slower progress if sessions are too far apart

People could join the studies if they:

• Were adults

• Had aphasia after stroke

• Had aphasia for at least 6 months (long-term)

Across the eight studies, there were 92 participants.

Average age: about 59 years (range 20s to 80s).

Gender: more men than women (about 2 men for every 1 woman).

Time since stroke: on average 4 years after stroke, but ranged from 4 months to over 20 years.

The research was done this way because:

• A review puts all the studies together.

• Putting results together (meta-analysis) helps see the bigger picture.

The included research was from 2018 or earlier.

The research was done in Australia, mainly at La Trobe University.

The research was funded by La Trobe University and the NHMRC in Australia.

Not many studies were found.

Small numbers of people took part.

The studies were not all strong quality.

The research is trustworthy in how it was done, but the evidence is still weak because of few, small studies.

More research is needed.

There might be newer research since this article came out (2020).

We need bigger, stronger studies to find clear answers.

We also need to know if some people do better with more sessions per week, while others do better with fewer.

You can watch a video summary on YouTube.