Therapeutic Interventions for Aphasia Initiated More than Six Months Post Stroke: A Review of the Evidence

Background: Aphasia effects up to 38% of acute stroke patients. For many of these individuals, this condition persists far beyond the acute phase. The purpose of this review is to evaluate the effectiveness of therapeutic interventions for aphasia initiated more than 6 months post stroke. Methods: A literature search was conducted for articles in which aphasia treatments were initiated more than 6 months post stroke. Searches were conducted in multiple databases including MEDLINE, Scopus, CINAHL, and EMBASE. Results: A total of 21 randomized controlled trials (RCTs) met the inclusion criteria. There is good evidence to suggest that the use of computer-based treatments, constraint-induced therapy, intensity of therapy, group language therapies, and training conversation/communication partners are effective treatments for chronic aphasia. Repetitive transcranial magnetic stimulation, transcranial direct current stimulation, and the use of the drugs piracetam, donepezil, memantime, and galantamine have also demonstrated evidence that they are effective treatments of aphasia 6 months or more post stroke onset. Neither filmed language instruction nor the drug bromocriptine has been shown to be effective in treating chronic aphasia. Conclusions: There is evidence to support the use of a number of treatments for chronic aphasia post stroke. Further research is required to fully support the use of these interventions and to explore the effectiveness of other aphasia interventions in the chronic stage.