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Updated Review of Literature on Key Principles of Constraint-Induced Language Therapy (CILT) (Cherney et al., 2008)

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posted on 2008-10-01, 00:00 authored by Leora R. Cherney, Janet P. Patterson, Anastasia Raymer, Tobi Frymark, Tracy Schooling
Purpose This systematic review summarizes evidence for intensity of treatment and constraint-induced language therapy (CILT) on measures of language impairment and communication activity/participation in individuals with stroke-induced aphasia.
Method A systematic search of the aphasia literature using 15 electronic databases (e.g., PubMed, CINAHL) identified 10 studies meeting inclusion/exclusion criteria. A review panel evaluated studies for methodological quality. Studies were characterized by research stage (i.e., discovery, efficacy, effectiveness, cost–benefit/public policy research), and effect sizes (ESs) were calculated wherever possible. Results In chronic aphasia, studies provided modest evidence for more intensive treatment and the positive effects of CILT. In acute aphasia, 1 study evaluated high-intensity treatment positively; no studies examined CILT. Four studies reported discovery research, with quality scores ranging from 3 to 6 of 8 possible markers. Five treatment efficacy studies had quality scores ranging from 5 to 7 of 9 possible markers. One study of treatment effectiveness received a score of 4 of 8 possible markers.
Conclusion Although modest evidence exists for more intensive treatment and CILT for individuals with stroke-induced aphasia, the results of this review should be considered preliminary and, when making treatment decisions, should be used in conjunction with clinical expertise and the client’s individual values.

Funding

This EBSR was supported by ASHA's National Center for Evidence-Based Practice in Communication Disorders (N-CEP), the Advisory Committee on Evidence-Based Practice in Communication Disorders, and ASHA's Special Interest Division 2: Neurophysiology and Neurogenic Speech and Language Disorders. We thank the following individuals who contributed to the preparation of this article: Rob Mullen, N-CEP Director; Beverly Wang, N-CEP Information Manager; and Floyd Roye, N-CEP Project Administrator. All members of this evidence-based review panel agreed to declare no competing interests in relation to this article. No author had any paid consultancy or any other conflict of interest with this document. The first three authors contributed equally to the preparation of this article, and the order does not reflect any differences in contribution.

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