This month we publish an important paper evaluating intensive aphasia therapy after acute stroke. Physiotherapy, speech and language therapy, and occupational therapy are important components of stroke rehabilitation, but despite their widespread use, there is limited data evaluating which components of each are most effective and how intensive therapy needs to be to gain maximal benefit. In the longer term, intensive therapy interventions have been shown to improve outcome; for example in upper limb neurorehabilitation.¹ However, whether “more intensive therapy is better” when commenced in the early phases after stroke, during which there is a rapid spontaneous recovery, is uncertain. The recent important AVERT trial in over 2000 acute stroke patients found frequent higher dose early mobilization, which was associated with a higher dose of therapy, was unexpectedly associated with a reduced odds of a favourable outcome at three months.² This questions the hypothesis that more intensive therapy is better at early timepoints after stroke.

中文翻译：

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中风后强化言语治疗

本月，我们发表了一篇评估急性中风后强化失语症治疗的重要论文。物理治疗、言语和语言治疗以及职业治疗是中风康复的重要组成部分，但尽管它们被广泛使用，但评估每种组成部分最有效的数据以及需要如何强化治疗才能获得最大益处的数据有限。从长远来看，强化治疗干预已被证明可以改善结果；例如上肢神经康复。¹然而，在卒中后的早期阶段开始“更强化治疗更好”，在此期间可快速自然恢复，尚不确定。最近在 2000 多名急性卒中患者中进行的重要 AVERT 试验发现，频繁的高剂量早期活动与更高剂量的治疗相关，出乎意料地与三个月时出现良好结果的几率降低有关。²这对卒中后早期强化治疗效果更好的假设提出了质疑。