{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T14:07:26Z","timestamp":1790950046466,"version":"4.1.0"},"reference-count":22,"publisher":"BMJ","issue":"6","funder":[{"DOI":"10.13039\/501100001659","name":"Deutsche Forschungsgemeinschaft","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001659","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["J Neurol Neurosurg Psychiatry"],"published-print":{"date-parts":[[2018,6]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Recent evidence has fuelled the debate on the role of massed practice in the rehabilitation of chronic post-stroke aphasia. Here, we further determined the optimal daily dosage and total duration of intensive speech-language therapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Individuals with chronic aphasia more than 1\u2009year post-stroke received Intensive Language-Action Therapy in a randomised, parallel-group, blinded-assessment, controlled trial. Participants were randomly assigned to one of two outpatient groups who engaged in either highly-intensive practice (Group I: 4\u2009hours daily) or moderately-intensive practice (Group II: 2\u2009hours daily). Both groups went through an initial waiting period and two successive training intervals. Each phase lasted 2\u2009weeks. Co-primary endpoints were defined after each training interval.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Thirty patients\u201415 per group\u2014completed the study. A primary outcome measure (Aachen Aphasia Test) revealed no gains in language performance after the waiting period, but indicated significant progress after each training interval (gradual 2-week\n                      <jats:italic>t<\/jats:italic>\n                      -score change [CI]: 1.7 [\u00b10.4]; 0.6 [\u00b10.5]), independent of the intensity level applied (4-week change in Group I: 2.4 [\u00b11.2]; in Group II: 2.2 [\u00b10.8]). A secondary outcome measure (Action Communication Test) confirmed these findings in the waiting period and in the first training interval. In the second training interval, however, only patients with moderately-intensive practice continued to make progress (Time-by-Group interaction:\n                      <jats:italic>P<\/jats:italic>\n                      =0.009,\n                      <jats:italic>\u03b7<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      =0.13).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our results suggest no added value from more than 2\u2009hours of daily speech-language therapy within 4\u2009weeks. Instead, these results demonstrate that even a small 2-week increase in treatment duration contributes substantially to recovery from chronic post-stroke aphasia.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/jnnp-2017-315962","type":"journal-article","created":{"date-parts":[[2017,12,22]],"date-time":"2017-12-22T12:19:09Z","timestamp":1513945149000},"page":"586-592","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":74,"title":["Efficacy of intensive aphasia therapy in patients with chronic stroke: a randomised controlled trial"],"prefix":"10.1136","volume":"89","author":[{"given":"Benjamin","family":"Stahl","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bettina","family":"Mohr","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Verena","family":"B\u00fcscher","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felix R","family":"Dreyer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guglielmo","family":"Lucchese","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Friedemann","family":"Pulverm\u00fcller","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2017,12,22]]},"reference":[{"key":"2020050722301625000_89.6.586.1","doi-asserted-by":"crossref","first-page":"1528","DOI":"10.1016\/S0140-6736(17)30067-3","article-title":"Intensive speech and language therapy in patients with chronic aphasia after stroke: a randomised, open-label, blinded-endpoint, controlled trial in a health-care setting","volume":"389","author":"Breitenstein","year":"2017","journal-title":"Lancet"},{"key":"2020050722301625000_89.6.586.2","doi-asserted-by":"publisher","DOI":"10.1044\/1092-4388(2008\/07-0206)"},{"key":"2020050722301625000_89.6.586.3","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.0000062343.64383.D0"},{"key":"2020050722301625000_89.6.586.4","doi-asserted-by":"publisher","DOI":"10.1310\/tsr1906-523"},{"key":"2020050722301625000_89.6.586.5","first-page":"CD000425","article-title":"Speech and language therapy for aphasia following stroke","volume":"6","author":"Brady","year":"2016","journal-title":"Cochrane Database Syst Rev"},{"key":"2020050722301625000_89.6.586.6","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.32.7.1621"},{"key":"2020050722301625000_89.6.586.7","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.115.009522"},{"key":"2020050722301625000_89.6.586.8","doi-asserted-by":"publisher","DOI":"10.1044\/jslhr.4101.172"},{"key":"2020050722301625000_89.6.586.9","first-page":"291","article-title":"The Aachen Aphasia Test","volume":"42","author":"Huber","year":"1984","journal-title":"Adv Neurol"},{"key":"2020050722301625000_89.6.586.10","doi-asserted-by":"publisher","DOI":"10.1016\/0028-3932(71)90067-4"},{"key":"2020050722301625000_89.6.586.11","doi-asserted-by":"publisher","DOI":"10.1207\/S15324826AN0704_8"},{"key":"2020050722301625000_89.6.586.12","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1016\/j.cortex.2016.09.021","article-title":"Using language for social interaction: communication mechanisms promote recovery from chronic non-fluent aphasia","volume":"85","author":"Stahl","year":"2016","journal-title":"Cortex"},{"key":"2020050722301625000_89.6.586.13","doi-asserted-by":"publisher","DOI":"10.3758\/BRM.41.4.1149"},{"key":"2020050722301625000_89.6.586.14","doi-asserted-by":"crossref","first-page":"1317","DOI":"10.1080\/02687038.2012.705815","article-title":"Intensive Language-Action Therapy (ILAT): the methods","volume":"26","author":"Difrancesco","year":"2012","journal-title":"Aphasiology"},{"key":"2020050722301625000_89.6.586.15","doi-asserted-by":"publisher","DOI":"10.1155\/2000\/421719"},{"key":"2020050722301625000_89.6.586.16","doi-asserted-by":"crossref","first-page":"223","DOI":"10.3389\/fnhum.2017.00223","article-title":"Communicative-pragmatic assessment is sensitive and time-effective in measuring the outcome of aphasia therapy","volume":"11","author":"Stahl","year":"2017","journal-title":"Front Hum Neurosci"},{"key":"2020050722301625000_89.6.586.17","unstructured":"Hebb DO . The organization of behavior. New York, NY: Wiley, 1949."},{"key":"2020050722301625000_89.6.586.18","doi-asserted-by":"publisher","DOI":"10.1038\/nrneurol.2010.201"},{"key":"2020050722301625000_89.6.586.19","doi-asserted-by":"crossref","unstructured":"Mazur JE . Learning and behavior. 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