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The COMPARE trial (Constraint-Induced or Multi-Modality Personalised Aphasia Rehabilitation) is a pan-antipodean, multicentre interventional study in 201 people with poststroke aphasia in the chronic phase (median ~2.5 years). The team compared two intensive aphasia therapies: Constraint-Induced Aphasia Therapy Plus (CIAT-Plus) and Multi-Modality Aphasia Therapy (M-MAT) with usual care. They found significant improvements in three key outcome measures, favouring the higher-intensity treatments, but not in their primary outcome measure, the Western Aphasia Battery (WAB-R-AQ).
The obvious question this result poses is, ‘What is the right outcome measure to use in interventional studies of people with aphasia?’ However, there is no simple answer to this for two main reasons. First, aphasia is an umbrella term covering both the range of severities across individuals as well as the fact that, within individuals, there are differing levels of impairment across a variety of language and cognitive domains. A corollary of this is that there are, necessarily, many different tools for measuring the primary effects of aphasic stroke. Second, these multiple primary impairments combine to cause ‘secondary’ problems at several levels including functional communication, social interaction, mood and economic independence. Any of …
Contributors APL and JC wrote the commentary.
Funding This study was funded by National Institute for Health and Care Research (RP-2015-06-012).
Competing interests None declared.
Provenance and peer review Commissioned; internally peer reviewed.