Conversation group Tx for people with aphasia (Hoover et al., 2025)

<b>Purpose: </b>Aphasia is a communication disorder that affects up to 30% of stroke survivors. Insufficient access to communication services creates personal, social, and financial costs to people with aphasia (PwA), care partners, and the community. Group conversation treatment has the potential to improve communication and reduce social isolation in a cost-effective manner, but little is known about its critical ingredients. This multicenter randomized controlled trial examined the effects of conversation treatment and whether the pattern of changes on outcome measures differed when treatment was delivered in large groups compared to dyads.<b>Method: </b>One hundred four PwA were randomly assigned to a dyad, large group, or delayed control condition. Conversation group treatment was 1 hr, twice weekly, over 10 weeks. Individual communication goals were addressed within thematically oriented conversation treatment. To evaluate treatment effects, primary (Aphasia Communication Outcome Measure [ACOM]) and secondary outcome measures were examined at pretreatment, posttreatment, and 6 weeks posttreatment.<b>Results: </b>The ACOM did not show significant changes in the planned omnibus analyses. Post hoc analyses suggested that the large group, but not dyad, treatment condition showed a treatment effect on the ACOM from pre- to posttreatment. Both treatment conditions showed changes on a measure of naming, and the dyads also showed improvement on a measure of repetition.<b>Conclusions: </b>The study failed to show the effects of conversation treatment in the omnibus analysis, but there was evidence that conversation group treatment, delivered in a large group, is effective for people with chronic aphasia. This study also illustrated how manipulating the size of the group may alter the outcomes for individuals. The results of this study offer support for a <i>cost-effective</i> treatment option for PwA across the continuum of care.<b>Supplemental Material S1.</b> Results of linear mixed-effect models for functional and patient-reported outcome measures.<b>Supplemental Material S2.</b> Results of linear mixed-effect models for linguistic measures: Comprehensive Aphasia Test and Verb Naming Test.<b>Supplemental Material S3.</b> Results of linear mixed-effect models for complete utterances.<b>Supplemental Material S4.</b> Results of linear mixed-effect models for mean number of core lexicon words.<b>Supplemental Material S5.</b> Results of linear mixed-effect models for functional and patient-reported outcome measures.<b>Supplemental Material S6.</b> Results of linear mixed-effect models for linguistic measures: Comprehensive Aphasia Test and Verb Naming Test.<b>Supplemental Material S7.</b> Results of linear mixed-effect models for complete utterances.<b>Supplemental Material S8.</b> Results of linear mixed-effect models for mean number of core lexicon words.<b>Supplemental Material S9.</b> Results of linear mixed-effect models for functional and patient-reported outcome measures.<b>Supplemental Material S10.</b> Results of linear mixed-effect models for linguistic measures: Comprehensive Aphasia Test and Verb Naming Test.<b>Supplemental Material S11.</b> Results of linear mixed-effect models for complete utterances.<b>Supplemental Material S12. </b>Results of linear mixed-effect models for mean number of core lexicon words.Hoover, E., Szabo, G., Kohen, F., Vitale, S., McCloskey, N., Maas, E., Kulkarni, V., &amp; DeDe, G. (2025). The benefits of conversation group treatment for individuals with chronic aphasia: Updated evidence from a multisite randomized controlled trial on measures of language and communication. <i>American Journal of Speech-Language Pathology</i><i>, 34</i>(3), 1203–1218. https://doi.org/10.1044/2025_AJSLP-24-00279

<b>目的：</b>失语症（Aphasia）是一种沟通障碍，影响多达30%的中风幸存者。沟通服务获取不足给失语症患者（PwA）、照护伙伴及社区带来了个人、社会和经济成本。团体对话治疗有望以具成本效益的方式改善沟通并减少社会孤立，但人们对其关键要素知之甚少。本多中心随机对照试验探讨了对话治疗的效果，以及当治疗以大型团体形式而非二人组形式开展时，结局指标的变化模式是否存在差异。<b>方法：</b>104名失语症患者（PwA）被随机分配至二人组、大型团体或延迟对照组。团体对话治疗为每周两次，每次1小时，持续10周。在主题导向的对话治疗中设定了个体沟通目标。为评估治疗效果，在治疗前、治疗后及治疗后6周对主要结局指标（失语症沟通结局量表[ACOM]）和次要结局指标进行了检测。<b>结果：</b>在预设的综合分析中，ACOM未显示显著变化。事后分析表明，大型团体治疗组（而非二人组）在治疗前后的ACOM上呈现出治疗效果。两种治疗形式均在命名测试中显示出变化，且二人组在重复测试中亦有改善。<b>结论：</b>本研究在综合分析中未显示对话治疗的效果，但有证据表明，以大型团体形式开展的对话治疗对慢性失语症患者有效。本研究还阐明了调整团体规模如何改变个体结局。研究结果为失语症患者（PwA）在整个照护连续体中提供了具成本效益的治疗选择依据。<b>补充材料S1.</b>功能及患者报告结局指标的线性混合效应模型结果。<b>补充材料S2.</b>语言指标的线性混合效应模型结果：综合失语症测试与动词命名测试。<b>补充材料S3.</b>完整话语的线性混合效应模型结果。<b>补充材料S4.</b>核心词汇平均数量的线性混合效应模型结果。<b>补充材料S5.</b>功能及患者报告结局指标的线性混合效应模型结果。<b>补充材料S6.</b>语言指标的线性混合效应模型结果：综合失语症测试与动词命名测试。<b>补充材料S7.</b>完整话语的线性混合效应模型结果。<b>补充材料S8.</b>核心词汇平均数量的线性混合效应模型结果。<b>补充材料S9.</b>功能及患者报告结局指标的线性混合效应模型结果。<b>补充材料S10.</b>语言指标的线性混合效应模型结果：综合失语症测试与动词命名测试。<b>补充材料S11.</b>完整话语的线性混合效应模型结果。<b>补充材料S12.</b>核心词汇平均数量的线性混合效应模型结果。Hoover, E.、Szabo, G.、Kohen, F.、Vitale, S.、McCloskey, N.、Maas, E.、Kulkarni, V. 及 DeDe, G.（2025）。团体对话治疗对慢性失语症患者的益处：来自多中心随机对照试验的语言与沟通指标最新证据。《美国言语语言病理学杂志》，34(3)，1203–1218。https://doi.org/10.1044/2025_AJSLP-24-00279