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Examining dose frameworks to improve aphasia rehabilitation research

Published:December 23, 2022DOI:https://doi.org/10.1016/j.apmr.2022.12.002

      Abstract

      The effect of treatment dose on recovery of post-stroke aphasia is not well understood. Inconsistent conceptualisation, measurement, and reporting of the multiple dimensions of dose hinders efforts to evaluate dose-response relationships in aphasia rehabilitation research. We review the state of dose conceptualisation in aphasia rehabilitation and compare the applicability of three existing dose frameworks to aphasia rehabilitation research – the Frequency, Intensity, Time, and Type principle (FITT), the Cumulative Intervention Intensity (CII) framework, and the Multidimensional Dose Articulation Framework (MDAF). The MDAF specifies dose in greater detail than the CII framework and the FITT principle. On this basis we selected the MDAF to be applied to three diverse examples of aphasia rehabilitation research. We next critically examined applicability of the MDAF to aphasia rehabilitation research and identified the next steps needed to systematically conceptualise, measure, and report the multiple dimensions of dose, which together can progress understanding of the effect of treatment dose on outcomes for people with aphasia following stroke. Further consideration is required to enable application of this framework to aphasia interventions that focus on participation, personal, and environmental interventions and to understand how the construct of episode difficulty applies across therapeutic activities used in aphasia interventions.

      Keywords

      List of abbreviations:

      CII (Cumulative Intervention Intensity), FITT (Frequency, intensity, time, and type), ICF (International Classification of Functioning, Disability and Health), MDAF (Multidimensional Dose Articulation Framework)
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