Abstract
ABSTRACT Background The maintenance of therapy gains is critical for successful aphasia rehabilitation, a topic often overlooked in both research and clinical practice. For some people with chronic aphasia, maintaining therapeutic gains can be challenging, potentially resulting in diminished communicative function over time. Furthermore, maintaining therapy gains may necessitate consistent, deliberate effort; however, little is known about the factors supporting this process. People living with chronic aphasia and their family members may provide critical insights into the behavioural factors that impact the maintenance of therapy gains. Understanding these factors will be crucial for developing long-lasting, effective aphasia interventions. Aim In this study, we explored the perspectives and practices of people with chronic aphasia and their partners concerning the maintenance of gains from therapy for post-stroke chronic aphasia. Methods & Procedures Eight in-depth, semi-structured interviews were conducted, involving four people with chronic aphasia and four partners. We employed inductive thematic data analysis to identify emergent themes. Outcomes & Results Five themes were identified that were perceived to influence the maintenance of gains made during aphasia rehabilitation. These were: 1) Beliefs about change: improvement, decline, and maintenance; 2) Personal abilities impact improvement and maintenance; 3) External support impacts improvement and maintenance; 4) Engaging in ongoing real-life communication impacts improvement and maintenance; and 5) Knowledge and services gaps in maintenance. The findings demonstrate the complexity and interaction of factors that potentially facilitate or hinder the maintenance of therapy gains in chronic aphasia. Conclusions People with chronic aphasia and their partners report having a limited understanding of the necessity and methods for maintaining therapy gains. They also describe a lack of services to support this. A lack of knowledge and services could hinder the ability to maintain therapeutic benefits. Our study also suggests various behavioural factors are involved in maintaining gains. Forming meaningful real-life communication routines may potentially optimise such gains. These findings highlight the necessity of placing maintenance at the heart of aphasia rehabilitation, informing future interventions and service development.
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