Large variations in intensive speech–language rehabilitation post-stroke

descriptions of practices, and perceptions of barriers and enablers from 26 clinics in Sweden




rehabilitation, aphasia, apraxia of speech, stroke, national guidelines


Background: Intensive rehabilitation of aphasia is recommended in the national guidelines for stroke care, but is far from implemented in Swedish healthcare.
Aim: To explore current practice and detect barriers and enablers for intensive aphasia rehabilitation among Speech Language Pathologists (SLPs) before they were enrolled in a national intervention study.
Method: Thirty-six SLPs in 26 clinics answered a web-based questionnaire. Responses were processed using descriptive statistics and thematic analysis.
Result: Treatment intensity, duration and delivery format varied widely, and two-thirds offered intensive rehabilitation rarely or never. Thematic analysis generated the following five barriers: understaffing, patient factors, teamwork/scheduling, prioritization, and accessibility, and three enablers: increased staffing, planned intervention programmes, and comprehensive delivery formats.
Conclusions: Compliance with Swedish stroke guidelines for intensive aphasia rehabilitation is low, and the current practice varies widely between different clinics. Increasing SLPs in primary care and restructuring care by using planned and comprehensive intervention approaches are suggested to stimulate implementation.



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Marika Schütz, Department of  Public Health and Caring Sciences, Uppsala University

Marika Schütz, speech-language pathologist and PhD student at the Department of Public Health and Caring Sciences, Uppsala University. Schütz does research in intensive rehabilitation of aphasia and apraxia of speech.  

Ingrid Henriksson, Division of Speech and Language Pathology, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg

Ingrid Henriksson, speech-language pathologist, PhD and associate professor at the Division of Speech and Language Pathology, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg. Henriksson has taken a particular interest in the research of aphasia and written language.

Trandur Ulfarsson,  Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg

Trandur Ulfarsson, medical doctor and specialist in rehabilitation medicine, PhD in Rehabilitation Medicine, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg. Ulfarsson has extensive interest in stroke rehabilitation research.

Ellika Schalling, Department of Public Health and Caring Sciences, Uppsala University, also affiliated with the Division of Speech and Language Pathology at Karolinska Institutet

Ellika Schalling, professor in speech-language pathology at the Department of Public Health and Caring Sciences, Uppsala University, also affiliated with the Division of Speech and Language Pathology at Karolinska Institutet. Schalling conducts research neurogenic communication disorders with a special focus on intervention research.


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Referera så här

Schütz, M., Henriksson, I., Ulfarsson, T., & Schalling, E. (2024). Large variations in intensive speech–language rehabilitation post-stroke: descriptions of practices, and perceptions of barriers and enablers from 26 clinics in Sweden. Acta Logopaedica, 1, 1–22.




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