Investigating a new tablet-based telerehabilitation app in patients with aphasia: a randomised, controlled, evaluator-blinded, multicentre trial protocol

Abstract

IntroductionAphasia is a common language disorder acquired after stroke that reduces the quality of life of affected patients. The impairment is frequently accompanied by a deficit in cognitive functions. The state-of-the-art therapy is speech and language therapy but recent findings highlight positive effects of high-frequency therapy. Telerehabilitation has the potential to enable high-frequency therapy for patients at home. This study investigates the effects of high-frequency telerehabilitation speech and language therapy (teleSLT) on language functions in outpatients with aphasia compared with telerehabilitative cognitive training. We hypothesise that patients training with high-frequency teleSLT will show higher improvement in language functions and quality of life compared with patients with high-frequency tele-rehabilitative cognitive training (teleCT).Methods and analysisThis study is a randomised controlled, evaluator-blinded multicentre superiority trial comparing the outcomes following either high-frequency teleSLT or teleCT. A total of 100 outpatients with aphasia will be recruited and assigned in a 1:1 ratio stratified by trial site and severity of impairment to one of two parallel groups. Both groups will train over a period of 4 weeks for 2 hours per day. Patients in the experimental condition will devote 80% of their training time to teleSLT and the remaining 20% (24 min/day) to teleCT, vice versa for patients in the control condition. The primary outcome measure is the understandability of verbal communication on the Amsterdam Nijmegen Everyday Language Test and secondary outcome measures are intelligibility of the verbal communication, impairment of receptive and expressive language functions, confrontation naming. Other outcomes measures are quality of life and acceptance (usability and subjective experience) of the teleSLT system.Ethics and disseminationThis study is approved by the Ethics Committee Bern (ID 2016-01577). Results will be submitted to a peer-reviewed journal.Trial registration numberNCT03228264.

Recent trends in telerehabilitation of stroke patients: A narrative review

“…Other challenges mean insufficient internet capacity and speed requiring for TR, especially among Chen et al, 2020;Cramer et al, 2019;Escalante-Gonzalbo et al, 2021;Guillén-Climent et al, 2021;Jonghyun Kim et al, 2020;Park et al, 2019;Qiu et al, 2020;Rogers et al, 2019;Sarfo, Adusei, et al, 2018;Smith & Tomita, 2020;Szturm et al, 2021;Thielbar et al, 2020; (Faria et al, 2020;Gil-Pagés et al, 2018;Isernia et al, 2019;Lawson et al, 2020;Torrisi et al, 2019;Withiel et al, 2019) Aphasia/linguistic communication disorders Chronic 236 30-120 1-6 4-24 20-100 (Braley et al, 2021;Cherney et al, 2021;Dial et al, 2019;E. S. Kim et al, 2021;Kurland et al, 2018;Maresca et al, 2019;Meltzer et al, 2018;Øra et al, 2020;Peñaloza et al, 2021;Uslu et al, 2020) Total: 995 15-120 1-7 1-24 1.25-100 patients living in homes with different infrastructure. Moreover, synchronous TR might face low quality connection during peak hours.…”

“…Additionally, Uslu et al (2020) introduced a protocol for home TR using tablet-based app with combination of speech/language therapy and cognitive training. Specifically, 100 aphasia outpatients will be assigned to parallel groups.…”

Telerehabilitation—A Viable Option for the Recovery of Post-Stroke Patients

“…biofeedback [17] comparable with face-to-face therapy Hemiparesis/lower limb few studies; not represented primary objective; reviews [5,23] heterogeneous exercises favorable telerehabilitation results; low costs Aphasia comparative studies [28]; randomized controlled trials [29][30][31][32] various interventions controversial results…”

Scientific Publication Patterns of Interactive Mobile Technologies for Psychological, Social, Medical and Business Interventions for Mental and Physical Health: Bibliometric Analysis

“…Bussone et al [34] focused on establishing trustworthy and secure digital platforms forindividualswithHIV.ThemHealthbasedinterventionforParkinson'sdiseasewas recognizedasfeasible [35].Usluetal. [1]assessedtheeffectivenessoftelerehabilitation apps among patients with aphasia.…”

“…Recentstudiesonusinginteractivemobiletechnologiesinvariousfieldsindicatedits significantimpactonreceivedoutcomes [1].Technologyincreasesoverallmentaland physicalwell-being [2],enhancesgainingknowledgeandprofessionalcompetencies [3], and provides efficient opportunities to successfully deal with suicide [4], stress [5], addictions [6], [7], psychosis [8], [9], pain [10], cancer [11] etc. Although some studies on technology used in the mentioned fields have been conducted, there still remain unanswered questions.…”