ReaDySpeech for people with dysarthria after stroke: protocol for a feasibility randomised controlled trial

Abstract

BackgroundDysarthria, a disordered speech production resulting from neuro-muscular impairment, is a common symptom after stroke. It causes significant problems for patients’ speech intelligibility, communication, psychological well-being, social engagement and stroke recovery. Rehabilitation for dysarthria is variable in quality, intensity and duration, which may be, in part, due to the lack of good quality evidence. An online therapy programme, ReaDySpeech, has the potential to improve quality, intensity and duration of speech rehabilitation and was considered in a proof-of-concept study to be acceptable to speech and language therapists and patients which warranted further evaluation. The present study aims to examine the feasibility of running a trial using the ReaDySpeech intervention.Methods/designA feasibility, randomised controlled trial, will recruit a minimum of 36 people with post-stroke dysarthria who are more than 1 week post stroke. Participants will be externally randomised in a 2:1 ratio to receive either ReaDySpeech and usual care (24 participants) or usual care only (12 participants). This study is single blind with the researcher carrying out the baseline and outcome measures while blinded to treatment allocation. The primary objective is to assess the feasibility of conducting a larger Phase III trial. The specific objectives are to determine the following: recruitment rate and reasons for non-recruitment; loss of participants to follow-up; acceptability of randomisation; adherence to the intervention; delivery of ReaDySpeech and content; acceptability of outcome measures; success of blinding strategies; defining ‘usual’ care; and the implications of the intervention for the patient/family/carer.DiscussionThis study will involve a regional, multi-centre, randomised controlled feasibility trial of a complex intervention in order to evaluate whether a Phase III randomised controlled trial is feasible.Trial registrationCurrent Controlled Trials, ISRCTN84996500 Electronic supplementary materialThe online version of this article (doi:10.1186/s40814-017-0169-0) contains supplementary material, which is available to authorized users.

A feasibility randomized controlled trial of ReaDySpeech for people with dysarthria after stroke

“…Both usual care and ReaDySpeech interventions are outlined in greater detail in the published protocol. 21 …”

A Systematic Review of Measures of Dysarthria Severity in Stroke Patients

“…FDA‐2 was the most commonly used scale for dysarthric patients after stroke 8,20,23‐26 . Speech Intelligibility Test (SIT) 27 was used in four studies, 24,28‐30 and Communication Outcomes After Stroke Scale (COAST) 31 was used in three studies 25,32,33 . Mackenzie et al 18 and Mitchell et al 25 used Dysarthria Impact Profile (DIP) 34 .…”

“…Speech Intelligibility Test (SIT) 27 was used in four studies, 24,28‐30 and Communication Outcomes After Stroke Scale (COAST) 31 was used in three studies 25,32,33 . Mackenzie et al 18 and Mitchell et al 25 used Dysarthria Impact Profile (DIP) 34 . Two studies 24,29 used Communicative Effectiveness Measure (CEM) 18 .…”

“…Two studies 24,29 used Communicative Effectiveness Measure (CEM) 18 . Mahler et al 10 and Wenke et al 19 used Assessment of Intelligibility of Dysarthric Speech (AIDS), 35 while Bowen et al 32 and Mitchell et al 25 used Dysarthria Therapy Outcome Measures Activity (TOMA) 36…”

Effects of Kaiyin Xuanfei Manipulation Treatment on Patients with Dysarthria after Stroke: Study Protocol for a Randomized Controlled Trial

“…The Frenchay scale has been widely used in dysarthria assessment [8,32,33] . It is mainly used to assess the severity of dysarthria, which is divided into two aspects: articulation (re ex, breathing, and speech) and structure (lips, tongue, jaw, soft palate, and throat), including 8 major items and 29 minor items.…”