Speech Telerehabilition After Stroke: Proof-of-Concept and Feasibility (North Carolina)

Project Final Report (PDF, 188.17 KB) Disclaimer

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Speech Telerehabilition After Stroke: Proof-of-Concept and Feasibility - Final Report

Citation:
Ellis C. Speech Telerehabilition After Stroke: Proof-of-Concept and Feasibility - Final Report. (Prepared by East Carolina University under Grant No. R03 HS025043). Rockville, MD: Agency for Healthcare Research and Quality, 2019. (PDF, 188.17 KB)

The findings and conclusions in this document are those of the author(s), who are responsible for its content, and do not necessarily represent the views of AHRQ. No statement in this report should be construed as an official position of AHRQ or of the U.S. Department of Health and Human Services.
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The use of telerehabilitation with stroke survivors with aphasia, is a feasible and cost-effective approach, with high patient satisfaction.

Project Details - Ended

Summary:

Stroke survivors are often left with a range of disabilities that require rehabilitation for successful return to their pre-stroke lifestyles. Aphasia, a language disorder that occurs in approximately one third of all stroke survivors, affects one’s ability to communicate, such as deficits in language comprehension, language expression, reading, and writing. The disorder reduces stroke survivors’ independence and quality of life. Aphasia rehabilitation is not readily accessible therapy in rural areas, leaving many stroke survivors with difficulty obtaining treatment.

Researchers conducted a proof-of-concept and feasibility study to observe a community-based intervention designed to treat aphasia via telerehabilitation in rural North Carolina. Social contact was a critical aspect of this study, as it has been shown to be a beneficial factor in improving self-confidence and self-worth. The intervention was held in a social setting such as a senior center or school. Several measures of the intervention’s implementation were collected, including recruitment success, completion of treatment, acceptability, and satisfaction with the treatment approach.

The specific aims of this research were as follows:

  • Evaluate the feasibility of using a telerehabilitation approach in rural eastern North Carolina to treat aphasia among stroke survivors. 
  • Evaluate the acceptability, credibility, and satisfaction of using a telerehabilitation approach in rural eastern North Carolina to treat aphasia among stroke survivors. 

The research team recruited 22 stroke survivors with aphasia living in community settings to participate in the study. The treating clinician was located in a medical campus aphasia laboratory, and delivered the rehabilitation to the participants through a cloud-based videoconferencing program via computer. The treatment used in this research was the Language-Oriented Treatment (LOT), a highly structured, psycholinguistic approach to aphasia designed to address a range of communication issues. Participants received 12 telerehabilitation sessions in a 6-week period and completed pre- and post-intervention questionnaires to measure acceptability and client satisfaction. Participant retention was measured by the number of sessions completed, missed, and participant dropouts. Researchers used a comprehensive test, the Western Aphasia Battery-Revised (WAB-R), to measure aphasia severity post telehealth intervention.

Researchers found that patients reported high levels of satisfaction with the treatment, deeming the approach a credible method of aphasia rehabilitation. Additionally, researchers found this method to be a cost-effective treatment, while providing stroke survivors opportunities for more frequent community access. This research greatly benefits the future development of telerehabilitation for stroke survivors with aphasia.