The effect of augmented speech-language therapy delivered by telerehabilitation on poststroke aphasia-a pilot randomized controlled trial
The effect of augmented speech-language therapy delivered by telerehabilitation on poststroke aphasia-a pilot randomized controlled trial
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DOI：
10.1177/0269215519896616
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发表时间：
2020-01-05
影响因子：
3
通讯作者：
Becker, Frank
中科院分区：
文献类型：
--
作者：
Ora, Hege Prag;Kirmess, Melanie;Becker, Frank
目的：在常规治疗的基础上，对卒中后失语患者进行一项确定性的远程言语康复随机对照试验，包括招募、脱落和语言效果。设计：初步单盲随机对照试验。设定：远程康复从三级康复中心提供给参与者在他们的家或承认二级康复中心。受试者：脑卒中后失语导致命名障碍的患者。干预措施：62名参与者被随机分配到5个小时的语音和语言远程康复视频会议，每周连续四周与常规护理或常规护理一起。远程康复的目标是功能性的，表达性的语言。主要措施：挪威基本失语症评估：命名（主要结局）、重复和听觉理解子测试;动词和句子测试句子生成子测试和基线、随机化后四周和4个月的沟通有效性指数。数据进行了分析，意向treat. Results：没有显着的组间差异，在命名或听觉理解挪威基本失语症评估在四周和四个月后随机化。远程康复组（n = 29）在随机化后4个月，挪威基本失语症评估重复评分比对照组（n = 27）高8.9分（P = 0.026），动词和句子测试评分比对照组高3分（P = 0.002）。沟通有效性指数在两组之间没有显著差异，但在两组内均显著增加。未报告不良事件。结论：通过视频会议的增强远程康复可能是一个可行的失语症影响语言功能的康复模式。需要一个有230名参与者的最终试验来确认结果。
Objective: Pilot a definitive randomized controlled trial of speech-language telerehabilitation in poststroke aphasia in addition to usual care with regard to recruitment, drop-outs, and language effects. Design: Pilot single-blinded randomized controlled trial. Setting: Telerehabilitation delivered from tertiary rehabilitation center to participants at their home or admitted to secondary rehabilitation centers. Subjects: People with naming impairment due to aphasia following stroke. Intervention: Sixty-two participants randomly allocated to 5 hours of speech and language telerehabilitation by videoconference per week over four consecutive weeks together with usual care or usual care alone. The telerehabilitation targeted functional, expressive language. Main measures: Norwegian Basic Aphasia Assessment: naming (primary outcome), repetition, and auditory comprehension subtests; Verb and Sentence Test sentence production subtest and the Communicative Effectiveness Index at baseline, four weeks, and four months postrandomization. Data were analyzed by intention to treat. Results: No significant between-group differences were seen in naming or auditory comprehension in the Norwegian Basic Aphasia Assessment at four weeks and four months post randomization. The telerehabilitation group (n = 29) achieved a Norwegian Basic Aphasia Assessment repetition score of 8.9 points higher (P = 0.026) and a Verb and Sentence Test score 3 points higher (P = 0.002) than the control group (n = 27) four months postrandomization. Communicative Effectiveness Index was not significantly different between groups, but increased significantly within both groups. No adverse events were reported. Conclusion: Augmented telerehabilitation via videoconference may be a viable rehabilitation model for aphasia affecting language outcomes poststroke. A definitive trial with 230 participants is needed to confirm results.