Self-managed aphasia therapy after stroke feasible

Jun 28 2012

By Helen Albert

A pilot study carried out in stroke patients with aphasia suggests that self-managed computer therapy is feasible and practical.

"There is growing evidence to suggest that the use of aphasia software can help to improve outcomes in language domains including reading, spelling, and expressive language," write Rebecca Palmer (University of Sheffield, UK) and colleagues.

"However, to date, studies of self-administered word-finding therapy have been limited to descriptive case series with the only reported randomized controlled study for computer use with patients with aphasia focused on reading therapy."

To investigate whether a large randomized controlled trial of self-managed (intervention) versus usual (control) care for patients with aphasia would be possible, Palmer and team recruited 34 individuals to take part in a pilot study.

Overall, 13 out of 17 people assigned to usual care (communication support group attendance, normal conversation, reading and writing activities) and 15 out of 17 assigned to self-managed computer therapy (speech and language therapy delivered using a computer program for 20 minutes 3 days per week) were followed up at 5 months.

Patients in the self-managed group completed an average of 25 hours of independent practice over the 5 months.

When percentage change in naming ability at 5 months was compared with ability at baseline, there was a 19.8% between-group difference in favor of those in the intervention group over those in the control group.

The team notes that patients with more severe aphasia seemed to gain less benefit from the intervention than those with a more moderate or mild version of the condition.

"This study demonstrates that use of a self-managed treatment for word-finding practice with minimal input from a speech language therapist, and volunteer support is a feasible means of enabling continued intervention for people with aphasia after stroke," write the authors in Stroke.

"People with aphasia were able to use the computer software to practice naming words independently, which supports findings from previous case series reports in the literature."

They conclude: "This study indicates that the intervention is potentially clinically and cost-effective and that it is feasible to conduct a large randomized controlled trial to provide robust evidence for this self-managed computer treatment for aphasia."

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