Telerehab for poststroke communication deficits (Mallet et al., 2023)

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posted on 2023-01-12, 19:41 authored by Karen H. Mallet, Rany M. Shamloul, Jacinthe Lecompte-Collin, Jennifer Winkel, Beth Donnelly, Dar Dowlatshahi

Purpose: Poststroke communication deficits (PSCD) are common following stroke. Early and intensive speech and language therapy is recommended to maximize outcomes. We wanted to test the feasibility of providing telerehabilitation for patients with PSCD using mobile tablet-based technology to bridge the gap between acute stroke care and outpatient speech-language therapy (SLT) services.

Method: This was a prospective, randomized, open-label, blinded end-point design. Patients were randomized to either the treatment arm (mobile tablet) or the control arm (standard of care). The study duration was either 8 weeks or when the patient was called to start outpatient SLT services, whichever occurred first. The primary outcome was feasibility, while secondary objective was to assess patient engagement and to explore improvement in communication ability.

Results: We had a 38% recruitment rate, with a 100% retention rate for the treatment arm and a 50% retention rate for the control arm. Fifty percent of patients in the treatment arm adhered to the recommended 1 hr per day, whereas none of the control arm did. Patients were engaged in using the mobile tablet and feedback on the protocol was positive.

Conclusions: SLT using telerehabilitation via mobile technology is feasible in the very early stages of acute stroke recovery. It is potentially an effective means of bridging the gap between discharge from the acute care setting to the start of outpatient SLT services. Our study supported proceeding to a clinical trial to assess efficacy of the intervention.

Supplemental Material S1. Commercially available applications and their Use

Supplemental Material S2. Therapy materials.

Supplemental Material S3. Demographics.

Supplemental Material S4. TeleRehab at home engagement survey SurveyMonkey® results.

Supplemental Material S5. Pre- and poststudy poststroke communication deficits severity ratings.

Supplemental Material S6. Pre- and poststudy results.

Mallet, K. H., Shamloul, R. M., Lecompte-Collin, J., Winkel, J., Donnelly, B., & Dowlatshahi, D. (2023). Telerehab at home: Mobile tablet technology for patients with poststroke communication deficits—A pilot feasibility randomized control trial. Journal of Speech, Language, and Hearing Research, 66(2), 648–655. https://doi.org/10.1044/2022_JSLHR-21-00616