Can telerehabilitation tools help patients with aphasia?

March 29, 2017

Living with aphasia negatively affects quality of life. Numerous studies have shown that intensive treatment has a positive correlation with language improvement, and that using telerehabilitation (TR) can improve therapeutic intensity.

Mayo Clinic researchers will soon begin a feasibility study that examines the use of TR to treat patients with aphasia. Led by physiatrist Allen W. Brown, M.D., director of brain rehabilitation research at Mayo Clinic's campus in Rochester, Minnesota, Mayo researchers hypothesize that by improving access to language therapy services and increasing treatment intensity, TR may lead to better communication performance and quality of life. Specific study goals include assessing the feasibility of providing a TR service directed at language disorders in individuals with stroke, and measuring the change in language function associated with the TR treatment during the study period.

"These technologies have the potential to improve access to care and expand continuity of care to persons with disabling conditions or to those living far from health care centers," says Dr. Brown. A wide variety of assessment and treatment interventions can be delivered to patients using such remote monitoring systems, but research studying whether they are more effective or less costly than usual care are lacking.

Multiple studies have shown that TR assessment and treatment of speech and language pathologies (SLP) are not inferior to face-to-face therapies, with aphasia severity found to have little effect on assessment accuracy for the majority.

The earliest reports on treatment of SLP from a distance appeared in the 1980s. More recently, a literature review described TR services treating a spectrum of SLP including swallowing disorders, voice disorders, stuttering and speech disorders in individuals with Parkinson's disease, cleft palate, autism and hearing impairment.

This feasibility study will help researchers decide whether to proceed with a larger clinical trial to determine whether this model of care should be integrated into routine clinical practice.

The study will enroll 10 participants with communication disorders related to stroke. Each participant will be treated twice a week for 30 minutes each time, for a total of 12 weeks. Mayo Clinic speech and language therapists will provide participants with treatment in their homes via a remote computer connection. This remote connection technology and the treatment programming software were developed by research collaborators from Gertner ReAbility Online, an initiative of Gertner Institute, located in Israel.

This aphasia treatment study is an extension of another feasibility study being conducted by Mayo in collaboration with Gertner ReAbility. In that study, researchers are assessing the feasibility of delivering telerehabilitation interventions using motion-sensing technology to treat patients with sensorimotor impairment after stroke.