scholarly journals Augmentative and alternative communication intervention for in-patient individuals with post-stroke aphasia: study protocol of a parallel-group, pragmatic randomized controlled trial

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Li Huang ◽  
Szu-Han Kay Chen ◽  
Shutian Xu ◽  
Yongli Wang ◽  
Xing Jin ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Augmentative And Alternative Communication ◽  
Controlled Trial ◽  
Communication Effectiveness ◽  
Alternative Communication ◽  
Language Performance ◽  
Early Recovery ◽  
Post Stroke ◽  
Randomized Controlled ◽  
Pilot Rct

Abstract Background People with post-stroke aphasia commonly receive speech-language therapy (SLT) when they are admitted to hospitals. Commonly, these patients reported communication difficulties in in-patient settings. Augmentative and alternative communication (AAC) has been reported as an effective treatment approach to improve communication effectiveness, language performance, decreasing depression, and improving quality of life for this population. However, little evidence has demonstrated the use of AAC intervention (AACT) in early recovery from people with post-stroke aphasia in in-patient rehabilitation settings for improving these patients’ communication effectiveness. The pilot randomized controlled trial (RCT) will explore the effectiveness and feasibility of including AACT in regular SLT for in-patient people with post-stroke aphasia. Method This pilot RCT is a single-blind, randomized controlled trial with two parallel groups. Both groups receive a 1-h treatment session, including either both AACT and SLT or SLT only for ten consecutive days. We aim to include 22 in-patient participants with post-stroke aphasia in each group. Participants will be assessed at pre- and post-intervention and 2 weeks after intervention. The primary outcomes are the ability of communication measured by the communication of basic needs subtest in the Functional Assessment of Communication Skills for Adult (FACS) and the overall language performance measured by the Chinese Standard Aphasia Battery (ABC). The secondary outcomes include a 10-min conversation, the 10-item Hospital version of the Stroke Aphasic Depression Questionnaire (SADQH-10), the Stroke-Specific Quality of Life Scale (SS-QOL), and a patient and caregiver satisfaction questionnaire. Discussion This pilot RCT will contribute to new scientific evidence to the field of aphasia rehabilitation in early recovery during the in-patient period. The paper describes the trial, which will explore the effect of combining AACT and SLT and SLT only, our choice of primary and secondary outcome measures, and proposed analyses. The study results will provide information for implementing AACT in the regular in-patient SLT of future RCTs. Trial registration Chinese Clinical Trial Registry database (ChiCTR) ChiCTR2000028870. Registered on 5 January 2020

scholarly journals Augmentative and Alternative Communication Intervention for in-patient Individuals With Post-stroke Aphasia: Study Protocol of a Parallel-group, Pragmatic Randomized Controlled Trial

2021 ◽  
Author(s):  
Li Huang ◽  
Szu-Han Kay Chen ◽  
Shutian Xu ◽  
Yongli Wang ◽  
Xing Jin ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Augmentative And Alternative Communication ◽  
Controlled Trial ◽  
Secondary Outcome ◽  
Communication Effectiveness ◽  
Alternative Communication ◽  
Early Recovery ◽  
Post Stroke ◽  
Randomized Controlled

Abstract Background: People with post-stroke moderate to severe aphasia commonly receive speech-language therapy (SLT). However, the outcomes of SLT sometimes is limited. Augmentative and alternative communication (AAC) has been reported as an effective treatment approach to improve communication effectiveness, language performance, decreasing depression, and improving quality of life for this population. However, little evidence has demonstrated the use of AAC intervention (AACT) in early recovery from people with post-stroke aphasia in in-patient rehabilitation settings. Besides, only a few studies use a randomized controlled trial (RCT) to compare AACT with SLT to date. The present study focuses on the effect of including AACT in regular SLT for people with post-stroke moderate to severe aphasia (PWAs) in an in-patient rehabilitation setting. The present study aims to compare the potential effectiveness of AACT combined with SLT on communication effectiveness and language recovery with SLT alone for PWAs in in-patient rehabilitation settings.Methods: We strive to include 30 PWAs, enroll in an in-patient program, a single-blind, randomized controlled trial with two parallel groups, and a 2-week follow-up. Patients receive a one-hour treatment session, including either both AAC and SLT or SLT alone daily for ten consecutive sessions. Three assessment points include baseline, after intervention sessions, and after the 2-week follow-up to compare the two groups' intervention effectiveness. The primary outcome measure is the score differences on the Communication of Basic Needs of Functional Assessment of Communication Skills for Adult (FACS) pre- and post- intervention. The secondary outcome measures include the results of the Chinese Standard Aphasia Battery (ABC), the 10-item Hospital version of the Stroke Aphasic Depression Questionnaire (SADQH-10), and the Stroke-Specific Quality of Life Scale (SS-QOL) as well as a patient and caregiver satisfaction questionnaire.Discussion: This RCT of AACT in an in-patient rehabilitation setting will contribute to new scientific evidence to the field of aphasia rehabilitation in early recovery during the in-patient period. The paper describes the trial, which will explore the effect of combining AACT and SLT and SLT only, our choice of primary and secondary outcome measures, and proposed analyses. The study results will provide information for implementing AACT in the regular in-patient SLT of future RCTs.Trial registration: This trial is registered in the Chinese Clinical Trial Registry database (ChiCTR) as ChiCTR2000028870. Date registered: 5 January 2020.

scholarly journals Randomized Controlled Trial of Supplemental Augmentative and Alternative Communication versus Voice Rest Alone after Phonomicrosurgery

2015 ◽  
Vol 152 (3) ◽  
pp. 494-500 ◽  
Author(s):  
Bernard Rousseau ◽  
Michelle L. Gutmann ◽  
Theodore Mau ◽  
David O. Francis ◽  
Jeffrey P. Johnson ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Augmentative And Alternative Communication ◽  
Controlled Trial ◽  
Alternative Communication ◽  
Randomized Controlled

scholarly journals “Enhanced recovery after surgery – ERAS in elective craniotomies-a non-randomized controlled trial”

BMC Neurology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Anirudh Elayat ◽  
Sritam S. Jena ◽  
Sukdev Nayak ◽  
R. N. Sahu ◽  
Swagata Tripathy
Keyword(s):  
Randomized Controlled Trial ◽  
Glycemic Control ◽  
Hospital Stay ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Controlled Trial ◽  
Early Recovery ◽  
Randomized Controlled ◽  
Pain Scores ◽  
High Dependency

Abstract Background Enhanced Recovery After Surgery (ERAS) is a multimodal perioperative care bundle aimed at the early recovery of patients. Well accepted in gastric and pelvic surgeries, there is minimal evidence in neurosurgery and neurocritical care barring spinal surgeries. We wished to compare the length of intensive care unit (ICU) or high dependency unit (HDU) stay of patients undergoing elective craniotomy for supratentorial neurosurgery: ERAS protocol versus routine care. The secondary objective was to compare the postoperative pain scores, opioid use, glycemic control, and the duration of postoperative hospital stay between the two groups. Methods In this pragmatic non-randomized controlled trial (CTRI/2017/07/015451), consenting adult patients scheduled for elective supratentorial intracranial tumor excision were enrolled prospectively after institutional ethical clearance and consent. Elements-of-care in the ERAS group were- Preoperative –family education, complex-carbohydrate drink, flupiritine; Intraoperative – scalp blocks, limited opioids, rigorous fluid and temperature regulation; Postoperative- flupiritine, early mobilization, removal of catheters, and initiation of feeds. Apart from these, all perioperative protocols and management strategies were similar between groups. The two groups were compared with regards to the length of ICU stay, pain scores in ICU, opioid requirement, glycemic control, and hospital stay duration. The decision for discharge from ICU and hospital, data collection, and analysis was by independent assessors blind to the patient group. Results Seventy patients were enrolled. Baseline demographics – age, sex, tumor volume, and comorbidities were comparable between the groups. The proportion of patients staying in the ICU for less than 48 h after surgery, the cumulative insulin requirement, and the episodes of VAS scores > 4 in the first 48 h after surgery was significantly less in the ERAS group – 40.6% vs. 65.7%, 0.6 (±2.5) units vs. 3.6 (±8.1) units, and one vs. ten episodes (p = 0.04, 0.001, 0.004 respectively). The total hospital stay was similar in both groups. Conclusion The study demonstrated a significant reduction in the proportion of patients requiring ICU/ HDU stay > 48 h. Better pain and glycemic control in the postoperative period may have contributed to a decreased stay. More extensive randomized studies may be designed to confirm these results. Trial registration Clinical Trial Registry of India (CTRI/2018/04/013247), registered retrospectively on April 2018.

A randomized controlled trial of strapping to prevent post-stroke shoulder pain

2000 ◽  
Vol 14 (4) ◽  
pp. 370-380 ◽  
Author(s):  
H C Hanger ◽  
P Whitewood ◽  
G Brown ◽  
M C Ball ◽  
J Harper ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Shoulder Pain ◽  
Controlled Trial ◽  
Post Stroke ◽  
Randomized Controlled

scholarly journals Effect of Neurofeedback Facilitation on Post-stroke Gait and Balance Recovery: A Randomized Controlled Trial

Neurology ◽  
2021 ◽  
pp. 10.1212/WNL.0000000000011989
Author(s):  
Masahito Mihara ◽  
Hiroaki Fujimoto ◽  
Noriaki Hattori ◽  
Hironori Otomune ◽  
Yuta Kajiyama ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Motor Imagery ◽  
Controlled Trial ◽  
Cortical Activation ◽  
Gait Disturbance ◽  
Balance Recovery ◽  
The Real ◽  
Post Stroke ◽  
Randomized Controlled ◽  
Real Group

Objective:To test the hypothesis that supplementary motor area (SMA) facilitation with functional near-infrared spectroscopy mediated neurofeedback (fNIRS-NFB) augments post-stroke gait and balance recovery. Using the 3-meter-Timed Up-and-Go (TUG) test, we conducted this two-center, double-blind, randomized controlled trial involving 54 Japanese patients.Methods:Patients with subcortical stroke-induced mild-to-moderate gait disturbance more than 12 weeks from onset, underwent 6 sessions of SMA neurofeedback facilitation during gait- and balance-related motor imagery using fNIRS-NFB. Participants were randomly allocated to intervention (REAL: 28 patients) or placebo (SHAM: 26 patients) group. In the REAL group, the fNIRS signal contained participants’ cortical activation information. Primary outcome was TUG improvement, 4 weeks post intervention.Results:The REAL group showed greater improvement in the TUG test (12.84 ± 15.07 s, 95% CI: 7.00-18.68) than the SHAM group (5.51± 7.64 s, 95% CI: 2.43 – 8.60; group difference 7.33 s, 95% CI: 0.83 – 13.83; p = 0.028), even after adjusting for covariates (group × time interaction; F1.23,61.69 = 4.50, p = 0.030, partial η2 = 0.083). Only the REAL group showed significantly increased imagery-related SMA activation and enhancement of resting-state connectivity between SMA and ventrolateral premotor area. Adverse effects associated with fNIRS-mediated neurofeedback intervention were absent.Conclusion:SMA facilitation during motor imagery using fNIRS neurofeedback may augment post-stroke gait and balance recovery by modulating the SMA and its related network.Classification of Evidence:This study provides Class III evidence that for patients with gait disturbance from subcortical stroke, SMA neurofeedback facilitation improves TUG time.

scholarly journals The ESCAPS study: a feasibility randomized controlled trial of early electrical stimulation to the wrist extensors and flexors to prevent post-stroke complications of pain and contractures in the paretic arm

2019 ◽  
Vol 33 (12) ◽  
pp. 1919-1930
Author(s):  
Joanna C Fletcher-Smith ◽  
Dawn-Marie Walker ◽  
Kate Allatt ◽  
Nikola Sprigg ◽  
Marilyn James ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Electrical Stimulation ◽  
Data Collection ◽  
Usual Care ◽  
Controlled Trial ◽  
Cost Effective ◽  
Outcome Data ◽  
Attrition Rates ◽  
Post Stroke ◽  
Randomized Controlled

Objective: To establish feasibility of initiating electrical stimulation treatment of wrist extensors and flexors in patients early after stroke to prevent muscle contractures and pain. Design: Feasibility randomized controlled trial with economic evaluation. Setting: A specialist stroke unit in Nottinghamshire. Subjects: A total of 40 patients recruited within 72 hours post-stroke with arm hemiparesis. Interventions: Participants were randomized to receive usual care or usual care and electrical stimulation to wrist flexors and extensors for 30 minutes, twice a day, five days a week for three months. Initial treatment was delivered by an occupational therapist or physiotherapist who trained participants to self-manage subsequent treatments. Measures: Measures of feasibility included recruitment and attrition rates, completion of treatment, and successful data collection. Outcome data on wrist range of motion, pain, arm function, independence, quality of life, and resource use were measured at 3-, 6-, and 12-months post-randomization. Results: A total of 40 participants (of 215 potentially eligible) were recruited in 15 months (20 men; mean age: 72 (SD: 13.0)). Half the participants lacked mental capacity and were recruited by consultee consent. Attrition at three-month follow-up was 12.5% (death ( n = 2), end-of-life care ( n = 2), and unable to contact ( n = 1)). Compliance varied (mean: 65 (SD: 53)) and ranged from 10 to 166 treatments per patient (target dosage was 120). Data for a valid economic analysis can be adequately collected. Conclusion: Early initiation of electrical stimulation was acceptable and feasible. Data collection methods used were feasible and acceptable to participants. A large definitive study is needed to determine if electrical stimulation is efficacious and cost effective.

Sign in / Sign up

Export Citation Format

Share Document