Implementation and Effects of an Information Technology-Based Intervention to Support Speech and Language Therapy Among Stroke Patients with Aphasia: Protocol for a Virtual Randomized Controlled Trial (Preprint)

Objectives: To explore trial participants’ experiences of the process and outcomes of early, enhanced speech and language therapy after stroke with support from an employed visitor. Design: Qualitative study nested within a randomized controlled trial. Participants: Twney-two people who, after stroke, had a diagnosis of aphasia (12), dysarthria (5) or both (5) and who participated in the ACT NoW study. Setting: Eight English NHS usual care settings. Method: Individual interviews. Thematic content analysis assisted by a bespoke data transformation protocol for incorporating non-verbal and semantically ambiguous data. Results: Participants highly regarded regular and sustained contact with someone outside of immediate family/friends who engaged them in deliberate activities/communication in the early months after stroke. Participants identified differences in the process of intervention between speech and language therapists and employed visitors. But no major discriminations were made between the impact or value of this contact according to whether provided by a speech and language therapist or employed visitor. Participant-defined criteria for effectiveness of contact included: impact on mood and confidence, self-recognition of progress and the meeting of individual needs. Conclusions: As in the randomized controlled trial, participants reported no evidence of added benefit of early communication therapy beyond that from attention control. The findings do not imply that regular contact with any non-professional can have beneficial effects for someone with aphasia or dysarthria in the early weeks following a stroke. The study points to specific conditions that would have to be met for contact to have a positive effect.

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Faculty Opinions recommendation of Prism adaptation therapy enhances rehabilitation of stroke patients with unilateral spatial neglect: a randomized, controlled trial.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.14267418.15779647 ◽

2012 ◽

Author(s):

Philippe Azouvi

Keyword(s):

Randomized Controlled Trial ◽

Controlled Trial ◽

Prism Adaptation ◽

Spatial Neglect ◽

Stroke Patients ◽

Unilateral Spatial Neglect ◽

Randomized Controlled

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Faculty Opinions recommendation of Intensive speech and language therapy in patients with chronic aphasia after stroke: a randomised, open-label, blinded-endpoint, controlled trial in a health-care setting.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.727367646.793532549 ◽

2017 ◽

Author(s):

Radek Ptak

Keyword(s):

Health Care ◽

Care Setting ◽

Controlled Trial ◽

Health Care Setting ◽

Speech And Language ◽

Language Therapy ◽

Open Label ◽

Speech And Language Therapy ◽

Chronic Aphasia

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Efficacy of repetitive transcranial magnetic stimulation combined with visual scanning treatment on cognitive and behavioral symptoms of left hemispatial neglect in right hemispheric stroke patients: study protocol for a randomized controlled trial

Trials ◽

10.1186/s13063-020-04943-6 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Francesco Di Gregorio ◽

Fabio La Porta ◽

Emanuela Casanova ◽

Elisabetta Magni ◽

Roberta Bonora ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Transcranial Magnetic Stimulation ◽

Magnetic Stimulation ◽

Repetitive Transcranial Magnetic Stimulation ◽

Controlled Trial ◽

Hemispatial Neglect ◽

Visual Scanning ◽

Stroke Patients ◽

Rehabilitation Protocol ◽

Randomized Controlled

Abstract Background Left hemispatial neglect (LHN) is a neuropsychological syndrome often associated with right hemispheric stroke. Patients with LHN have difficulties in attending, responding, and consciously representing the right side of space. Various rehabilitation protocols have been proposed to reduce clinical symptoms related to LHN, using cognitive treatments, or on non-invasive brain stimulation. However, evidence of their benefit is still lacking; in particular, only a few studies focused on the efficacy of combining different approaches in the same patient. Methods In the present study, we present the SMART ATLAS trial (Stimolazione MAgnetica Ripetitiva Transcranica nell’ATtenzione LAteralizzata dopo Stroke), a multicenter, randomized, controlled trial with pre-test (baseline), post-test, and 12 weeks follow-up assessments based on a novel rehabilitation protocol based on the combination of brain stimulation and standard cognitive treatment. In particular, we will compare the efficacy of inhibitory repetitive-transcranial magnetic stimulation (r-TMS), applied over the left intact parietal cortex of LHN patients, followed by visual scanning treatment, in comparison with a placebo stimulation (SHAM control) followed by the same visual scanning treatment, on visuospatial symptoms and neurophysiological parameters of LHN in a population of stroke patients. Discussion Our trial results may provide scientific evidence of a new, relatively low-cost rehabilitation protocol for the treatment of LHN. Trial registration ClinicalTrials.gov NCT04080999. Registered on September 2019.

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