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Telerehab at Home: Mobile Tablet Technology for Patients With Poststroke Communication Deficits- A Pilot Feasibility Randomized Control Trial

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AMER SPEECH-LANGUAGE-HEARING ASSOC
DOI: 10.1044/2022_JSLHR-21-00616

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The purpose of this study was to test the feasibility of providing telerehabilitation for patients with poststroke communication deficits (PSCD) using mobile tablet-based technology. The study found that speech and language therapy (SLT) using telerehabilitation in the early stages of acute stroke recovery was feasible and potentially effective in bridging the gap between acute care and outpatient SLT services. The study supported proceeding to a clinical trial to assess the intervention.
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 of the intervention.

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