Background And Purpose: Despite comprehensive evidence that supports the utility of aphasia therapy in persons with chronic (≥6 months) stroke-induced aphasia, the amount of therapy provided to patients in the United States is typically far less than what is likely necessary to maximize recovery. Two potential contributors to this discrepancy are limited access to rehabilitation services due to the availability of providers and logistical difficulties with transportation. One way to increase access to aphasia therapy is to rely on telerehabilitation.
Methods: The TEleRehabilitation foR Aphasia (TERRA) trial is a prospective, randomized, rater-blinded, multicenter phase II non-inferiority trial to evaluate telerehabilitation for aphasia therapy in persons with chronic post-stroke aphasia. Participants are randomized (1:1) to receive either aphasia remote therapy or in-clinic therapy for 30 total days of treatment (15 days of a semantically focused approach and 15 days of a phonologically focused approach) for 45 min per day. A total of 100 adults (ages 21-80) with a history of left hemisphere ischemic or hemorrhagic stroke incurred at least 12 months prior to study enrollment will be randomized. The trial will be conducted at the clinical research facilities at two sites: the Medical University of South Carolina and the University of South Carolina.
Conclusions: This paper details the design of the TERRA trial, which aims to test whether aphasia therapy delivered by a remote speech-language pathologist through videoconferencing (i.e., via telerehabilitation) is not clinically worse than in-clinic therapy for individuals with chronic post-stroke aphasia to provide an opportunity to move to a definitive phase III trial.
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http://dx.doi.org/10.1016/j.conctc.2024.101406 | DOI Listing |
Brain Sci
December 2024
Department of Speech and Language Therapy, University of Patras, 26504 Patras, Greece.
This systematic review of neuropsychological rehabilitation strategies for primary progressive aphasia will consider recent developments in cognitive neuroscience, especially neuroimaging techniques such as EEG and fMRI, to outline how these tools might be integrated into clinical practice to maximize treatment outcomes. A systematic search of peer-reviewed literature from the last decade was performed following the PRISMA guidelines across multiple databases. A total of 63 studies were included, guided by predefined inclusion and exclusion criteria, with a focus on cognitive and language rehabilitation in PPA, interventions guided by neuroimaging, and mechanisms of neuroplasticity.
View Article and Find Full Text PDFFront Psychiatry
December 2024
Department of Neurology, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.
Am J Occup Ther
January 2025
Henry C. Hrdlicka, PhD, is Director of Research, Milne Institute for Healthcare Innovation, Gaylord Specialty Healthcare, Wallingford, CT;
Importance: No single cognitive screen adequately captures the cognitive domains needed for inpatient occupational therapy treatment planning.
Objective: To assess the construct validity of the Gaylord Occupational Therapy Cognitive (GOT-Cog©) screen, a novel comprehensive cognitive screen that evaluates functional cognition.
Design: Randomized crossover controlled study design using the St.
Stroke
January 2025
Center for Brain Recovery, Boston University, MA (M.J.M., E.C., M.S., M.R.-M., S.K.).
Background: Predicting treated language improvement (TLI) and transfer to the untreated language (cross-language generalization, CLG) after speech-language therapy in bilingual individuals with poststroke aphasia is crucial for personalized treatment planning. This study evaluated machine learning models to predict TLI and CLG and identified the key predictive features (eg, patient severity, demographics, and treatment variables) aligning with clinical evidence.
Methods: Forty-eight Spanish-English bilingual individuals with poststroke aphasia received 20 sessions of semantic feature-based naming treatment in either their first or second language.
Disabil Rehabil
January 2025
École des sciences de la réadaptation, Faculté de médecine, Université Laval, Québec, QC, Canada.
Purpose: Aphasia, a language disorder caused by brain injury, often results in action naming difficulties. This systematic review reports and analyzes the studies on speech-therapy interventions that use sensorimotor strategies for treating isolated verbs in individuals with chronic aphasia.
Methods: Following PRISMA guidelines, the MEDLINE, CINAHL and PsycInfo databases were searched on January 18, 2024, for articles published in English and French between 1996 and 2024.
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