Is home based therapy as effective in-clinic therapy for patients with aphasia
Creators: name: Godlove, Jason
name: Anantha, Veera
name: Swathi Kiran
Publisher: name: F1000 Research Limited
Year: 2019

description: Research Objectives – To understand if computer-based therapies can provide an affordable and practical alternative for continued rehabilitation for chronic stroke patients.<br> <br>Design – Retrospective analysis (2013-2014) of anonymously aggregated data collected for over 4500 patients with post-stroke aphasia.  <br> <br>Setting: Patients used a mobile therapy platform, Constant Therapy, downloaded on a tablet and agreed to their data being analyzed for scientific purposes.<br> <br>Participants: 4500 participants either received therapy only at home (N= 2438) or only in the clinic (N= 2105). There was no difference in the two groups in terms of age (range = 13-71 years) or time since stroke (range = 6 months to 10 years).<br> <br>Interventions: Constant Therapy includes over 60 evidence-based therapies for language and cognitive skills. This program was individualized for each patient with targeted tasks that dynamically adapted to each individual’s progress.<br> <br>Main outcome measures: Patients with &lt;60% accuracy were analyzed to determine how long it took them to reach &gt;90% accuracy after eliminating the first three items.<br> <br>Results:  Results showed that both home-therapy and clinic patients reached 90% accuracy on their tasks similarly (Median = 3 sessions), but the frequency of therapy was significantly different with 50% of home users receiving therapy at least every 2 days while 50% of clinic patients only had therapy once every 7 days (p &lt; 0.001). Thus, home-therapy users were able to master tasks in a shorter time (median: 6 days) than clinic patients (13 days) (p &lt; 0.001).<br> <br>Conclusions – Home based therapy is as effective as patients practicing under the guidance of a clinician, with the added advantage that patients can practice therapy more often than the traditional once per week therapy visit.<br> <br>References<br>Allen, L., et al., Therapeutic interventions for aphasia initiated more than six months post stroke: a review of the evidence. Topics in Stroke Rehabilitation, 2012. 19(6): p. 523-35.<br>Brady, M.C., et al., Speech and language therapy for aphasia following stroke. The Cochrane database of systematic reviews, 2012. 5: p. CD000425.<br>Cherney, L.R., et al., Evidence-based systematic review: Effects of intensity of treatment and constraint-induced language therapy for individuals with stroke-induced aphasia. Journal of Speech, Language, and Hearing Research, 2008. 51(5): p. 1282-1299.<br>Des Roches CA, Balachandran I, Ascenso EM, Tripodis Y and Kiran S (2015) Effectiveness of an impairment-based individualized rehabilitation program using an iPad-based software platform. <i>Front. Hum. Neurosci.</i> 8:1015. doi: 10.3389/fnhum.2014.01015<br>Kelly, H., M.C. Brady, and P. Enderby, Speech and language therapy for aphasia following stroke. The Cochrane database of systematic reviews, 2010(5): p. CD000425.<br>Wisenburn, B. and K. Mahoney, A meta-analysis of word-finding treatments for aphasia. Aphasiology, 2009. 23(11): p. 1338-1352.