Tablet-based Aphasia Therapy in the Chronic Phase

Study Overview
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Brief Summary
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Aphasia is one of the most common and disabling disorders following stroke, in many cases resolving in long-term deficits. There is evidence that intensive aphasia therapy is effective for language recovery, even in the chronic phase post-stroke. However, as many patients are left with residual language disorders and intensive aphasia rehabilitation is difficult to achieve, the investigators are exploring tablet-based therapies to further facilitate language recovery in a cost-effective manner.

Detailed Description
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This study will investigate the clinical effects of intensive tablet-based aphasia therapy as an add-on to conventional aphasia therapy (= high intensive) compared to conventional aphasia therapy (either alone, or in combination with recreational tablet use (= low intensive) in patients with aphasia following stroke, as measured by specific linguistic tests, within task improvements, functional communication and quality of life. Furthermore, the investigators want to learn more about the recovery of specific underlying language processes via event-related potentials (ERPs). At last, the investigators aim to explore whether patients with aphasia are satisfied with a tablet-based aphasia therapy, whether the app is user-friendly and which barriers the participants might have encountered.

Official Title
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The Effect of a Tablet-based Aphasia Therapy in the Chronic Phase After Stroke

Conditions
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Aphasia, Stroke

Intervention / Treatment
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* Device: speech app
* Device: brain games
* Behavioral: aphasia therapy


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: diagnosed with mild-severe aphasia (token test score between 7 and 49) after a left hemispheric ischemic or hemorrhagic stroke inclusion starting from 6 months post-stroke age 18 - 85 years being right-handed (according to the questionnaire for handedness, Van Strien) mother tongue: Dutch imaging (CT or MRI) prior to inclusion signed informed consent Exclusion Criteria: history of a previous stroke with persistent (> 24 hours) language symptoms history of other diseases of the central nervous system, psychological disorders and (developmental) speech and/or language disorders serious non-linguistic, cognitive disorders (as documented in the patients' medical history) inability to perform tablet-based tasks (based on a short training session) excessive use of alcohol or drugs

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 85 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: aphasia therapy + speech app<br>3 hours per week of conventional aphasia therapy during 3 weeks + 5 hours per week during 3 weeks independent practice via the speech app | Device: speech app<br>* language exercises provided by the speech therapist in hospital + independent practice of language exercises via a tablet and speech app<br>Behavioral: aphasia therapy<br>* language exercises provided by the speech therapist in hospital<br>|
| Active Comparator: aphasia therapy + brain games<br>3 hours per week of conventional aphasia therapy during 3 weeks + 5 hours per week during 3 weeks of recreational tables use (brain games) | Device: brain games<br>* language exercises provided by the speech therapist in hospital + independent recreational tablet use via brain games<br>Behavioral: aphasia therapy<br>* language exercises provided by the speech therapist in hospital<br>|
| Active Comparator: aphasia therapy<br>3 hours per week of conventional aphasia therapy during 3 weeks | Behavioral: aphasia therapy<br>* language exercises provided by the speech therapist in hospital<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Boston Naming Test (BNT) | Measure of word retrieval. Patients will have to name line drawings that gradually increase in difficulty | 4 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Spontaneous speech of the Aachen Aphasia Test (AAT) | spontaneous speech is elicited and scored during a semi-standardized interview | 4 months | 
| Quality of life (SAQOL-39-Nl) | a questionnaire investigating the health-related quality of life of patients following stroke | 4 months | 
| Usability questionnaire | a self-prepared 5 point-Likert Scale concerning the usability of the app | 1 day |