VR and Script Training of PWA

Study Overview
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Brief Summary
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The goal of this intervention study is to investigate the effects of immersive virtual reality in rehabilitation of language and communication of individuals with post-stroke aphasia. The main research questions are: Is VR-based script training a feasible treatment to Cantonese-speaking PWA? Will VR-based script training, when compared to conventional script training, better enhance treatment outcomes in functional communication of PWA? Participants will be assessed before, in the middle of, immediately after treatment and 8-week post treatment in terms of their performance on: Accuracy and time for producing trained scripts. Accuracy and time for producing un-trained scripts Standardized aphasia test on severity of language impairment Standardized aphasia test on functional communication The participants will be randomly allocated to receive one of the treatment: Virtual reality-based computerized script training; or Computerized script training without virtual reality Researchers will compare the treatment outcomes of the two treatment conditions and see if treatment with virtual reality would better promote outcomes when compared to training without virtual reality.

Official Title
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Utilization of Immersive Virtual Reality in Computerized Script Training for People With Aphasia: A Feasibility Study

Conditions
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Aphasia, Acquired, Chronic Stroke

Intervention / Treatment
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* Behavioral: VR-based script training
* Behavioral: Conventional script training


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: a stroke onset more than six months, with an Aphasia Quotient (AQ) below 96.4, as evaluated by the Cantonese version of Western Aphasia Battery (CAB; Yiu, 1992), premorbid fluent Cantonese speakers, aged between 30 and 80 years, no reported progressive neurogenic disorders such as dementia or Parkinson's disease, no motor speech disorders of moderate to severe level, and normal or corrected-to-normal vision and hearing functions Exclusion Criteria: concurrent participation in other aphasia treatment trials, and incompatibility with immersive VR exposure such as complains of nausea, headache, or other severe discomforts during trial use of a head-mounted device during screening.

Ages Eligible for Study
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Minimum Age: 30 Years
Maximum Age: 80 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: VR-based script training<br> | Behavioral: VR-based script training<br>* The PWA will wear a head-mounted VR device (e.g., Metaverse Oculus Quest 2 or other commercially available devices) for 30 minutes, which intends to create an immersive environment for training. Scripts trained in the computerized script training program in a particular session will be practiced. Cinematic 360˚ photo-real scenarios of daily contexts such as a restaurant or a grocery store will be displayed in the device while a communication partner, e.g., a waiter in the restaurant or a shopkeeper of a grocery store will initiate the conversation by producing the corresponding part of the script. The PWA will be given time to respond. Upon the completion of PWA's respond, the next conversational turn will be initiated. The clinical assistant, who accompanies the PWA in the entire training session, will control the flow of the 360 ˚ videos.<br>|
| Active Comparator: Conventional script training<br> | Behavioral: Conventional script training<br>* The flow of training is identical to the VR condition, except that photos depicting the scenarios and pre-recorded conversational turns will be presented to the PWA on a computer screen with the same procedures mentioned in the VR condition.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Percentage correct in reading aloud the sentences included in the trained scripts | Trained scripts will be shown in written form while the PWA will be asked to read aloud the scripts. | From baseline up to 1-week post training | 
| Time required in read aloud of trained scripts | Total time to read aloud the trained scripts | From baseline up to 1-week post training | 
| Percentage correct in spontaneous production of the sentences included in the trained scripts | No written cue will be provided while the PWA will produce the scripts upon questions. | From baseline up to 1-week post training | 
| Time required for spantaneous production of trained scripts | No written cue will be provided while the PWA will produce the scripts upon questions. | From baseline up to 1-week post training | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| CAB | Cantonese version of the Western Aphasia Battery | From baseline up to 1-week post training | 
| CANELT | Cantonese version of the Amsterdam-Nijmegen Everyday Language Test (ANELT; Blomert et al., 1994) | From baseline up to 1-week post training | 
| Percentage correct in producing untrained but related scripts | No written cue will be provided while the PWA will produce the untrained scripts that share similar contexts with the trained scripts. | From baseline up to 1-week post training | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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functional communication, randomized study, script training, immersive virtual reality, aphasia intervention