The effects of COVID-19 on the rehabilitation of persons with aphasia: A scoping review.

BACKGROUND:  The impact of the Coronavirus disease 2019 (COVID-19) pandemic was more pronounced on the well-being of persons with disabilities, especially in low- and middle-income countries. There is documented evidence of the rippling effects of COVID-19 on persons with disabilities. However, not much is known about the impact of COVID-19 on the rehabilitation of persons with aphasia. OBJECTIVE:  The scoping review explores how COVID-19 affected the rehabilitation of persons living with aphasia. METHOD:  A scoping review was conducted using Arksey and O'Malley's framework. A search was conducted on Science Direct, PubMed, Medline, Scopus, ProQuest and Google Scholar, to identify relevant studies published between 2019 and 2022. Data were analysed using thematic analysis. RESULTS:  Most studies regarding the effects of COVID-19 on persons living with aphasia were conducted in the United Kingdom. Five themes emerged from the data, namely, (1) negative impact on rehabilitative care, (2) telehealth and its limitations, (3) impact on social participation, (4) compromised caregiver involvement and (5) mental health challenges. CONCLUSIONS:  Findings highlight the need for healthcare professionals to pursue innovative ways in which aphasia rehabilitation and conversational support programmes can be made accessible to persons with aphasia, despite the limitations brought about by a pandemic. Telerehabilitation programmes need to be tailored to the needs of persons with aphasia if they are to be successful. This study highlights the importance and need for the prioritisation of mental health services for persons with aphasia and their caregivers during a pandemic.

Recent trends in telerehabilitation of stroke patients: A narrative review.

BACKGROUND: Stroke is the main reason for disabilities worldwide leading to motor dysfunction, spatial neglect and cognitive problems, aphasia, and other speech-language pathologies, reducing the life quality. To overcome disabilities, telerehabilitation (TR) has been recently introduced. OBJECTIVE: The aim of this review was to analyze current TR approaches for stroke patients' recovery. METHODS: We searched 6 online databases from January 2018 to October 2021, and included 70 research and review papers in the review. We analyzed TR of 995 individuals, which was delivered synchronously and asynchronously. RESULTS: Findings show TR is feasible improving motor function, cognition, speech, and language communication among stroke patients. However, the dose of TR sessions varied significantly. We identified the following limitations: lack of equipment, software, and space for home-based exercises, insufficient internet capacity and speed, unavailability to provide hands on guidance, low digital proficiency and education, high cognitive demand, small samples, data heterogeneity, and no economic evaluation. CONCLUSIONS: The review shows TR is superior or similar to conventional rehabilitation in clinical outcomes and is used as complementary therapy or as alternative treatments. More importantly, TR provides access to rehabilitation services of a large number of patients with immobility, living in remote areas, and during COVID-19 pandemic or similar events.

Post-stroke aphasia at the time of COVID-19 pandemic: a telerehabilitation perspective.

We report on our remote speech therapy experience in post-stroke aphasia. The aim was to test the feasibility and utility of telerehabilitation to support future randomized controlled trials. Post-stroke aphasia is a common and disabling speech disorder, which significantly affects patients' and caregivers' health and quality of life. Due to COVID-19 pandemic, most of the conventional speech therapy approaches had to stop or "switch" into telerehabilitation procedures to ensure the safety of patients and operators but, concomitantly, the best rehabilitation level possible. Here, we planned a 5-month telespeech therapy programme, twice per week, of a patient with non-fluent aphasia following an intracerebral haemorrhage. Overall, treatment adherence based on the operator's assessments was high, and incomplete adherence for technical problems occurred very rarely. In line with the patient's feedback, acceptability was also positive, since he was constantly motivated during the sessions and the exercises performed autonomously, as confirmed by the speech therapist and caregiver, respectively. Moreover, despite the sequelae from the cerebrovascular event, evident in some writing tests due to the motor deficits in his right arm and the disadvantages typical of all telepractices, more relevant results were achieved during the telerehabilitation period compared to those of the "face-to-face" therapy before the COVID-19 outbreak. The telespeech therapy performed can be considered successful and the patient was able to return to work. Concluding, we support it as a feasible approach offering patients and their families the opportunity to continue the speech and language rehabilitation pathway, even at the time of pandemic.

The Impact of COVID-19 on Speakers With Aphasia: What Is Currently Known and Missing?

Purpose Enhancing social participation and reducing emotional distress in persons with aphasia (PWA) are a critical rehabilitation goal. Social relationships and meaningful activities performed by PWA are also crucial to promote positive psychosocial well-being. As a precautionary measure specific to the COVID-19 pandemic, most PWA worldwide have generally followed the guidelines of going out less, restricting when and where to gather with friends and peers, reducing social activities, and maintaining appropriate social distance; these acts are contrary to the traditional principles of managing aphasia. This article aims to (a) highlight and add to our understanding of issues related to the impact of the currently evolving COVID-19 pandemic on PWA, (b) direct readers to relevant reports in the literature of telerehabilitation for aphasia to look for useful information regarding remote assessment and therapy to be considered during the pandemic, (c) summarize support initiatives developed and resources compiled thus far as well as provide links for caregivers and PWA to find more information about COVID-19 in their communities, and (d) offer recommendations to potentially move the field of aphasia research and clinical PWA services forward in a positive way to endure the pandemic and in the forthcoming post-COVID world. Conclusions At present, there are significant knowledge gaps regarding the short and long-term impacts of COVID-19 on PWA and their caregivers. It is crucial that different stakeholders be sensitive and flexible when addressing the psychosocial and rehabilitation needs of PWA to mitigate the negative effects during and after the COVID-19 era.