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1.
J Speech Lang Hear Res ; 64(6): 2038-2046, 2021 06 04.
Article in English | MEDLINE | ID: covidwho-1263515

ABSTRACT

Purpose The use of technology (e.g., telehealth) in clinical settings has rapidly increased, and its use in research settings continues to grow. The aim of this report is to present one potential solution to a clinical issue that of virtual and remote assessment for the purposes of spoken language research in persons with aphasia (PWA). To do so, we report detailed methods for conducting a multitimepoint (test-retest) virtual paradigm, assessing lifestyle, physiological, cognitive, and linguistic factors in persons with and without aphasia. Method Procedures for virtual assessment are detailed in a sample of adults with no brain damage (N = 24) and PWA (N = 25) on a test-retest paradigm (data collection approximately 10 ± 3 days apart). This report provides practical information about pre-assessment (e.g., recruitment, scheduling), assessment (e.g., aphasia-friendly consent presentation, investigator fidelity), and postassessment (e.g., data storage, quality check) procedures for human behavior research using a virtual platform. Results Preliminary study data are provided, indicating high retention rates, high rates of data acquisition, and feasibility. Common technological troubles and solutions are discussed, and solutions are offered. The results suggest that our pre-assessment, assessment, and postassessment procedures contributed to the success of our study. Conclusions We provide a practical methodology for conducting a multitimepoint study, with considerations for PWA, adding to the body of research on telehealth in clinical populations. Future studies should continue to evaluate telemethodology, which may be core for diversifying studies, improving study retention, and enrolling larger sample sizes. Supplemental Material https://doi.org/10.23641/asha.14608101.


Subject(s)
Aphasia , Brain Injuries , Adult , Humans , Linguistics
2.
Front Neurol ; 12: 626780, 2021.
Article in English | MEDLINE | ID: covidwho-1110313

ABSTRACT

Background: Post-stroke aphasia is a chronic condition that impacts people's daily functioning and communication for many years after a stroke. Even though these individuals require sustained rehabilitation, they face extra burdens to access care due to shortages in qualified clinicians, insurance limitations and geographic access. There is a need to research alternative means to access intervention remotely, such as in the case of this study using a digital therapeutic. Objective: To assess the feasibility and clinical efficacy of a virtual speech, language, and cognitive digital therapeutic for individuals with post-stroke aphasia relative to standard of care. Methods: Thirty two participants completed the study (experimental: average age 59.8 years, 7 female, 10 male, average education: 15.8 years, time post-stroke: 53 months, 15 right handed, 2 left handed; control: average age 64.2 years, 7 female, 8 male, average education: 15.3 years, time post-stroke: 36.1 months, 14 right handed, 1 left handed). Patients in the experimental group received 10 weeks of treatment using a digital therapeutic, Constant Therapy-Research (CT-R), for speech, language, and cognitive therapy, which provides evidence-based, targeted therapy with immediate feedback for users that adjusts therapy difficulty based on their performance. Patients in the control group completed standard of care (SOC) speech-language pathology workbook pages. Results: This study provides Class II evidence that with the starting baseline WAB-AQ score, adjusted by -0.69 for every year of age, and by 0.122 for every month since stroke, participants in the CT-R group had WAB-AQ scores 6.43 higher than the workbook group at the end of treatment. Additionally, secondary outcome measures included the WAB-Language Quotient, WAB-Cognitive Quotient, Brief Test of Adult Cognition by Telephone (BTACT), and Stroke and Aphasia Quality of Life Scale 39 (SAQOL-39), with significant changes in BTACT verbal fluency subtest and the SAQOL-39 communication and energy scores for both groups. Conclusions: Overall, this study demonstrates the feasibility of a fully virtual trial for patients with post-stroke aphasia, especially given the ongoing COVID19 pandemic, as well as a safe, tolerable, and efficacious digital therapeutic for language/cognitive rehabilitation. Clinical Trial Registration: www.ClinicalTrials.gov, identifier NCT04488029.

3.
J Speech Lang Hear Res ; 64(1): 176-180, 2021 01 14.
Article in English | MEDLINE | ID: covidwho-1065979

ABSTRACT

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.


Subject(s)
Aphasia/rehabilitation , COVID-19 , Humans , Telerehabilitation
4.
Z Evid Fortbild Qual Gesundhwes ; 156-157: 1-8, 2020 Nov.
Article in German | MEDLINE | ID: covidwho-841442

ABSTRACT

INTRODUCTION: About 35,000 people in Germany suffered from stroke-related aphasia in 2019. One of the most frequent manifestations of aphasia are word finding disorders. In times of the COVID-19 pandemic, the temporary approval of video therapy enables the maintenance of speech therapy treatment. This leads to the necessity to investigate the effectiveness of screen-to-screen therapy via a video conferencing system compared to conventional face-to-face therapy of adult aphasia patients. METHODS: For this scoping review, a literature search in the databases Cochrane, Pubmed and Web of Science was conducted for the period February 2010 to 2020. We included German- and English-language studies comparing the effectiveness of a classic face-to-face therapy with a screen-to-screen therapy of adults with aphasia. The studies were selected using the PRISMA flowchart. RESULTS: A total of five studies were identified. Both face-to-face therapy and screen-to-screen therapy showed significant improvements in naming performance in an Italian crossover study, a Canadian randomized study and a quasi-randomized study conducted in the UK. No improvements were found for both forms of intervention in an Israeli crossover study. In a German comparative study, significant improvements in naming performance were found for face-to-face therapy, but the results did not differ significantly from the screen-to-screen therapy intervention group. DISCUSSION: In all included studies, screen-to-screen therapy and face-to-face therapy had a comparable effectiveness on naming performance. The results demonstrate the feasibility of a screen-to-screen therapy under everyday conditions. However, it is possible that this form of therapy cannot always be implemented. Barriers to screen-to-screen therapy can be the use of technologies and restrictions in the visual field due to a neglect. One limitation of the scoping review was that only the naming performance was considered as an outcome, another was the small number of studies included. CONCLUSION: For many patients screen-to-screen therapy is currently the only possibility to receive speech therapy treatment. Therefore it is a positive aspect that screen-to-screen therapy is as effective as face-to-face therapy. Screen-to-screen therapy can provide expanded access to health care and professional expertise in health services. In this way, speech therapy care during the COVID-19 pandemic can be largely maintained. Further research is needed on evidence-based treatment methods and user-oriented apps for video therapy.


Subject(s)
Aphasia , Coronavirus Infections , Pandemics , Pneumonia, Viral , Stroke , Telemedicine , Videoconferencing , Adult , Aphasia/therapy , Betacoronavirus , COVID-19 , Canada , Cross-Over Studies , Germany , Humans , Randomized Controlled Trials as Topic , SARS-CoV-2 , Stroke/complications , Stroke/therapy , User-Computer Interface
5.
Neurol Sci ; 41(12): 3381-3384, 2020 Dec.
Article in English | MEDLINE | ID: covidwho-807501

ABSTRACT

COVID-19 following infection by SARS-CoV-2 can affect the brain causing confusion, depression, and dementia-like signs. Nonetheless, the presence of more specific neuropsychological signs because of COVID-19 remains unexplored. We report on LA, a patient who was affected by a left-hemisphere ischemic stroke, probably because of SARS-CoV-2. The patient showed a highly specific neuropsychological profile characterized by severe agraphia and some signs of conduction aphasia. All other cognitive and sensorimotor functions remained intact. We sustain that specific neuropsychological signs can be observed in patients with COVID-19. Therefore, in-depth and comprehensive neuropsychological assessment should be included to better explore and qualify the neuropsychological consequences of COVID-19. This is a new challenge for diagnosis and rehabilitation, with important consequences for the involved neuropsychological services.


Subject(s)
Agraphia/etiology , Aphasia, Conduction/etiology , Coronavirus Infections/complications , Pneumonia, Viral/complications , Stroke/virology , Betacoronavirus , COVID-19 , Humans , Male , Middle Aged , Pandemics , SARS-CoV-2 , Stroke/complications , Stroke/pathology
6.
Rinsho Shinkeigaku ; 60(10): 706-711, 2020 Oct 24.
Article in Japanese | MEDLINE | ID: covidwho-745654

ABSTRACT

During the COVID-19 pandemic in 2020, an 81-year-old afebrile woman was transported to our institute at 44 minutes after she was found to have global aphasia and weakness of the right extremities. The onset time was unclear. CT showed an occlusion of the left middle cerebral artery without early ischemic changes. MRI revealed a negative fluid-attenuated inversion recovery (FLAIR) pattern, in which several small acute infarcts were seen in diffusion-weighted images with no corresponding hyperintensity lesions on FLAIR. Accordingly, intravenous thrombolysis with alteplase (0.6 mg/kg, the dose approved in Japan) was administered at 1,660 minutes after the last known well and 116 minutes after the symptom recognition. An immediate internal carotid angiogram showed severe stenosis at the distal end of the horizontal portion of the left middle cerebral artery. In the follow-up angiogram at 164 minutes after the symptom recognition, the stenotic lesion almost resolved with the restoration of quick and nearly complete antegrade flow. Her symptoms also resolved promptly. Although the use of MRI is recommended to be minimized in the emergency stroke management during the COVID-19 pandemic, MRI is occasionally mandatory for patient selection, such as cases with unclear onset to perform intravenous thrombolysis. The individualized protected code stroke is essential and must be well considered by each institute for diagnosing patients by selecting appropriate modalities.


Subject(s)
Coronavirus Infections/prevention & control , Diffusion Magnetic Resonance Imaging , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Stroke/diagnostic imaging , Stroke/drug therapy , Thrombolytic Therapy/methods , Tissue Plasminogen Activator/therapeutic use , Aged, 80 and over , COVID-19 , Female , Humans , Infusions, Intravenous , Time Factors , Tissue Plasminogen Activator/administration & dosage
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