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Posted by on Sep 20, 2019 in Stroke | 0 comments

In a nutshell

This study investigated the effectiveness of home-based computerized speech and language therapy (CSLT) in patients with speech problems after stroke. Researchers suggested that CSLT resulted in an improvement in word-finding for these patients.

Some background

A stroke happens when blood flow to the brain is cut-off. This can be due to a blood clot or a ruptured blood vessel. Brain cells stop receiving oxygen and begin to die. The abilities controlled by these cells are lost leaving survivors with symptoms such as aphasia. This condition consists of an inability to talk or understand other people talking. These patients might also not be able to read and write. This affects their daily activities and quality of life. More than 1 in 3 stroke survivors have aphasia (30 to 43% remain affected long-term).

Speech and language therapy (SLT) consists of treatment of patients who have problems in talking, eating, drinking and swallowing. It is known that SLT improves long-term aphasia. However, these patients often cannot access the SLT they need due to healthcare costs. A prior study showed that a home and computer-based SLT (CSLT) may improve the outcomes of patients with long-term aphasia at a lower cost.

The effectiveness of a home-based CSLT to treat stroke survivors with aphasia remains unclear.

Methods & findings

This study included information about 278 stroke survivors with aphasia. 101 (36%) received standard care alone, 97 (35%) received standard care and CSLT and 80 (29%) received no treatment. Patients in the CSLT group received home-based, word-finding exercise on a computer. This treatment was tailored to the needs of each patient. The no-treatment group was asked to complete paper-based puzzle book activities (like sudoku) every day.

The average improvement in the standard care group was 1.1%. This improvement in the CSLT group was 16.4% and in the no-treatment group was 2.4%. Improvements were maintained at 9 and 12 months.

Serious side effects were very limited and were not related or unlikely to be related to the treatment. 27% of the CSLT group reported tiredness or anxiety at one point during the 6 months of computer-use.

The bottom line

This study suggested that standard care combined with CSLT improved the language outcomes of stroke survivors with aphasia.

Published By :

The Lancet. Neurology

Date :

Sep 01, 2019

Original Title :

Self-managed, computerised speech and language therapy for patients with chronic aphasia post-stroke compared with usual care or attention control (Big CACTUS): a multicentre, single-blinded, randomised controlled trial.

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