Background: The Cochrane review on the effectiveness of speech and language therapy for aphasia following\nstroke suggests intensity of therapy is a key predictor for outcome. Current aphasia services cannot provide\nintervention at the intensity observed within trial contexts because of resource limitations. Telerehabilitation\ncould widen access to speech-language pathologists (SLPs) in geographically remote contexts and reduce the\ntime spent on travel by the therapist and patient. The current academic literature within this field is in its infancy,\nwith few trials of speech and language therapy (SLT) delivered by videoconference. Our pilot randomized controlled\ntrial (RCT) will explore feasibility aspects and effectiveness of telerehabilitation for aphasia in addition to standard SLT.\nMethod/design: Our study is a pragmatic, exploratory, pilot randomized controlled trial, where participants will be\nrandomized to a telerehabilitation group or a control group. Both groups receive standard SLT (usual care) but the\ntelerehabilitation group receives an additional 5 h of telerehabilitation per week over 4 weeks through videoconference.\nThis additional telerehabilitation focuses on spoken language with an emphasis on word naming. We aim to include 40\npatients in each group, with inclusion criteria being aphasia any time post stroke. Participants will be assessed blindly at\npre-randomization (baseline), and 4 weeks and 4 months after randomization. The primary endpoint is naming ability 3\nmonths after the completed intervention, measured by the Norwegian Basic Aphasia Assessment (NGA) naming subtest.\nSecondary endpoints include other subtests of the NGA, the VAST (Verb and Sentence Test) subtest sentence production,\nCommunicative Effectiveness Index (CETI) and the Stroke and Aphasia Quality of Life scale (SAQOL-39). Experiences of\npatients and SLPs with telerehabilitation are assessed using questionnaires and semi-structured interviews. Statistical\nbetween group comparisons will be in line with an intention-to-treat analysis.\nDiscussion: This pilot RCT of intensive language training by videoconference will contribute new scientific evidence to\nthe field of aphasia telerehabilitation. Here, we describe our trial which will explore the feasibility of telerehabilitation for\naphasia as an intervention, our choice of primary and secondary outcome measures and proposed analyses. Our trial will\nprovide information for the development and delivery of future definitive RCTs.
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