Mallet Karen H, Shamloul Rany M, Corbett Dale, Finestone Hillel M, Hatcher Simon, Lumsden Jim, Momoli Franco, Shamy Michel C F, Stotts Grant, Swartz Richard H, Yang Christine, Dowlatshahi Dar
Champlain Regional Stroke Network, Ottawa, Ontario, Canada.
The Ottawa Hospital, Ottawa, Ontario, Canada.
PLoS One. 2016 Dec 21;11(12):e0167950. doi: 10.1371/journal.pone.0167950. eCollection 2016.
Approximately 40% of patients diagnosed with stroke experience some degree of aphasia. With limited health care resources, patients' access to speech and language therapies is often delayed. We propose using mobile-platform technology to initiate early speech-language therapy in the acute care setting. For this pilot, our objective was to assess the feasibility of a tablet-based speech-language therapy for patients with communication deficits following acute stroke.
We enrolled consecutive patients admitted with a stroke and communication deficits with NIHSS score ≥1 on the best language and/or dysarthria parameters. We excluded patients with severe comprehension deficits where communication was not possible. Following baseline assessment by a speech-language pathologist (SLP), patients were provided with a mobile tablet programmed with individualized therapy applications based on the assessment, and instructed to use it for at least one hour per day. Our objective was to establish feasibility by measuring recruitment rate, adherence rate, retention rate, protocol deviations and acceptability.
Over 6 months, 143 patients were admitted with a new diagnosis of stroke: 73 had communication deficits, 44 met inclusion criteria, and 30 were enrolled into RecoverNow (median age 62, 26.6% female) for a recruitment rate of 68% of eligible participants. Participants received mobile tablets at a mean 6.8 days from admission [SEM 1.6], and used them for a mean 149.8 minutes/day [SEM 19.1]. In-hospital retention rate was 97%, and 96% of patients scored the mobile tablet-based communication therapy as at least moderately convenient 3/5 or better with 5/5 being most "convenient".
Individualized speech-language therapy delivered by mobile tablet technology is feasible in acute care.
约40%被诊断为中风的患者会出现某种程度的失语症。由于医疗资源有限，患者获得言语和语言治疗的机会往往会延迟。我们建议在急性护理环境中使用移动平台技术启动早期言语-语言治疗。对于这项试点研究，我们的目标是评估基于平板电脑的言语-语言治疗对急性中风后有沟通障碍患者的可行性。
我们纳入了连续入院的中风且有沟通障碍的患者，其在最佳语言和/或构音障碍参数上的NIHSS评分≥1。我们排除了存在严重理解障碍而无法沟通的患者。在言语-语言病理学家（SLP）进行基线评估后，根据评估为患者提供安装有个性化治疗应用程序的移动平板电脑，并指示他们每天至少使用一小时。我们的目标是通过测量招募率、依从率、保留率、方案偏差和可接受性来确定可行性。
在6个月的时间里，143例患者被新诊断为中风：73例有沟通障碍，44例符合纳入标准，30例被纳入RecoverNow（中位年龄62岁，女性占26.6%），招募率为符合条件参与者的68%。参与者从入院到收到移动平板电脑的平均时间为6.8天[标准误1.6]，每天平均使用149.8分钟[标准误19.1]。住院期间的保留率为97%，96%的患者将基于移动平板电脑的沟通治疗评为至少中等方便（3/5或更高，5/5为最“方便”）。
通过移动平板电脑技术提供个性化的言语-语言治疗在急性护理中是可行的。
