Communication Sciences and Disorders, University of Texas at Austin, Austin, TX, USA,
Speech Pathology, Wake Forest Baptist Health, Winston-Salem, NC, USA.
Clin Interv Aging. 2019 Feb 25;14:453-471. doi: 10.2147/CIA.S178878. eCollection 2019.
Primary progressive aphasia (PPA) is a neurodegenerative disorder characterized by progressive deterioration of speech and language. A growing body of research supports the utility of speech and language intervention in individuals with PPA, although access to these services remains limited. One potential means of increasing treatment accessibility is the delivery of treatment via telemedicine. Evidence supports the use of teletherapy in stroke-induced aphasia, but research examining the application of teletherapy in PPA is limited. In the current study, a non-randomized group comparison design was used to evaluate the feasibility and utility of treatment delivered via teletherapy relative to treatment administered in person for individuals with PPA.
Two treatment protocols were administered as part of a larger study investigating treatment for speech and language deficits in PPA. Participants with semantic (n=10) and logopenic (n=11) PPA received lexical retrieval treatment and individuals with nonfluent/agrammatic PPA (n=10) received video-implemented script training for aphasia designed to promote speech production and fluency. Treatment was administered via teletherapy for approximately half of the participants receiving each intervention. Treatment outcomes and performance on standardized tests were assessed at pre-treatment and post-treatment, as well as 3, 6, and 12 months post-treatment.
Overall, both treatment approaches resulted in significant gains for primary outcome measures. Critically, comparison of in-person and teletherapy groups revealed comparable outcomes. Generalization to untrained targets and tasks and maintenance of treatment-induced gains were also comparable for traditional vs teletherapy participants.
Overall, treatment outcomes were largely equivalent for individuals receiving treatment via teletherapy vs traditional, in-person delivery. Results support the application of teletherapy for administering restitutive interventions to individuals with mild-to-moderate PPA. Potential implications for using teletherapy in the treatment of cognitive-linguistic and motoric impairments in other disorders and suggestions for administering treatment via telemedicine are discussed.
原发性进行性失语症(PPA)是一种以言语和语言逐渐恶化为特征的神经退行性疾病。越来越多的研究支持在 PPA 患者中进行言语和语言干预的效用,尽管获得这些服务的机会仍然有限。增加治疗可及性的一种潜在方法是通过远程医疗提供治疗。有证据支持远程治疗在中风后失语症中的应用,但研究在 PPA 中应用远程治疗的研究有限。在当前的研究中,使用非随机组比较设计来评估与面对面治疗相比,通过远程治疗为 PPA 患者提供治疗的可行性和效用。
作为一项更大的研究的一部分,该研究调查了 PPA 患者的言语和语言缺陷治疗,实施了两种治疗方案。接受语义(n=10)和命名性失语症(n=11)PPA 的患者接受词汇检索治疗,非流利/语法障碍性 PPA 患者(n=10)接受旨在促进言语产生和流畅性的视频实施的失语症脚本训练。大约一半接受每种干预措施的参与者通过远程治疗接受治疗。在治疗前、治疗后以及治疗后 3、6 和 12 个月评估治疗结果和标准化测试的表现。
总体而言,两种治疗方法都对主要结果测量产生了显著的收益。至关重要的是,面对面治疗组和远程治疗组的比较显示出可比的结果。传统治疗组和远程治疗组在未训练目标和任务上的泛化以及治疗引起的收益的维持也相当。
总体而言,通过远程治疗接受治疗的个体与传统的面对面治疗相比,治疗结果基本相当。结果支持为轻度至中度 PPA 患者应用远程治疗来提供恢复性干预。讨论了在其他疾病中使用远程治疗治疗认知语言和运动障碍以及通过远程医疗提供治疗的建议。