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远程康复提供的强化言语治疗对脑卒中后失语症的影响——一项前瞻性随机对照试验

The effect of augmented speech-language therapy delivered by telerehabilitation on poststroke aphasia-a pilot randomized controlled trial.

作者信息

Øra Hege Prag, Kirmess Melanie, Brady Marian C, Partee Iselin, Hognestad Randi Bjor, Johannessen Beate Bertheau, Thommessen Bente, Becker Frank

机构信息

Sunnaas Rehabilitation Hospital, Bjørnemyr, Norway.

Institute of Clinical Medicine, University of Oslo, Oslo, Norway.

出版信息

Clin Rehabil. 2020 Mar;34(3):369-381. doi: 10.1177/0269215519896616. Epub 2020 Jan 5.

Abstract

OBJECTIVE

Pilot a definitive randomized controlled trial of speech-language telerehabilitation in poststroke aphasia in addition to usual care with regard to recruitment, drop-outs, and language effects.

DESIGN

Pilot single-blinded randomized controlled trial.

SETTING

Telerehabilitation delivered from tertiary rehabilitation center to participants at their home or admitted to secondary rehabilitation centers.

SUBJECTS

People with naming impairment due to aphasia following stroke.

INTERVENTION

Sixty-two participants randomly allocated to 5 hours of speech and language telerehabilitation by videoconference per week over four consecutive weeks together with usual care or usual care alone. The telerehabilitation targeted functional, expressive language.

MAIN MEASURES

Norwegian Basic Aphasia Assessment: naming (primary outcome), repetition, and auditory comprehension subtests; Verb and Sentence Test sentence production subtest and the Communicative Effectiveness Index at baseline, four weeks, and four months postrandomization. Data were analyzed by intention to treat.

RESULTS

No significant between-group differences were seen in naming or auditory comprehension in the Norwegian Basic Aphasia Assessment at four weeks and four months post randomization. The telerehabilitation group ( = 29) achieved a Norwegian Basic Aphasia Assessment repetition score of 8.9 points higher ( = 0.026) and a Verb and Sentence Test score 3 points higher ( = 0.002) than the control group ( = 27) four months postrandomization. Communicative Effectiveness Index was not significantly different between groups, but increased significantly within both groups. No adverse events were reported.

CONCLUSION

Augmented telerehabilitation via videoconference may be a viable rehabilitation model for aphasia affecting language outcomes poststroke. A definitive trial with 230 participants is needed to confirm results.

摘要

目的

除常规护理外,开展一项关于中风后失语症言语远程康复的确定性随机对照试验,涉及招募、失访和语言效果方面。

设计

单盲随机对照试验试点。

地点

从三级康复中心向在家中的参与者或入住二级康复中心的参与者提供远程康复服务。

受试者

中风后因失语导致命名障碍的患者。

干预措施

62名参与者被随机分配,一组连续四周每周通过视频会议接受5小时的言语和语言远程康复服务并接受常规护理,另一组仅接受常规护理。远程康复以功能性表达性语言为目标。

主要测量指标

挪威基本失语症评估:命名(主要结果)、复述和听觉理解子测试;动词和句子测试句子生成子测试以及随机分组后基线、四周和四个月时的沟通有效性指数。数据采用意向性分析。

结果

随机分组后四周和四个月时,挪威基本失语症评估中命名或听觉理解方面两组间无显著差异。随机分组四个月后,远程康复组(n = 29)的挪威基本失语症评估复述得分比对照组(n = 27)高8.9分(P = 0.026),动词和句子测试得分高3分(P = 0.002)。两组间沟通有效性指数无显著差异,但两组内均显著增加。未报告不良事件。

结论

通过视频会议增强的远程康复可能是一种可行的中风后失语症康复模式,影响语言结局。需要一项有230名参与者的确定性试验来证实结果。

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