Mesulam Center for Cognitive Neurology and Alzheimer's Disease, Northwestern University, Chicago, Illinois, USA.
Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
J Gerontol B Psychol Sci Soc Sci. 2022 Jun 1;77(6):1017-1025. doi: 10.1093/geronb/gbab165.
Previous reports established the feasibility of a telehealth model for delivering speech-language therapy via Internet videoconferencing, which connects individuals with primary progressive aphasia (PPA) to an expert speech and language pathologist for treatment. This study reports feasibility of the same telehealth intervention in a larger set of progressive aphasia participants and explores factors potentially influencing functional intervention outcomes.
Participants with PPA or progressive aphasia in the context of a neurodegenerative dementia syndrome and their communication partners were enrolled into an 8-session intervention, with 3 evaluations (baseline, 2 months, and 6 months postenrollment). Half of the participants were randomized into a "check-in" group and received 3-monthly half-hour sessions postintervention. Mixed linear models with post hoc testing and percent change in area under the curve were used to examine communication confidence over time, as well as the influence of check-in sessions and the role of communication partner engagement on communication confidence.
Communication confidence improved at the 2-month evaluation and showed no significant decline at the 6-month evaluation. Item-level analysis revealed gains in communication confidence across multiple communication contexts. Gains and maintenance of communication confidence were only present for the engaged communication partner group and were not bolstered by randomization to the check-in group.
Internet-based, person-centered interventions demonstrate promise as a model for delivering speech-language therapy to individuals living with PPA. Maintenance is possible for at least 6 months postenrollment and is better for those with engaged communication partners, which supports the use of dyadic interventions.
先前的报告已经证实了通过互联网视频会议提供言语治疗的远程医疗模式的可行性，该模式将原发性进行性失语症（PPA）患者与专业言语语言病理学家联系起来进行治疗。本研究报告了在更大的进行性失语症患者群体中应用相同远程医疗干预的可行性，并探讨了可能影响功能干预结果的因素。
患有 PPA 或进行性失语症且伴有神经退行性痴呆综合征的患者及其交流伙伴被纳入 8 节干预课程，共进行 3 次评估（基线、2 个月和 6 个月入组后）。参与者被随机分为“签到”组和对照组，其中“签到”组在干预结束后每 3 个月接受半小时的课程。采用混合线性模型和事后检验以及曲线下面积的百分比变化来检测沟通信心随时间的变化，以及签到课程的影响和沟通伙伴参与度对沟通信心的作用。
沟通信心在 2 个月评估时提高，在 6 个月评估时没有显著下降。项目水平分析显示，在多个沟通情境中，沟通信心都有所提高。只有在有参与感的沟通伙伴组中，才会出现沟通信心的提高和维持，而随机分配到签到组并不能增强这种效果。
基于互联网的、以人为本的干预措施为向 PPA 患者提供言语治疗提供了一种有前景的模式。至少在入组后 6 个月内可以维持，且对于有参与感的沟通伙伴效果更好，这支持了使用双元干预措施。
