Spaccavento Simona, Falcone Rosanna, Cellamare Fara, Picciola Emilia, Glueckauf Robert L
Istituti Clinici Scientifici Maugeri - SPA SB IRCCS, Institute of Bari, Via Generale Bellomo, 73/75 - 70124 Bari, Italy.
Department of Behavioral Sciences & Social Medicine, College of Medicine, Florida State University, 1115W. Call St., Suite G101-C, Tallahassee, FL 32306-4300, United States.
J Commun Disord. 2021 Nov-Dec;94:106158. doi: 10.1016/j.jcomdis.2021.106158. Epub 2021 Oct 8.
The burgeoning growth of computer-based rehabilitation technologies has led to a paradigm shift in the delivery of aphasia intervention. The aim of this study was to conduct a pilot non-inferiority study comparing computer-based training for people with aphasia versus traditional therapist-mediated training on language skills, functional communication and quality of life outcomes in the hospital setting.
Twenty-two fluent, monolingual Italian speakers with stroke-related aphasia in the acute phase of recovery were enrolled in the study. Participants were assigned randomly to computer-based or therapist-mediated aphasia treatment. Both groups received one, 50-minute session for 5 days per week over a period of 8 weeks. During the training, they were administered words and sentence comprehension, written naming, word completion, fluency, word and sentence reorganization tasks. The complexity of each task was increased progressively based on the severity of each person's language deficits.
Participants in both computer-based and traditional therapist-mediated aphasia intervention showed significant gains in language skills, functional communication and quality of life from pre- to post-treatment. Statistically significant within-group differences were found across all outcome measures. In contrast, no significant between-group and group x time interaction effects were found across language skills, functional communication and quality-of-life measures.
The overall pattern of findings suggested computer-based intervention was not inferior to traditional therapist-based intervention for enhancing functional communication deficits in stroke-related aphasia during the acute phase of recovery. A follow-up, fully-powered clinical trial is needed to confirm the reliability of these results.
基于计算机的康复技术的迅速发展已导致失语症干预方式的范式转变。本研究的目的是进行一项试点非劣效性研究，比较在医院环境中对失语症患者进行基于计算机的训练与传统治疗师介导的训练在语言技能、功能沟通和生活质量结果方面的差异。
招募了22名处于恢复急性期的、流利的单语意大利语使用者，他们患有与中风相关的失语症。参与者被随机分配到基于计算机的或治疗师介导的失语症治疗组。两组均每周接受一次50分钟的训练，共8周，每周训练5天。在训练过程中，对他们进行单词和句子理解、书面命名、单词完成、流利度、单词和句子重组任务。根据每个人语言缺陷的严重程度逐步增加每项任务的难度。
基于计算机的失语症干预组和传统治疗师介导的失语症干预组的参与者在治疗前到治疗后，在语言技能、功能沟通和生活质量方面均有显著提高。在所有结果测量中均发现了具有统计学意义的组内差异。相比之下，在语言技能、功能沟通和生活质量测量方面，未发现显著的组间差异和组×时间交互作用。
研究结果的总体模式表明，在恢复急性期，基于计算机的干预在改善与中风相关的失语症患者的功能沟通缺陷方面并不劣于传统的基于治疗师的干预。需要进行一项后续的、有充分效力的临床试验来证实这些结果的可靠性。
