Jewell Courtney C, Diedrichs Victoria A, Blackett Deena Schwen, Durfee Alexandra Zezinka, Harnish Stacy M
Department of Speech and Hearing Science, College of Arts and Sciences, The Ohio State University, Columbus.
Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine, Northwestern University, Chicago, IL.
Am J Speech Lang Pathol. 2025 Jan 7;34(1):218-230. doi: 10.1044/2024_AJSLP-24-00172. Epub 2024 Nov 18.
In light of COVID-19, telepractice for speech therapy has been increasingly adopted. Telepractice promotes accessibility to therapy services for those in rural environments, lowers the frequency of missed appointments, and reduces the costs of rehabilitation. The efficacy of telepractice has been scarcely explored in the aphasia literature. Preliminary research has demonstrated comparable results of telepractice and in-person therapy for people with aphasia, but the current scope of research is insufficient to guide clinical practice. The present study examined whether the virtual administration of a picture-naming therapy paradigm was as effective as in-person administration.
The treatment effects of two similar clinical trials, one completed in-person ( = 13) and one completed virtually ( = 13), are compared. Participants were adults with chronic (> 6 months) poststroke aphasia. Both clinical trials administered Cued Picture-Naming Therapy 4 days a week for 2 weeks (eight treatment sessions). Treatment outcomes were analyzed using Tau- effect sizes and Mann-Whitney tests.
Weighted Tau- averages showed an advantage of telepractice over in-person treatment in the acquisition effects of trained words, with participants demonstrating a very large effect (0.84, < .01) following telepractice and a large effect (0.75, < .01) following in-person treatment. Both telepractice and in-person rehabilitation demonstrated significant treatment effects and were not significantly different from each other per Mann-Whitney independent-samples tests.
The present study demonstrated that telepractice of a picture-naming paradigm is as effective as in-person treatment administration. This justifies the use of telepractice to overcome accessibility and cost barriers to speech therapy administration and justifies taking patient preference into account. Future research should explore the efficacy of telepractice for treatments that promote greater generalizability to functional communication.
鉴于2019冠状病毒病（COVID-19），言语治疗的远程实践越来越多地被采用。远程实践提高了农村地区患者获得治疗服务的便利性，降低了错过预约的频率，并降低了康复成本。在失语症文献中，远程实践的疗效鲜有探讨。初步研究表明，失语症患者的远程实践和面对面治疗结果相当，但目前的研究范围不足以指导临床实践。本研究检验了图片命名治疗范式的虚拟实施是否与面对面实施一样有效。
比较两项相似临床试验的治疗效果，一项为面对面完成（n = 13），另一项为虚拟完成（n = 13）。参与者为患有慢性（>6个月）中风后失语症的成年人。两项临床试验均每周进行4天的提示图片命名治疗，为期2周（共8次治疗疗程）。使用Tau效应量和曼-惠特尼U检验分析治疗结果。
加权Tau-average显示，在训练单词的习得效果方面，远程实践优于面对面治疗，远程实践后的参与者显示出非常大的效应（0.84，p <.01），面对面治疗后显示出大的效应（0.75，p <.01）。远程实践和面对面康复均显示出显著的治疗效果，根据曼-惠特尼U独立样本检验，两者之间无显著差异。
本研究表明，图片命名范式的远程实践与面对面治疗一样有效。这证明了使用远程实践来克服言语治疗实施中的可及性和成本障碍是合理的，也证明了考虑患者偏好的合理性。未来的研究应探讨远程实践对促进功能沟通更具普遍性的治疗方法的疗效。
