Computer therapy compared with usual care for people with long-standing aphasia poststroke: a pilot randomized controlled trial.
OBJECTIVE
The purpose of this study was to test the feasibility of conducting a randomized controlled trial to study the effectiveness of self-managed computer treatment for people with long-standing aphasia after stroke.


METHODS
In this pilot single-blinded, parallel-group, randomized controlled trial participants with aphasia were allocated to self-managed computer treatment with volunteer support or usual care (everyday language activity). The 5-month intervention period was followed by 3 months without intervention to investigate treatment maintenance.


RESULTS
Thirty-four participants were recruited. Seventeen participants were allocated to each group. Thirteen participants from the usual care group and 15 from the computer treatment group were followed up at 5 months. An average of 4 hours 43 minutes speech and language therapy time and 4 hours volunteer support time enabled an average of 25 hours of independent practice. The difference in percentage change in naming ability from baseline at 5 months between groups was 19.8% (95% CI, 4.4-35.2; P=0.014) in favor of the treatment group. Participants with more severe aphasia showed little benefit. Results demonstrate early indications of cost-effectiveness of self-managed computer therapy.


CONCLUSIONS
This pilot trial indicates that self-managed computer therapy for aphasia is feasible and that it will be practical to recruit sufficient participants to conduct an appropriately powered clinical trial to investigate the effectiveness of self-managed computer therapy for people with long-standing aphasia. Clinical Trial Registration- www.controlled-trials.com. Unique identifier: ISRCTN91534629.
University of Sheffield, Sheffield Teaching Hospitals Foundation Trust, 107 Innovation Centre, 217 Portobello, Sheffield S1 4DP, UK. r.l.palmer@sheffield.ac.uk
Rebecca
R
Palmer
Pam
P
Enderby
Cindy
C
Cooper
Nick
N
Latimer
Steven
S
Julious
Gail
G
Paterson
Munyaradzi
M
Dimairo
Simon
S
Dixon
Jane
J
Mortley
Rose
R
Hilton
Audrey
A
Delaney
Helen
H
Hughes
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001037:Aphasia / Q000191:economics / Q000453:epidemiology* / Q000628:therapy*; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D012648:Self Care / Q000191:economics / Q000379:methods*; D016037:Single-Blind Method; D020521:Stroke / Q000191:economics / Q000453:epidemiology* / Q000628:therapy*; D013813:Therapy, Computer-Assisted / Q000191:economics / Q000379:methods*; D013997:Time Factors; D016896:Treatment Outcome