title: RecoverNow: Feasibility of a Mobile Tablet-Based Rehabilitation Intervention to Treat Post-Stroke Communication Deficits in the Acute Care Setting.
abstract: BACKGROUND
  Approximately 40% of patients diagnosed with stroke experience some degree of aphasia. With limited health care resources, patients' access to speech and language therapies is often delayed. We propose using mobile-platform technology to initiate early speech-language therapy in the acute care setting. For this pilot, our objective was to assess the feasibility of a tablet-based speech-language therapy for patients with communication deficits following acute stroke.
  
  
  METHODS
  We enrolled consecutive patients admitted with a stroke and communication deficits with NIHSS score ≥1 on the best language and/or dysarthria parameters. We excluded patients with severe comprehension deficits where communication was not possible. Following baseline assessment by a speech-language pathologist (SLP), patients were provided with a mobile tablet programmed with individualized therapy applications based on the assessment, and instructed to use it for at least one hour per day. Our objective was to establish feasibility by measuring recruitment rate, adherence rate, retention rate, protocol deviations and acceptability.
  
  
  RESULTS
  Over 6 months, 143 patients were admitted with a new diagnosis of stroke: 73 had communication deficits, 44 met inclusion criteria, and 30 were enrolled into RecoverNow (median age 62, 26.6% female) for a recruitment rate of 68% of eligible participants. Participants received mobile tablets at a mean 6.8 days from admission [SEM 1.6], and used them for a mean 149.8 minutes/day [SEM 19.1]. In-hospital retention rate was 97%, and 96% of patients scored the mobile tablet-based communication therapy as at least moderately convenient 3/5 or better with 5/5 being most "convenient".
  
  
  CONCLUSIONS
  Individualized speech-language therapy delivered by mobile tablet technology is feasible in acute care.
authors.affiliation: Champlain Regional Stroke Network, Ottawa, Ontario, Canada.|The Ottawa Hospital, Ottawa, Ontario, Canada.|Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
authors.forename: Karen H
authors.identifier: http://orcid.org/0000-0003-0222-2638
authors.initials: KH
authors.lastname: Mallet
authors.affiliation: Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
authors.forename: Rany M
authors.initials: RM
authors.lastname: Shamloul
authors.affiliation: Brain and Mind Research Institute, University of Ottawa, Ottawa, Ontario, Canada.|Canadian Partnership for Stroke Recovery, Ottawa, Ontario, Canada.
authors.forename: Dale
authors.initials: D
authors.lastname: Corbett
authors.affiliation: Brain and Mind Research Institute, University of Ottawa, Ottawa, Ontario, Canada.|Canadian Partnership for Stroke Recovery, Ottawa, Ontario, Canada.|Élisabeth Bruyère Hospital, Ottawa, Ontario, Canada.
authors.forename: Hillel M
authors.initials: HM
authors.lastname: Finestone
authors.affiliation: Brain and Mind Research Institute, University of Ottawa, Ottawa, Ontario, Canada.
authors.forename: Simon
authors.initials: S
authors.lastname: Hatcher
authors.affiliation: Champlain Regional Stroke Network, Ottawa, Ontario, Canada.|The Ottawa Hospital, Ottawa, Ontario, Canada.
authors.forename: Jim
authors.initials: J
authors.lastname: Lumsden
authors.affiliation: Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.|Brain and Mind Research Institute, University of Ottawa, Ottawa, Ontario, Canada.|Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada.
authors.forename: Franco
authors.initials: F
authors.lastname: Momoli
authors.affiliation: The Ottawa Hospital, Ottawa, Ontario, Canada.|Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.|Brain and Mind Research Institute, University of Ottawa, Ottawa, Ontario, Canada.
authors.forename: Michel C F
authors.initials: MC
authors.lastname: Shamy
authors.affiliation: The Ottawa Hospital, Ottawa, Ontario, Canada.|Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.|Brain and Mind Research Institute, University of Ottawa, Ottawa, Ontario, Canada.
authors.forename: Grant
authors.initials: G
authors.lastname: Stotts
authors.affiliation: University of Toronto, Toronto, Ontario, Canada.
authors.forename: Richard H
authors.initials: RH
authors.lastname: Swartz
authors.affiliation: Brain and Mind Research Institute, University of Ottawa, Ottawa, Ontario, Canada.|Élisabeth Bruyère Hospital, Ottawa, Ontario, Canada.
authors.forename: Christine
authors.initials: C
authors.lastname: Yang
authors.affiliation: The Ottawa Hospital, Ottawa, Ontario, Canada.|Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.|Brain and Mind Research Institute, University of Ottawa, Ottawa, Ontario, Canada.|Canadian Partnership for Stroke Recovery, Ottawa, Ontario, Canada.
authors.forename: Dar
authors.initials: D
authors.lastname: Dowlatshahi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001037:Aphasia / Q000209:etiology / Q000534:rehabilitation*; D034201:Computers, Handheld; D003422:Critical Care; D005240:Feasibility Studies; D005260:Female; D006760:Hospitalization; D006801:Humans; D007808:Language Therapy; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D020521:Stroke / Q000150:complications / Q000175:diagnosis*