1
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Macoir J, Routhier S, Auclair-Ouellet N, Wilson MA, Hudon C. Validation of and Normative Data of the DVAQ-30, a New Video-Naming Test for Assessing Verb Anomia. ARCHIVES OF CLINICAL NEUROPSYCHOLOGY : THE OFFICIAL JOURNAL OF THE NATIONAL ACADEMY OF NEUROPSYCHOLOGISTS 2023; 38:80-90. [PMID: 35901465 DOI: 10.1093/arclin/acac052] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/27/2022] [Indexed: 01/25/2023]
Abstract
OBJECTIVE Anomia is usually assessed using picture-naming tests. While many tests evaluate anomia for nouns, very few tests have been specifically designed for verb anomia. This article presents the DVAQ-30, a new naming test for detecting verb anomia in adults and elderly people. METHOD The article describes three studies. Study 1 focused on the DVAQ-30 development phase. In Study 2, healthy participants and individuals with post-stroke aphasia, mild cognitive impairment, Alzheimer's disease, or primary progressive aphasia were assessed using the DVAQ-30 to establish its convergent and discriminant validity, test-retest reliability, and internal consistency. In Study 3, a group of adults and elderly Quebec French-speaking adults were assessed to obtain normative data. RESULTS The DVAQ-30 had good convergent validity and distinguished the performance of healthy participants from that of participants with pathological conditions. The test also had good internal consistency, and the test-retest analysis showed that the scores had good temporal stability. Furthermore, normative data were collected on the performance of 244 participants aged 50 years old and over. CONCLUSIONS The DVAQ-30 fills an important gap and has the potential to help clinicians and researchers better detect verb anomia associated with pathological aging and post-stroke aphasia.
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Affiliation(s)
- J Macoir
- Faculté de médecine, Département de réadaptation, Université Laval, Québec, Canada.,Centre de recherche CERVO - Brain Research Centre, Québec, Canada
| | - S Routhier
- Centre de recherche sur le vieillissement, CSSS-IUGS, Sherbrooke, Canada
| | | | - M A Wilson
- Faculté de médecine, Département de réadaptation, Université Laval, Québec, Canada.,Centre interdisciplinaire de recherche en réadaptation et intégration sociale, Québec, Canada
| | - C Hudon
- Centre de recherche CERVO - Brain Research Centre, Québec, Canada.,Faculté des sciences sociales, École de psychologie, Université Laval, Québec, Canada.,Centre de recherche VITAM, Québec, Canada
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2
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Bu X, Ng PH, Tong Y, Chen PQ, Fan R, Tang Q, Cheng Q, Li S, Cheng AS, Liu X. A Mobile-based Virtual Reality Speech Rehabilitation App for Patients With Aphasia After Stroke: Development and Pilot Usability Study. JMIR Serious Games 2022; 10:e30196. [PMID: 35389349 PMCID: PMC9031062 DOI: 10.2196/30196] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Revised: 02/28/2022] [Accepted: 03/05/2022] [Indexed: 01/29/2023] Open
Abstract
Background Stroke has the highest disability-adjusted life-years lost in any disease, and approximately one-third of the patients get aphasia. Computers and tablets are innovative and aid in intensive treatments in speech rehabilitation for patients with aphasia. However, mechanical training limits the help to patients. Objective This study aims to provide a framework for an integrated virtual reality (VR) app to provide speech rehabilitation for patients with aphasia. Methods The content was generated through an in-depth literature review and discussion with experienced rehabilitation physicians and occupational therapists. We then conducted a 2-round Delphi study with 15 experts from hospitals and universities to rate the content using a 5-point Likert scale. The app was developed by an interdisciplinary team involving VR, medical science of rehabilitation, and therapeutic rehabilitation. Pilot usability testing of this novel app was conducted among 5 patients with aphasia, 5 healthy volunteers, 5 medical staff, and 2 VR experts. Results We designed 4 modules of speech rehabilitation: oral expression, auditory comprehension, cognition, and comprehensive application. Our VR-based interactive and intelligent app was developed to provide an alternative option for patients with aphasia. Pilot usability testing revealed user satisfaction with the app. Conclusions This study designed and tested a novel VR-based app for speech rehabilitation specifically adapted to patients with aphasia. This will guide other studies to develop a similar program or intelligent system in a clinical setting.
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Affiliation(s)
- Xiaofan Bu
- Nursing Teaching and Research Section, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China
| | - Peter Hf Ng
- Department of Computing, The Hong Kong Polytechnic University, Hong Kong, China
| | - Ying Tong
- Department of Rehabilitation, Brain Hospital of Hunan Province, Hunan University of Chinese Medicine, Changsha, China
| | - Peter Q Chen
- Department of Computing, The Hong Kong Polytechnic University, Hong Kong, China
| | - Rongrong Fan
- Nursing Teaching and Research Section, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China
| | - Qingping Tang
- Department of Rehabilitation, Brain Hospital of Hunan Province, Hunan University of Chinese Medicine, Changsha, China
| | - Qinqin Cheng
- Faculty of Medicine, Nethersole School of Nursing, Chinese University of Hong Kong, Hong Kong, China
| | - Shuangshuang Li
- Department of Nursing, Second Xiangya Hospital of Central South University, Changsha, China
| | - Andy Sk Cheng
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | - Xiangyu Liu
- Department of Health Service Center, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China
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3
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Fares N, Sherratt RS, Elhajj IH. Directing and Orienting ICT Healthcare Solutions to Address the Needs of the Aging Population. Healthcare (Basel) 2021; 9:147. [PMID: 33540510 PMCID: PMC7912863 DOI: 10.3390/healthcare9020147] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 01/25/2021] [Accepted: 01/26/2021] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND With an aging population, it is essential to maintain good health and autonomy for as long as possible. Instead of hospitalisation or institutionalisation, older people with chronic conditions can be assisted in their own home with numerous "smart" devices that support them in their activities of daily living, manage their medical conditions, and prevent fall incidents. Information and Communication Technology (ICT) solutions facilitate the monitoring and management of older people's health to improve quality of life and physical activity with a decline in caregivers' burden. METHOD The aim of this paper was to conduct a systematic literature review to analyse the state of the art of ICT solutions for older people with chronic conditions, and the impact of these solutions on their quality of life from a biomedical perspective. RESULTS By analysing the literature on the available ICT proposals, it is shown that different approaches have been deployed by noticing that the more cross-interventions are merged then the better the results are, but there is still no evidence of the effects of ICT solutions on older people's health outcomes. Furthermore, there are still unresolved ethical and legal issues. CONCLUSION While there has been much research and development in healthcare ICT solutions for the aging population, ICT solutions still need significant development in order to be user-oriented, affordable, and to manage chronic conditions in the aging wider population.
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Affiliation(s)
- Nada Fares
- Department of Biomedical Engineering, School of Biological Sciences, University of Reading, Berkshire RG6 6AY, UK;
| | - R. Simon Sherratt
- Department of Biomedical Engineering, School of Biological Sciences, University of Reading, Berkshire RG6 6AY, UK;
| | - Imad H. Elhajj
- Department of Electrical and Computer Engineering, American University of Beirut, Beirut 1107 2020, Lebanon;
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4
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Adjunctive Approaches to Aphasia Rehabilitation: A Review on Efficacy and Safety. Brain Sci 2021; 11:brainsci11010041. [PMID: 33401678 PMCID: PMC7823462 DOI: 10.3390/brainsci11010041] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 12/24/2020] [Accepted: 12/31/2020] [Indexed: 12/14/2022] Open
Abstract
Aphasia is one of the most socially disabling post-stroke deficits. Although traditional therapies have been shown to induce adequate clinical improvement, aphasic symptoms often persist. Therefore, unconventional rehabilitation techniques which act as a substitute or as an adjunct to traditional approaches are urgently needed. The present review provides an overview of the efficacy and safety of the principal approaches which have been proposed over the last twenty years. First, we examined the effectiveness of the pharmacological approach, principally used as an adjunct to language therapy, reporting the mechanism of action of each single drug for the recovery of aphasia. Results are conflicting but promising. Secondly, we discussed the application of Virtual Reality (VR) which has been proven to be useful since it potentiates the ecological validity of the language therapy by using virtual contexts which simulate real-life everyday contexts. Finally, we focused on the use of Transcranial Direct Current Stimulation (tDCS), both discussing its applications at the cortical level and highlighting a new perspective, which considers the possibility to extend the use of tDCS over the motor regions. Although the review reveals an extraordinary variability among the different studies, substantial agreement has been reached on some general principles, such as the necessity to consider tDCS only as an adjunct to traditional language therapy.
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5
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Macoir J, Lavoie M, Routhier S, Bier N. Key Factors for the Success of Self-Administered Treatments of Poststroke Aphasia Using Technologies. Telemed J E Health 2019; 25:663-670. [DOI: 10.1089/tmj.2018.0116] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Joël Macoir
- Department of Rehabilitation, Faculty of Medicine, Laval University, Québec, Canada
- Cervo Brain Research Center, Québec, Canada
| | - Monica Lavoie
- Department of Rehabilitation, Faculty of Medicine, Laval University, Québec, Canada
- Cervo Brain Research Center, Québec, Canada
| | | | - Nathalie Bier
- School of Rehabilitation, Montreal University, Montréal, Canada
- Research Center of the University Institute of Geriatrics of Montreal, Montréal, Canada
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6
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Ballard KJ, Etter NM, Shen S, Monroe P, Tien Tan C. Feasibility of Automatic Speech Recognition for Providing Feedback During Tablet-Based Treatment for Apraxia of Speech Plus Aphasia. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2019; 28:818-834. [PMID: 31306595 DOI: 10.1044/2018_ajslp-msc18-18-0109] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Purpose Individuals with neurogenic speech disorders require ongoing therapeutic support to achieve functional communication goals. Alternative methods for service delivery, such as tablet-based speech therapy applications, may help bridge the gap and bring therapeutic interventions to the patient in an engaging way. The purpose of this study was to evaluate an iPad-based speech therapy app that uses automatic speech recognition (ASR) software to provide feedback on speech accuracy to determine the ASR's accuracy against human judgment and whether participants' speech improved with this ASR-based feedback. Method Five participants with apraxia of speech plus aphasia secondary to stroke completed an intensive 4-week at-home therapy program using a novel word training app with built-in ASR. Multiple baselines across participants and behaviors designs were employed, with weekly probes and follow-up at 1 month posttreatment. Four sessions a week of 100 practice trials each were prescribed, with 1 being clinician-run and the remainder done independently. Dependent variables of interest were ASR-human agreement on accuracy during practice trials and human-judged word production accuracy over time in probes. Also, user experience surveys were completed immediately posttreatment. Results ASR-human agreement on accuracy averaged ~80%, which is a common threshold applied for interrater agreement. All participants demonstrated improved word production accuracy over time with the ASR-based feedback and maintenance of gains after 1 month. All participants reported enjoying using the app with support of a speech pathologist. Conclusion For these participants with apraxia of speech plus aphasia due to stroke, satisfactory gains were made in word production accuracy with an app-based therapy program providing ASR-based feedback on accuracy. Findings support further testing of this ASR-based approach as a supplement to clinician-run sessions to assist clients with similar profiles in achieving higher amount and intensity of practice as well as empowering them to manage their own therapy program. Supplemental Material https://doi.org/10.23641/asha.8206628.
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Affiliation(s)
- Kirrie J Ballard
- Faculty of Health Sciences, University of Sydney, New South Wales, Australia
| | - Nicole M Etter
- Department of Communication Sciences and Disorders, Pennsylvania State University, University Park
| | - Songjia Shen
- Games Studio, University of Technology Sydney, New South Wales, Australia
| | - Penelope Monroe
- Faculty of Health Sciences, University of Sydney, New South Wales, Australia
| | - Chek Tien Tan
- InfoComm Technology Cluster, Singapore Institute of Technology, Singapore
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7
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Lavoie M, Bier N, Macoir J. Efficacy of a self-administered treatment using a smart tablet to improve functional vocabulary in post-stroke aphasia: a case-series study. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2019; 54:249-264. [PMID: 30426650 DOI: 10.1111/1460-6984.12439] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Revised: 10/16/2018] [Accepted: 10/17/2018] [Indexed: 06/09/2023]
Abstract
BACKGROUND Aphasia is an acquired language disorder that occurs secondary to brain injury, such as stroke. It causes communication difficulties that have a significant impact on quality of life and social relationships. Although the efficacy of speech-language therapy has been clearly demonstrated in this population, long-term services are currently limited due to logistical and financial constraints. In this context, the potential contribution of technology, such as smart tablets, is worth exploring, especially to improve vocabulary that is relevant in daily life. AIMS The main aim was to investigate the efficacy of a self-administered treatment using a smart tablet to improve naming of functional words in post-stroke anomia. METHODS & PROCEDURES Four adults with post-stroke aphasia took part in the study. An ABA design with multiple baselines was used to compare naming performances for four equivalent lists: (1) trained with functional words chosen with the participant; (2) trained with words randomly chosen from a picture database; (3) exposed but not trained; and (4) not exposed (control). OUTCOMES & RESULTS For all participants, the treatment self-administered at home (four times/week for 4 weeks) resulted in a significant improvement for both sets of trained words that was maintained 2 months after the end of treatment. Moreover, in two participants, evidence of generalization to conversation was found. CONCLUSIONS & IMPLICATIONS This study confirms the efficacy of using smart tablets to improve naming in post-stroke aphasia. Although more studies are needed, the use of new technologies is unquestionably a promising approach to improve communication skills in people with aphasia, especially by targeting vocabulary that is relevant to them in their daily lives.
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Affiliation(s)
- Monica Lavoie
- Département de réadaptation, Université Laval, Quebec, QC, Canada
- Centre de recherche CERVO-Brain Research Centre, Quebec, QC, Canada
| | - Nathalie Bier
- École de réadaptation, Université de Montréal, Montreal, QC, Canada
- Centre de recherche, Institut universitaire de gériatrie de Montréal, Montreal, QC, Canada
| | - Joël Macoir
- Département de réadaptation, Université Laval, Quebec, QC, Canada
- Centre de recherche CERVO-Brain Research Centre, Quebec, QC, Canada
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8
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Lavoie M, Bier N, Laforce R, Macoir J. Improvement in functional vocabulary and generalization to conversation following a self-administered treatment using a smart tablet in primary progressive aphasia. Neuropsychol Rehabil 2019; 30:1224-1254. [PMID: 30714482 DOI: 10.1080/09602011.2019.1570943] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Currently, public services in speech-language pathology for primary progressive aphasia (PPA) are very limited, although several interventions have been shown to be effective. In this context, new technologies have the potential to enable people with PPA to improve their communication skills. The main aim of this study was to investigate the efficacy of a self-administered therapy using a smart tablet to improve naming of functional words and to assess generalization to an ecological conversation task. Five adults with PPA completed the protocol. Using an ABA design with multiple baselines, naming performance was compared across four equivalent lists: (1) trained with functional words; (2) trained with words from a picture database; (3) exposed but not trained; and (4) not exposed (control). Treatment was self-administered four times a week for a period of four consecutive weeks. A significant improvement for trained words was found in all five participants, and gains were maintained two months post-treatment in four of them. Moreover, in three participants, evidence of generalization was found in conversation. This study supports the efficacy of using a smart tablet to improve naming in PPA and suggests the possibility of generalization to an ecological context.
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Affiliation(s)
- Monica Lavoie
- Département de réadaptation, Université Laval, Québec, QC, Canada.,Centre de recherche CERVO - Brain Research Centre, Québec, QC, Canada
| | - Nathalie Bier
- École de réadaptation, Université de Montréal, Montréal, QC, Canada.,Centre de recherche, Institut universitaire de gériatrie de Montréal, Montréal, QC, Canada
| | - Robert Laforce
- Clinique interdisciplinaire de mémoire, CHU de Québec-Hôpital de l'Enfant-Jésus, Québec, QC, Canada.,Département de médecine, Université Laval, Québec, QC, Canada
| | - Joël Macoir
- Département de réadaptation, Université Laval, Québec, QC, Canada.,Centre de recherche CERVO - Brain Research Centre, Québec, QC, Canada
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9
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Pugliese M, Ramsay T, Shamloul R, Mallet K, Zakutney L, Corbett D, Dukelow S, Stotts G, Shamy M, Wilson K, Guerinet J, Dowlatshahi D. RecoverNow: A mobile tablet-based therapy platform for early stroke rehabilitation. PLoS One 2019; 14:e0210725. [PMID: 30682076 PMCID: PMC6347149 DOI: 10.1371/journal.pone.0210725] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Accepted: 12/31/2018] [Indexed: 11/18/2022] Open
Abstract
Introduction Stroke survivors frequently experience a range of post-stroke deficits. Specialized stroke rehabilitation improves recovery, especially if it is started early post-stroke. However, resource limitations often preclude early rehabilitation. Mobile technologies may provide a platform for stroke survivors to begin recovery when they might not be able to otherwise. The study objective was to demonstrate the feasibility of RecoverNow, a tablet-based stroke recovery platform aimed at delivering speech and cognitive therapy. Methods We recruited a convenience sample of 30 acute stroke patients to use RecoverNow for up to 3 months. Allied health professionals assigned specific applications based on standard of care assessments. Participants were encouraged to take home the RecoverNow tablets upon discharge from acute care. The study team contacted participants to return for a follow-up interview 3 months after enrollment. The primary outcome of interest was feasibility, defined using 5 facets: recruitment rate, adherence rate, retention rate, the proportion of successful follow-up interventions, and protocol deviations. We tracked barriers to tablet-based care as a secondary outcome. Results We successfully recruited 30 of 62 eligible patients in 15 weeks (48% recruitment rate). Participants were non-adherent to tablet-based therapy inside and outside of acute care, using RecoverNow for a median of 12 minutes a day. Retention was high with 23 of 30 patients participating in follow-up interviews (77% retention rate) and all but 3 of the 23 interviews (87%) were successfully completed. Only 2 major protocol deviations occurred: one enrollment failure and one therapy protocol violation. Barriers to tablet-based care were frequently encountered by study participants with many expressing the assigned applications were either too easy or too difficult. Conclusions Acute stroke patients are interested in attempting tablet-based stroke rehabilitation and are easily recruited early post-stroke. However, tablet-based therapy may be challenging due to patient, device and system-related barriers. Reducing the frequency of common barriers will be essential to keeping patients engaged in tablet-based therapy.
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Affiliation(s)
- Michael Pugliese
- School of Epidemiology and Public Health, University of Ottawa, Ontario, Canada
- * E-mail:
| | - Tim Ramsay
- School of Epidemiology and Public Health, University of Ottawa, Ontario, Canada
- Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Rany Shamloul
- Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Karen Mallet
- Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
- Champlain Regional Stroke Network, Ottawa, Ontario, Canada
- The Ottawa Hospital, Ottawa, Ontario, Canada
- Canadian Partnership for Stroke Recovery, Ottawa, Ontario, Canada
| | - Lise Zakutney
- Champlain Regional Stroke Network, Ottawa, Ontario, Canada
- The Ottawa Hospital, Ottawa, Ontario, Canada
| | - Dale Corbett
- Canadian Partnership for Stroke Recovery, Ottawa, Ontario, Canada
- Department of Cellular and Molecular Medicine, University of Ottawa, Ottawa, Ontario, Canada
- Brain and Mind Research Institute, University of Ottawa, Ottawa, Ontario, Canada
| | - Sean Dukelow
- Canadian Partnership for Stroke Recovery, Ottawa, Ontario, Canada
- Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada
| | - Grant Stotts
- Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
- Champlain Regional Stroke Network, Ottawa, Ontario, Canada
- The Ottawa Hospital, Ottawa, Ontario, Canada
- Brain and Mind Research Institute, University of Ottawa, Ottawa, Ontario, Canada
| | - Michel Shamy
- Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
- Champlain Regional Stroke Network, Ottawa, Ontario, Canada
- The Ottawa Hospital, Ottawa, Ontario, Canada
| | - Kumanan Wilson
- School of Epidemiology and Public Health, University of Ottawa, Ontario, Canada
- Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
- The Ottawa Hospital, Ottawa, Ontario, Canada
| | | | - Dar Dowlatshahi
- School of Epidemiology and Public Health, University of Ottawa, Ontario, Canada
- Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
- Champlain Regional Stroke Network, Ottawa, Ontario, Canada
- The Ottawa Hospital, Ottawa, Ontario, Canada
- Canadian Partnership for Stroke Recovery, Ottawa, Ontario, Canada
- Brain and Mind Research Institute, University of Ottawa, Ottawa, Ontario, Canada
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Macedonia M, Hammer F, Weichselbaum O. Guided Embodiment and Potential Applications of Tutor Systems in Language Instruction and Rehabilitation. Front Psychol 2018; 9:927. [PMID: 29951017 PMCID: PMC6008518 DOI: 10.3389/fpsyg.2018.00927] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Accepted: 05/22/2018] [Indexed: 11/13/2022] Open
Abstract
Intelligent tutor systems (ITSs) in mobile devices take us through learning tasks and make learning ubiquitous, autonomous, and at low cost (Nye, 2015). In this paper, we describe guided embodiment as an ITS essential feature for second language learning (L2) and aphasia rehabilitation (ARe) that enhances efficiency in the learning process. In embodiment, cognitive processes, here specifically language (re)learning are grounded in actions and gestures (Pecher and Zwaan, 2005; Fischer and Zwaan, 2008; Dijkstra and Post, 2015). In order to guide users through embodiment, ITSs must track action and gesture, and give corrective feed-back to achieve the users' goals. Therefore, sensor systems are essential to guided embodiment. In the next sections, we describe sensor systems that can be implemented in ITS for guided embodiment.
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Affiliation(s)
- Manuela Macedonia
- Information Engineering, Johannes Kepler Universität Linz, Linz, Austria.,Neural Mechanisms of Human Communication, Max-Planck-Institut für Kognitions- und Neurowissenschaften, Leipzig, Germany
| | | | - Otto Weichselbaum
- Information Engineering, Johannes Kepler Universität Linz, Linz, Austria.,Sew Systems Gmbh, Linz, Austria
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Kurland J, Liu A, Stokes P. Effects of a Tablet-Based Home Practice Program With Telepractice on Treatment Outcomes in Chronic Aphasia. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2018; 61:1140-1156. [PMID: 29710115 PMCID: PMC6195077 DOI: 10.1044/2018_jslhr-l-17-0277] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2017] [Accepted: 12/19/2017] [Indexed: 05/14/2023]
Abstract
PURPOSE The aim of this study was to determine if a tablet-based home practice program with weekly telepractice support could enable long-term maintenance of recent treatment gains and foster new language gains in poststroke aphasia. METHOD In a pre-post group study of home practice outcomes, 21 individuals with chronic aphasia were examined before and after a 6-month home practice phase and again at follow-up 4 months later. The main outcome measure studied was change in naming previously treated or untreated, practiced or unpracticed pictures of objects and actions. Individualized home practice programs were created in iBooks Author with semantic, phonemic, and orthographic cueing in pictures, words, and videos in order to facilitate naming of previously treated or untreated pictures. RESULTS Home practice was effective for all participants with severity moderating treatment effects, such that individuals with the most severe aphasia made and maintained fewer gains. There was a negative relationship between the amount of training required for iPad proficiency and improvements on practiced and unpracticed pictures and a positive relationship between practice compliance and same improvements. CONCLUSION Unsupervised home practice with weekly video teleconferencing support is effective. This study demonstrates that even individuals with chronic severe aphasia, including those with no prior smart device or even computer experience, can attain independent proficiency to continue practicing and improving their language skills beyond therapy discharge. This could represent a low-cost therapy option for individuals without insurance coverage and/or those for whom mobility is an obstacle to obtaining traditional aphasia therapy.
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Affiliation(s)
- Jacquie Kurland
- Department of Communication Disorders, University of Massachusetts Amherst
| | - Anna Liu
- Department of Mathematics and Statistics, University of Massachusetts Amherst
| | - Polly Stokes
- Department of Communication Disorders, University of Massachusetts Amherst
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12
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Pugliese M, Ramsay T, Johnson D, Dowlatshahi D. Mobile tablet-based therapies following stroke: A systematic scoping review of administrative methods and patient experiences. PLoS One 2018; 13:e0191566. [PMID: 29360872 PMCID: PMC5779660 DOI: 10.1371/journal.pone.0191566] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Accepted: 01/06/2018] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND AND PURPOSE Stroke survivors are often left with deficits requiring rehabilitation to recover function and yet, many are unable to access rehabilitative therapies. Mobile tablet-based therapies (MTBTs) may be a resource-efficient means of improving access to timely rehabilitation. It is unclear what MTBTs have been attempted following stroke, how they were administered, and how patients experienced the therapies. The review summarizes studies of MTBTs following stroke in terms of administrative methods and patient experiences to inform treatment feasibility. METHODS Articles were eligible if they reported the results of an MTBT attempted with stroke participants. Six research databases were searched along with grey literature sources, trial registries, and article references. Intervention administration details and patient experiences were summarized. RESULTS The search returned 903 articles of which 23 were eligible for inclusion. Most studies were small, observational, and enrolled chronic stroke patients. Interventions commonly targeted communication, cognition, or fine-motor skills. Therapies tended to be personalized based on patient deficits using commercially available applications. The complexity of therapy instructions, fine-motor requirements, and unreliability of internet or cellular connections were identified as common barriers to tablet-based care. CONCLUSIONS Stroke patients responded positively to MTBTs in both the inpatient and home settings. However, some support from therapists or caregivers may be required for patients to overcome barriers to care. Feasibility studies should continue to identify the administrative methods that minimize barriers to care and maximize patient adherence to prescribed therapy regiments.
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Affiliation(s)
- Michael Pugliese
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Tim Ramsay
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Dylan Johnson
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Dar Dowlatshahi
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
- Neuroscience Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
- Medicine (Neurology), Ottawa Hospital, Ottawa, Ontario, Canada
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13
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iPad Use in Stroke Neuro-Rehabilitation. Geriatrics (Basel) 2017; 2:geriatrics2010002. [PMID: 31011013 PMCID: PMC6371109 DOI: 10.3390/geriatrics2010002] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2016] [Revised: 12/20/2016] [Accepted: 01/04/2017] [Indexed: 11/29/2022] Open
Abstract
Neuro-rehabilitation services are essential in reducing post-stroke impairments, enhancing independence, and improving recovery in hospital and post-discharge. However these services are therapist-dependent and resource intensive. Patients’ disengagement and boredom in stroke units are common which adversely affect functional and psychological outcomes. Novel techniques such as use of iPads™ are increasingly researched to overcome such challenges. The aim of this review is to determine the feasibility, effectiveness, acceptability, and barriers to the use of iPads™ in stroke neuro-rehabilitation. Four databases and manual literature search were used to identify published studies using the terms “iPad”, “Stroke”, and “neuro-rehabilitation”. Studies were included in accordance with the review selection criteria. A total of 16 articles were included in the review. The majority of the studies focused on iPads use in speech and language therapy. Although of small scale, the studies highlighted that iPads are feasible, have the potential to improve rehabilitation outcomes, and can improve patient’s social isolation. Patients’ stroke severity and financial limitations are some of the barriers highlighted in this review. This review presents preliminary data supportive for the use of iPad technology in stroke neuro-rehabilitation. However, further research is needed to determine impact on rehabilitation goals acquisition, clinical efficacy, and cost-efficiency.
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Lavoie M, Macoir J, Bier N. Effectiveness of technologies in the treatment of post-stroke anomia: A systematic review. JOURNAL OF COMMUNICATION DISORDERS 2017; 65:43-53. [PMID: 28171741 DOI: 10.1016/j.jcomdis.2017.01.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Revised: 01/12/2017] [Accepted: 01/19/2017] [Indexed: 06/06/2023]
Abstract
BACKGROUND Technologies are becoming increasingly popular in the treatment of language disorders and offer numerous possibilities, but little is known about their effectiveness and limitations. AIM The aim of this systematic review was to investigate the effectiveness of treatments delivered by technology in the management of post-stroke anomia. METHODS As a guideline for conducting this review, we used the PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions. We conducted a systematic search of publications in PubMed, PsycInfo and Current Contents. We also consulted Google Scholar. Without any limitations as to publication date, we selected studies designed to assess the effectiveness of an intervention delivered by a technology, namely computer or smart tablet, to specifically improve anomia in post-stroke participants. The main outcomes studied were improvement in naming skills and generalisation to untreated items and daily communication. RESULTS We examined 23 studies in this review. To date, computers constitute the most popular technology by far; only a few studies explored the effectiveness of smart tablets. In some studies, technology was used as a therapy tool in a clinical setting, in the presence of the clinician, while in others, therapy with technology was self-administered at home, without the clinician. All studies confirmed the effectiveness of therapy provided by technology to improve naming of trained items. However, generalisation to untrained items is unclear and assessment of generalisation to daily communication is rare. DISCUSSION The results of this systematic review confirm that technology is an efficient approach in the management of post-stroke anomia. In future studies, ecological tasks aimed at evaluating therapy's effectiveness with word retrieval in real-life situations should be added since the ultimate goal of improving anomia is to increase the ability to retrieve words more easily in everyday life.
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Affiliation(s)
- Monica Lavoie
- Département de Réadaptation, Université Laval, Québec, QC, Canada; Centre de Recherche, Institut Universitaire en santé mentale de Québec, Québec, QC, Canada.
| | - Joël Macoir
- Département de Réadaptation, Université Laval, Québec, QC, Canada; Centre de Recherche, Institut Universitaire en santé mentale de Québec, Québec, QC, Canada.
| | - Nathalie Bier
- École de Réadaptation, Université de Montréal, Québec, QC, Canada; Centre de Recherche, Institut Universitaire de gériatrie de Montréal, Québec, QC, Canada
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Murray L, Salis C, Martin N, Dralle J. The use of standardised short-term and working memory tests in aphasia research: a systematic review. Neuropsychol Rehabil 2016; 28:309-351. [PMID: 27143500 DOI: 10.1080/09602011.2016.1174718] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Impairments of short-term and working memory (STM, WM), both verbal and non-verbal, are ubiquitous in aphasia. Increasing interest in assessing STM and WM in aphasia research and clinical practice as well as a growing evidence base of STM/WM treatments for aphasia warrant an understanding of the range of standardised STM/WM measures that have been utilised in aphasia. To date, however, no previous systematic review has focused on aphasia. Accordingly, the goals of this systematic review were: (1) to identify standardised tests of STM and WM utilised in the aphasia literature, (2) to evaluate critically the psychometric strength of these tests, and (3) to appraise critically the quality of the investigations utilising these tests. Results revealed that a very limited number of standardised tests, in the verbal and non-verbal domains, had robust psychometric properties. Standardisation samples to elicit normative data were often small, and most measures exhibited poor validity and reliability properties. Studies using these tests inconsistently documented demographic and aphasia variables essential to interpreting STM/WM test outcomes. In light of these findings, recommendations are provided to foster, in the future, consistency across aphasia studies and confidence in STM/WM tests as assessment and treatment outcome measures.
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Affiliation(s)
- Laura Murray
- a Department of Speech & Hearing Sciences , Indiana University , Bloomington , IN , USA
| | - Christos Salis
- b Speech & Language Sciences , Newcastle University , Newcastle upon Tyne , UK
| | - Nadine Martin
- c Department of Communication Sciences & Disorders , Temple University , Philadelphia , PA , USA
| | - Jenny Dralle
- d Department of Neurology , Brandenburgklinik , Bernau bei Berlin , Germany
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