Therapist-Guided Tablet-Based Telerehabilitation for Patients With Aphasia: Proof-of-Concept and Usability Study
Stephan M. GerberNarayan SchützArif Sinan UsluNadine SchmidtCarina RöthlisbergerPatric WyssSandra PernyCorina WyssMonica Koenig‐BruhinPrabitha UrwylerThomas NyffelerLaura Marchal–CrespoUrs P. MosimannRené M. MüriTobias Nef
40
Citation
47
Reference
10
Related Paper
Citation Trend
Abstract:
Aphasia is the loss or impairment of language functions and affects everyday social life. The disorder leads to the inability to understand and be understood in both written and verbal communication and affects the linguistic modalities of auditory comprehension, verbal expression, reading, and writing. Due to heterogeneity of the impairment, therapy must be adapted individually and dynamically to patient needs. An important factor for successful aphasia therapy is dose and intensity of therapy. Tablet computer-based apps are a promising treatment method that allows patients to train independently at home, is well accepted, and is known to be beneficial for patients. In addition, it has been shown to ease the burden of therapists.The aim of this project was to develop an adaptive multimodal system that enables aphasic patients to train at home using language-related tasks autonomously, allows therapists to remotely assign individualized tasks in an easy and time-efficient manner, and tracks the patient's progress as well as creation of new individual exercises.The system consists of two main parts: (1) the patient's interface, which allows the patient to exercise, and (2) the therapist's interface, which allows the therapist to assign new exercises to the patient and supervise the patient's progress. The pool of exercises is based on a hierarchical language structure. Using questionnaires, therapists and patients evaluated the system in terms of usability (ie, System Usability Scale) and motivation (ie, adapted Intrinsic Motivation Inventory).A total of 11 speech and language therapists (age: mean 28, SD 7 years) and 15 patients (age: mean 53, SD 10 years) diagnosed with aphasia participated in this study. Patients rated the Bern Aphasia App in terms of usability (scale 0-100) as excellent (score >70; Z=-1.90; P=.03) and therapists rated the app as good (score >85; Z=-1.75; P=.04). Furthermore, patients enjoyed (scale 0-6) solving the exercises (score>3; mean 3.5, SD 0.40; Z=-1.66; P=.049).Based on the questionnaire scores, the system is well accepted and simple to use for patients and therapists. Furthermore, the new tablet computer-based app and the hierarchical language exercise structure allow patients with different types of aphasia to train with different doses and intensities independently at home. Thus, the novel system has potential for treatment of patients with aphasia as a supplement to face-to-face therapy.Keywords:
Modalities
System usability scale
Telerehabilitation
Speech Therapist
Cite
Speech-Language Pathology
Aphasiology
Speech Therapist
Cite
Citations (13)
Telerehabilitation is the provision at a distance of rehabilitation services such as physiotherapy, speech pathology or occupational therapy. The primary aim is to provide equitable access to rehabilitation services. Broadly speaking, the technologies used for telemedicine-based physical rehabilitation can be classified as: (1) image-based telerehabilitation; (2) sensor-based telerehabilitation; and (3) virtual environments and virtual reality telerehabilitation. To date, much of the research has been technology focused, and has consisted of single case or small sample research designs. The next step is to demonstrate viable telerehabilitation services in real world environments using well controlled research methodologies with large patient cohorts. In addition, the broader issues of cost-benefit and cost-effectiveness require investigation. If this can be done, then the undoubted potential benefits of telerehabilitation, for both the patient and health-care systems, can be realized.
Telerehabilitation
Telehealth
Videoconferencing
Cite
Citations (232)
Telerehabilitation, or the use of technology to provide rehabilitation services remotely, has been shown to be effective in a variety of settings. It has the potential to improve access to rehabilitation services for individuals living in rural or remote areas, reduce barriers to care such as transportation and childcare, and increase patient satisfaction. However, there are also potential drawbacks to telerehabilitation, such as the need for reliable internet access and privacy concerns. Overall, telerehabilitation can be a useful addition to traditional rehabilitation services, but further research is needed to fully understand its effectiveness and optimal implementation.
Telerehabilitation
Cite
Citations (0)
Introduction: This study explores allied health students’ experience with and perceptions of telerehabilitation prior to and following the rapid transition of university clinical placements to telerehabilitation due to COVID-19. Methods: Semi-structured interviews were conducted with allied health students who had completed a clinical placement (between March and September 2020) at the University of Queensland that was rapidly transitioned to telerehabilitation due to COVID-19. Students were asked to report on their pre-conceptions, lived experience and post placement reflections of delivering consultations via telerehabilitation rather than in-person. Qualitative data were analysed using thematic content analysis. Results: 18 students (72% female, 20 to 31 years of age) from speech pathology (39%), physiotherapy (39%), occupational therapy (11%) and audiology (11%) conducted telerehabilitation consultations. Reflections on preconceptions of telerehabilitation nested under four themes: clinical effectiveness, interacting/communicating via telerehabilitation, technology and anticipation about a telerehabilitation placement. Experiences during placement clustered under similar topics of clinical effectiveness, interacting/communicating, practical aspects and technology. Reflections upon completion of placements related to experience in a global pandemic, benefits of combining technology and telerehabilitation, convenience, future use and knowledge, skills, and confidence with telerehabilitation. Conclusion: Despite initial concerns, students were able to rapidly transition to telerehabilitation and effectively deliver quality care, modify techniques, and achieve positive client outcomes. Student skills, knowledge and confidence improved with rapid exposure through learning “on the go”, and many indicated willingness to continue to use telerehabilitation in the future.
Telerehabilitation
Thematic Analysis
Cite
Citations (7)
Social telerehabilitation, which focuses on solving limitations and social issues associated with health conditions, represents a further specialization in telerehabilitation. Both telerehabilitation and social telerehabilitation are grounded in the delivery of rehabilitation services through telecommunication networks, especially by means of the Internet. Essentially, telerehabilitation comprises methods of delivering rehabilitation services using ICT to minimize the barriers of distance, time, and cost. One can define social telerehabilitation as being the application of ICT to provide equitable access to social rehabilitation services, at a distance, to individuals who are geographically remote, and to those who are physically and economically disadvantaged.
Telerehabilitation
Disadvantaged
Cite
Citations (3)
The participation of the patient’s family with aphasia in the process of speech therapy is necessary and essential prerequisite for speech recovery. However, our society is not sufficiently informed about aphasia. As a result, the family members of a person with aphasia often do not know how to deal with a relative who has lost his/her speech. As a consequence, there is oftena misunderstanding regarding the patient’s activities and behavior. The essential content of the speech therapy consultancy with the family members of the patients with aphasia is introduced in the article. The authors stress the importance of providing information to the family members of people with aphasia, regarding aphasia symptoms and its overcoming features. Particularly it is mentioned, that aphasia is not an indication of a mental disorder or dementia. In case of aphasia, the social and speech isolation of a person who has lost his/her speech, is troubling. In the article, recommendations aimed at the establishment of contact between the patient and his/her relatives, as well as increasing the effectiveness of speech restoration process are introduced. Following the speech therapy recommendations will help the relatives to avoid common mistakes in the process of communication, which cause psychological harm. Taking into account the fact, that the speech restoration is a long-lasting process, the article also provides examples of assignments and exercises for supporting the speech restoration at home. The essential goal of speech therapy consultation is the establishment of speech-communication environment, which supports the restoration of speech and communication of patients with aphasia.
Speech-Language Pathology
Speech Therapist
Cite
Citations (0)
Social telerehabilitation, which focuses on solving limitations and social issues associated with health conditions, represents a further specialization in telerehabilitation. Both telerehabilitation and social telerehabilitation are grounded in the delivery of rehabilitation services through telecommunication networks, especially by means of the internet. Essentially, telerehabilitation comprises methods of delivering rehabilitation services using ICT to minimize the barriers of distance, time, and cost. One can define social telerehabilitation as being the application of ICT to provide equitable access to social rehabilitation services, at a distance, to individuals who are geographically remote, and to those who are physically and economically disadvantaged.
Telerehabilitation
Disadvantaged
Cite
Citations (0)
This study examined the feasibility and acceptability of a telerehabilitation program during the COVID-19 pandemic in a sample of adult patients with physical disabilities. Of the twenty-three patients enrolled, 11 agreed to participate in a video-based telerehabilitation program. Barriers and facilitators to the adoption of telerehabilitation were identified and clinical, demographic, and psychological variables were analysed as predictors of success. Age, cognitive reserve, and resilience were significant predictors of satisfaction with telerehabilitation (p<0.05). The telerehabilitation program was perceived as feasible and was well accepted by patients, despite some technology challenges. However, patients who took advantage of telerehabilitation perceived differences in the quality of service and preferred traditional in-person treatment to service delivery via telerehabilitation.
Telerehabilitation
Resilience
Cite
Citations (27)
Stroke is currently the world's second cause of disability. It can cause deficits such as postural control, and telerehabilitation could improve the therapeutic dose as well as functional results. The aim of this work is to determine the effectiveness and usability of a low-cost telerehabilitation system in patients with stroke. We developed a telerehabilitation system based on exergames on smartphones, inertial sensors, and a cloud database. We trained the balance of six participants (three men and three women) in early subacute stroke (seven weeks of progress). In addition to their conventional treatment, these participants trained for a total of nine sessions of 30 min per week, for four weeks. The telerehabilitation group was compared with a control group of four clinically similar participants (three men and one woman). Clinical and usability measurements were made before and after the training. The results show a significant improvement of 11.3 ± 3.5 points in the Berg Balance Scale, 8.3 ± 3.01 points in the Mini-BESTest, and 17.5 ± 9.87 points in the Barthel scale for the telerehabilitation group. However, only the improvements of Berg and Barthel scales were statistically higher for the telerehabilitation group compared to the control group. The proposed system achieved excellent usability on the System Usability Scale (87.5 ± 11.61). Our results demonstrate that a complementary low-cost telemedicine approach is feasible, and that it can significantly improve the balance of stroke patients; therefore, the proposed clinical strategy could potentially improve dosage and overall treatment effectiveness.
Telerehabilitation
Berg Balance Scale
System usability scale
Stroke
Cite
Citations (29)
Background: Telerehabilitation is emerging in Saudi Arabia. This study investigated occupational therapy professionals’ perspectives on using telerehabilitation in their practice. Method: Data were collected through semi-structured phone interviews conducted with nine Saudi occupational therapists. A pragmatic qualitative evaluation approach was used. Findings: Experience and perceptions of participants regarding telerehabilitation were represented as follows: awareness and knowledge of telerehabilitation; how telerehabilitation increases occupational therapy availability and access in Saudi Arabia; telerehabilitation in the pandemic; telerehabilitation is preferred; suitability of telerehabilitation in Saudi Arabia; telerehabilitation care pathways; telerehabilitation readiness in Saudi Arabia; and telerehabilitation willingness by Saudi occupational therapists. Conclusion: Saudi occupational therapists have good knowledge and awareness of telerehabilitation, and some had used it during the pandemic. They showed positive attitudes and a willingness to use telerehabilitation if appropriate technology infrastructure, official policy standards and guidelines, training, data security, and financial resources could be provided to support implementation.
Telerehabilitation
Telehealth
Cite
Citations (0)