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Virtual Reality in Aphasia Telerehabilitation

Not Applicable
Not yet recruiting
Conditions
Aphasia, Acquired
Interventions
Behavioral: VR-treatment
Behavioral: Treatment as usual
Registration Number
NCT04828759
Lead Sponsor
University of Oulu
Brief Summary

The main purpose of this study is to evaluate the use of the immersive 3D HMD VR technology in the language intervention with a home-based telerehabilitation approach for people with aphasia. The assessments will be conducted at the baseline (prior the intervention periods) and after each intervention period (i.e. after the VR-intervention period and the waitlist period).

Detailed Description

The purpose of the present project is to study the effects, feasibility, and the participants' experiences of this novel kind of language intervention. The effects of the intervention will be studied with various outcome measures in terms of language performance, functional communication, and quality of life. The aim is to explore the VR-intervention on the group level and with a randomized waitlist control group design (or delayed crossover design). In this study, the people with aphasia will be practicing at their home with support of their relatives, and participants will also receive regular remote guidance by a speech and language therapist (SLT) during the intervention. The relatives are also involved in the assessment process.

Recruitment & Eligibility

Status
NOT_YET_RECRUITING
Sex
All
Target Recruitment
20
Inclusion Criteria
  • Post-stroke aphasia ≥ 3 months from stroke
  • Age 18-75 years
  • Finnish as a native language
  • Relative have the motivation and willingness to support person with aphasia in rehabilitation process
  • At least some level of spoken output
  • Moderate-to-severe aphasia
  • Deficit in a word retrieval process
Exclusion Criteria
  • Participation in other intervention study during the study
  • Participation in other traditional speech and language therapy during the VR-intervention (i.e. 9-10 weeks period).
  • Severe and current psychotic disorder
  • Dementia/other neurodegenerative disease
  • History of previous stroke (/strokes) if not recovered, excluding TIAs (the criteria for the recovery: no residual aphasia or other disabilities caused by stroke which would affect in significant manner on everyday life)
  • Active epilepsy / migraine (< 3 years)
  • Severe apraxia of speech
  • Inability to act according to given instruction
  • Severe neuropsychological disorder or the decline of cognitive / memory functions, which would significantly affect for training during the VR-intervention
  • Vision or hearing impairment which would prevent the use of VR HMD
  • if the participant's treatment or medication is unsuitable with the use of VR HMD device as assessed by the physician
  • if the participant has the pacemaker or implantable (electric) medical device

Study & Design

Study Type
INTERVENTIONAL
Study Design
CROSSOVER
Arm && Interventions
GroupInterventionDescription
VR-treatment, then Treatment as usualVR-treatmentParticipants will receive 8 weeks of VR-treatment. Participants are allowed to practice as much as they wish during the VR-intervention. However, they are given a recommendation of the amount of practice (5 h / week). Before the VR-intervention, the participants will receive a guidance for using the VR-devices (i.e. orientation period) by the SLT. Participants will be able to contact the SLT freely during the 8 weeks VR-intervention period. After the orientation period, the participants will be practicing at their homes independently. However, they will receive remote guidance by the SLT. The guidance includes weekly remote guidance sessions by SLT (8 x 45 min) to ensure that training is fluent and unproblematic. Additionally, the content of exercises can be modified during these sessions. The SLT is also able to monitor the training of participants with the system. Devices: VR headset and controller, Tablet computer.
Treatment as usual, then VR-treatmentTreatment as usualWait list control group: During the waitlist period the participants will receive the traditional speech and language therapy rehabilitation offered by (if offered) the general health care system in their own home municipality. The amount of rehabilitation is not controlled during the wait list period. However, the amount of received traditional speech and language rehabilitation in waitlist period will be documented. The waitlist control group will receive the same VR intervention period after the 8 weeks waitlist period.
Primary Outcome Measures
NameTimeMethod
Change in language abilities from baseline to week 9 and to week 18Change from baseline to week 9 and to week 18

Language abilities are assessed using language quotient LQ score of Western Aphasia Battery (WAB), performed at the baseline (prior the intervention periods) and after each intervention period (i.e. after the VR-intervention period and the waitlist period)

Change in quality of life from baseline to week 9 and to week 18Change from baseline to week 8 and to week 18

Quality of life is assessed with Stroke and Aphasia Quality of Life Scale-39 (SAQOL-39), performed at the baseline (prior the intervention periods) and after each intervention period (i.e. after the VR-intervention period and the waitlist period)

Change in naming abilities from baseline to week 9 and to week 18Change from baseline to week 9 and to week 18

Naming abilities for nouns and verbs are assessed with Boston Naming Test (BNT) and TNT-test (action naming test in Finnish) performed at the baseline (prior the intervention periods) and after each intervention period (i.e. after the VR-intervention period and the waitlist period)

Change in verbal fluency from baseline to week 9 and to week 18Change from baseline to week 9 and to week 18

Verbal fluency is assessed using multiple categories (produced words per one minute in each category), performed at the baseline (prior the intervention periods) and after each intervention period (i.e. after the VR-intervention period and the waitlist period)

Change in functional communication skills from baseline to week 9 and to week 18Change from baseline to week 9 and to week 18

Functional communication skills are assessed with Communication Effectiveness Index (CETI), performed at the baseline (prior the intervention periods) and after each intervention period (i.e. after the VR-intervention period and the waitlist period)

Secondary Outcome Measures
NameTimeMethod
Participants' experiences of the waitlist periodAfter waitlist period, at the week 9 or at the week 18, depending of the group the patient has been randomized

The structural survey of participants' experiences of the waitlist period

Data collected by VR-devices regarding the performance of participants during the VR-interventionThrough the VR-intervention up to 8 weeks or through the weeks 10-17, depending of the group the patient has been randomized

Amounts of training (in minutes) and e.g. naming speed and range of head movements collected automatically by VR-devices

Participants' experiences of the VR-interventionAfter VR-intervention period, at the week 9 or at the week 18, depending of the group the patient has been randomized

The structural survey of participants' experiences of the VR-intervention.

Attrition rates during the study.Through study completion, up to 18 weeks

Amount of drop outs of participants during the study,

Date collected by remote sessions regarding the experiences of participants and feasibility of VR-interventionWeekly during the VR-intervention up to 8 weeks or through the weeks 10-17, depending of the group the patient has been randomized

Data collected with semi-structural interview during remote guidance sessions (8 times during the VR-period) by the researcher. In addition, participants will be able to contact the researcher freely during the 8 weeks VR-intervention period.

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