Rehabilitation researchers from two Medical Universities and a University of Science and Technology in Moscow, Russia have reviewed articles on telerehabilitation for persons with post-stroke aphasia and cognitive problems. Their interest stems from service delivery challenges caused by pandemic-related restrictions on meeting in person, as well as difficulties in reaching patients at remote locations. The goal of their review is to summarize current approaches and clinical findings from several countries, regarding distance communication technologies in treating persons with these disorders.
For their review, the authors searched the Scopus, PubMed, and Sciencedirect databases for articles published between 2017 and 2021 in peer-reviewed journals, reporting on the effectiveness of aphasia, cognitive, and memory telerehabilitation of patients post-stroke. A total of sixteen articles met their criteria for inclusion in this report, with the preponderance of reports coming from three countries – the United States, Russia, and Italy.
In their presentation of findings, the authors focus first on cognitive and memory rehabilitation, then devote a section to aphasia rehabilitation. One representative study here involved 40 patients who were randomly assigned either to an experimental group using a virtual reality application, or a comparison group that was treated with standard cognitive training. Interventions continued for six months, with individual session occupying 50 minutes, three times a week. Assessment instruments included, among others, the Montreal Overall Cognitive Assessment, Ray Auditory Verbal Learning Test, and the Hamilton Rating Scales for Anxiety and for Depression. Outcome analyses indicated telerehabilitation was effective in improving outcomes.
Similar findings were reported regarding telerehabilition interventions for persons with aphasia. In one study – a randomized non-inferiority study of persons with chronic, post-stroke aphasia – subjects were randomly assigned to equivalent therapy services delivered either face-to-face or using distance communication technologies, with opportunities for both groups also to practice independently using on-line TalkPath Therapy material. Outcome assessments included the Western Aphasia Battery, the Communicative Effectiveness Index, and the Communication Confidence Rating Scale for Aphasia. Results show that linguistic and communicative outcomes were comparable in the two groups.
The authors conclude that telerehabilitation for post-stroke patients holds promise, but note the need for further study of best practices.
For further reading: V. A. Nikolaev, O. G. Safonicheva, A. A. Nikolaev, 2022, A review of international experience for telerehabilitation of post-stroke patients with aphasia and cognitive problems. Bulletin of Rehabilitation Medicine, 21(1): 64-69. https://doi.org/10.38025/2078-1962-2022-21-1-64-69