Abstract
About a third of strokes cause aphasia, or language loss, with profound consequences for the person’s social participation and quality of life. These problems may be mitigated by group social support. But this intervention is not available to all individuals. This study investigated whether it is feasible to deliver group social support to people with aphasia via a multi-user, virtual reality platform. It also explored the indicative effects of intervention and the costs. Intervention aimed to promote wellbeing and communicative success. It enabled participants to form new social connections and share experiences of living with aphasia. It comprised 14 sessions delivered over 6 months and was led by community based co-ordinators and volunteers. Feasibility measures comprised: recruitment and retention rates, compliance with intervention and assessment of treatment fidelity. Effects of intervention were explored using a waitlist randomised controlled design, with outcome measures of wellbeing, communication, social connectedness and quality of life. Two intervention groups were randomised to an immediate condition and two were randomised to a delayed condition. The main analysis explored scores on the measures between two time points, between which those in the immediate condition had received intervention, but those in the delayed group had not (yet). A comprehensive approach to economic data collection ensured that all costs of treatment delivery were recorded. Feasibility findings showed that the recruitment target was met (N = 34) and 85.3% (29/34) of participants completed intervention. All groups ran the 14 sessions as planned, and participants attended a mean of 11.4 sessions (s.d. 2.8), which was 81.6% of the intended dose. Fidelity checking showed minimal drift from the manualised intervention. No significant change was observed on any of the outcome measures, although the study was not powered to detect these. Costs varied across the four groups, from £7,483 - £12,562 British Pounds Sterling ($10,972 - $18,419 US dollars), depending on travel costs, the relative contributions of volunteers and the number of hardware loans that were needed. The results suggest that a larger trial of remote group support, using virtual reality, would be merited. However the treatment content and regime, and the selection of outcome measures should be reviewed before conducting the trial.Trail registration: Study registered with ClinicalTrials.gov; Identifier: https://www.ncbi.nlm.nih.gov/NCT03115268.
Highlights
Aphasia is an impairment of language caused by stroke or other neurological events, with profound consequences for a person’s well-being and quality of life
The study reported in this paper further explores the feasibility of remote provision of group social support for people with aphasia
Thirty four people with aphasia were recruited over a period of 13 weeks, out of 67 screened
Summary
Aphasia is an impairment of language caused by stroke or other neurological events, with profound consequences for a person’s well-being and quality of life. People with aphasia report reduced social networks [1], lower levels of social activity than their age matched peers [2] and lower quality of life than stroke survivors without aphasia [3]. Losses in social participation, coupled with the communication constraints imposed by aphasia, may threaten a person’s sense of self, leading some to describe aphasia as identity theft [5]. Groups are a platform for natural communication and humour [8] and a potential forum for increasing social connectedness [9] and rebuilding a sense of self [7, 10]
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