Abstract
BackgroundDysarthria, a disordered speech production resulting from neuro-muscular impairment, is a common symptom after stroke. It causes significant problems for patients’ speech intelligibility, communication, psychological well-being, social engagement and stroke recovery. Rehabilitation for dysarthria is variable in quality, intensity and duration, which may be, in part, due to the lack of good quality evidence. An online therapy programme, ReaDySpeech, has the potential to improve quality, intensity and duration of speech rehabilitation and was considered in a proof-of-concept study to be acceptable to speech and language therapists and patients which warranted further evaluation. The present study aims to examine the feasibility of running a trial using the ReaDySpeech intervention.Methods/designA feasibility, randomised controlled trial, will recruit a minimum of 36 people with post-stroke dysarthria who are more than 1 week post stroke. Participants will be externally randomised in a 2:1 ratio to receive either ReaDySpeech and usual care (24 participants) or usual care only (12 participants). This study is single blind with the researcher carrying out the baseline and outcome measures while blinded to treatment allocation. The primary objective is to assess the feasibility of conducting a larger Phase III trial. The specific objectives are to determine the following: recruitment rate and reasons for non-recruitment; loss of participants to follow-up; acceptability of randomisation; adherence to the intervention; delivery of ReaDySpeech and content; acceptability of outcome measures; success of blinding strategies; defining ‘usual’ care; and the implications of the intervention for the patient/family/carer.DiscussionThis study will involve a regional, multi-centre, randomised controlled feasibility trial of a complex intervention in order to evaluate whether a Phase III randomised controlled trial is feasible.Trial registrationCurrent Controlled Trials, ISRCTN84996500
Highlights
Dysarthria, a disordered speech production resulting from neuro-muscular impairment, is a common symptom after stroke
This study will involve a regional, multi-centre, randomised controlled feasibility trial of a complex intervention in order to evaluate whether a Phase III randomised controlled trial is feasible
This paper summarises a protocol for our feasibility trial of the online programme ‘ReaDySpeech’ for people with dysarthria, accessed via any Wi-Fi enabled device
Summary
Dysarthria, a disordered speech production resulting from neuro-muscular impairment, is a common symptom after stroke It causes significant problems for patients’ speech intelligibility, communication, psychological well-being, social engagement and stroke recovery. ReaDySpeech, has the potential to improve quality, intensity and duration of speech rehabilitation and was considered in a proof-ofconcept study to be acceptable to speech and language therapists and patients which warranted further evaluation. A Cochrane review found no trials [6], and a more recent update found that while five trials could be included these were considered low to very low in quality [7] These more recent randomised controlled trials are inconclusive about which intervention for dysarthria rehabilitation is most effective [8,9,10,11,12]. Using technology to support dysarthria intervention could be cost-effective and enhance clinical and patient-reported outcomes from rehabilitation after stroke
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