Meltzer 2018.
Methods | RCT | |
Participants | Recruited from the community in Canada Inclusion criteria: a history of unilateral stroke resulting in a communication disorder, occurring at least 6 months in the past; availability of a communication partner to participate in the treatment programme; ability to travel to the treatment site if not at home, and ability to hear instructions and operate an iPad tablet to perform homework exercises Exclusion criteria: dementia or other neurological disorder Age, years: intervention group 66.8 (11.2), control group 62.9 (11.6) Gender: 59% men intervention group, 69% men control group Time post‐stroke: not reported (at least 6 months post‐stroke) |
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Interventions | The study took place over 12 weeks for each participant, with an assessment in the first and last weeks and therapy during the intervening 10 weeks. Telerehabilitation intervention (Aphasia telerehab): remote therapy sessions were conducted via teleconferencing equipment and software. Participants possessing adequate equipment at home consulted the therapist using WebEx, a commercial teleconferencing program. Some clients visited the clinic to receive the telerehabilitation (provided in a separate room and contact with the therapist prohibited). During weeks 2‐11, the therapist conducted a 1‐hour weekly treatment session and TalkPath software was used for homework exercises. Control intervention (Aphasia in‐person): same therapy provided in‐person |
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Outcomes | Timing of outcome assessment: baseline and post‐intervention (12 weeks) Measures: Western Aphasia Battery Revised Part 1, Cognitive Linguistic Quick Test, Communication Confidence Rating Scale for Aphasia, Communication Effectiveness Index |
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Notes | ||
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | Unclear risk | Not reported |
Allocation concealment (selection bias) | Unclear risk | Not reported |
Blinding of outcome assessment (detection bias) All outcomes | Unclear risk | Assessments were conducted by a therapist not involved in the study but not clear if they were blind to allocation. |
Incomplete outcome data (attrition bias) All outcomes | Unclear risk | Reporting of recruitment and withdrawals had limited detail including balance between groups. |
Selective reporting (reporting bias) | Unclear risk | Could not identify study protocol or trial registration |
Other bias | Unclear risk | Groups were separated by diagnosis; however it was not clear whether this was factored into the randomisation process. |