Outcomes After Stroke Improved With Digital Speech, Language, and Cognitive Therapy

As published in the Journal of Medical Internet Research, use of a digital therapy program (Constant Therapy, Lexington, MA) resulted in dose-dependent improvements on the app in speech, language, and cognitive domains. The study found the optimal dosage was use of the mobile app on 4 days per week. 

“Access to this very large real-world data set from Constant Therapy illustrates the actual patient usage patterns outside of a research environment and underscores the real-world validity of the study results, thereby making findings more readily applicable to clinicians’ recommendations for therapy in clinical practice,” said Swathi Kiran, PhD, CCC-SLP, Director of the Aphasia Research Laboratory, Boston University. “This study represents an important step toward the development of optimal dose recommendations for self-managed mobile speech, language, and cognitive therapy.”

The researchers analyzed anonymized data from 2,249 post-stroke survivors who used the program. Data included therapy tasks spanning 13 different speech, language, and cognitive skill domains. For each patient, weekly therapy dosage was calculated based on the median number of days per week of usage (1, 2, 3, 4, or 5+) over the 10-week therapy period. 

Linear mixed-effects models (LMMs) were run to examine the change in performance over time as a function of dosage group, with post-hoc comparisons of slopes to evaluate the performance gain associated with each additional day of practice. 

These data add to the body of literature supporting the use of high-dose and high-intensity speech-language therapy for poststroke rehabilitation. A strength of this retrospective study is the large number of individuals evaluated. A weakness is that the measure of improvement was performance on the app used rather than an already validated measure, so improvements outside the environment of app use are not addressed.