Participatory Development of a Speech-Language Telerehabilitation Intervention Combined With Home-Based Transcranial...

Area of Science:

• Neuroscience
• Speech-Language Pathology
• Rehabilitation Medicine

Background:

• Primary progressive aphasia (pwPPA) presents significant communication challenges.
• Intensive speech-language therapy (SLT) and transcranial direct current stimulation (tDCS) show potential but face feasibility hurdles.
• Combined telerehabilitation approaches require careful development and stakeholder input.

Purpose of the Study:

• To develop and assess the feasibility of a novel home-based telerehabilitation program for pwPPA.
• To combine remotely supervised, self-administered tDCS with intensive SLT.
• To involve pwPPA and caregivers in the design of this combined intervention.

Main Methods:

• Qualitative and quantitative analysis of semistructured interviews with 8 pwPPA and 16 caregivers.
• Development of a step-by-step manual based on stakeholder needs and preferences.
• Usability testing of the manual and intervention by 4 pwPPA dyads with follow-up interviews.

Main Results:

• Stakeholder input was crucial for refining the treatment program.
• pwPPA and caregivers reported high acceptance and perceived need for the combined approach.
• pwPPA could independently manage over half of the telerehabilitation tasks, but required assistance with tDCS.

Conclusions:

• A combined home-based telerehabilitation and tDCS program is acceptable and initially feasible for pwPPA.
• Caregiver assistance is essential for the successful implementation of technically demanding tDCS components.
• Stakeholder involvement is vital for optimizing complex, technology-dependent intervention programs.