Stroke patients who received in-home rehabilitation therapy from a tablet-based app had similar outcomes to those completing the same treatment with physician guidance, suggesting that the digital treatment could be effective without provider supervision, according to a paper recently published in Frontiers in Neurology.

The study’s 3,686 patients each had post-stroke aphasia affecting their speech or cognition, and were provided with the Constant Therapy app developed by The Learning Corporation (which conducted the study). The rehabilitation tool includes more than 70 different therapies targeting language and cognitive skill, and can be personalized with specific tasks that are based on the patient’s progress.

Topline data

Although both the at-home (n = 2,100) and in-clinic (n = 1,577) groups required a median three sessions to improve from a less than 60 percent accuracy rate to a greater than 90 percent rate, home users achieved proficiency in a median six days compared to clinic users’ median 12 days (p < .001).

This difference was driven by the frequency with which patients underwent the therapy, as those practicing at home engaged with the therapy significantly more often than those in the clinic (p < .001). On the other hand, clinic users did complete more items per therapy day than the home users (p < .001). The researchers observed no differences in improvement across specific age groups or time since injury.

How it was done

The researchers conducted a retrospective analysis of post-stroke aphasia patient data collected through the app from 2013 to 2017. The researchers included a number of filters to the review — for instance, limiting analysis to therapy tasks in which a patient initially struggled but eventually gained proficiency, or to therapy tasks that at least 15 patients from each group completed.

What’s the history

From virtual reality to computer vision, new in-home rehabilitation products are employing a number of different technologies to move care out of the clinic and into the home. Many of these platforms involve both a patient-facing product for independent use at home and a clinician or therapist-facing dashboard — for instance, Reflexion Health’s VERAHome and VERAClinic, both of which launched last year.

On the record

“These insights from real world patient experience could help update existing guidelines, and highlight areas for future study to uncover how improvements in specific tasks can help people living post-stroke regain the skills they cherish, such as reading a newspaper, having a complete conversation, or ordering from a menu at a restaurant,” Veera Anantha, CTO of The Learning Corporation, said in a statement.