ABSTRACT

Rehabilitation of memory remains an unmet need for many stroke survivors. Telehealth methods may provide a solution, however evidence supporting the efficacy of remotely-delivered therapy is needed. A non-concurrent multiple baseline design was used with randomized onset of intervention across five individuals with chronic stroke-related memory complaints. A six-week compensatory memory skills programme was delivered individually via internet videoconferencing. Target behaviours of frequencies of self-reported lapses of everyday and prospective memory were measured weekly across baseline, intervention, and follow-up phases. A secondary outcome of functional goal attainment was measured once per phase, with participants setting two personal rehabilitation goals. Data were analysed visually and statistically. Improvements in memory functioning were statistically significant on at least one measure of target behaviour for four out of five participants at intervention or follow-up. Visual evidence of level change indicated at least modest improvements for all participants by follow-up. All participants attained at least one functional goal by follow-up. High rates of treatment adherence and participant satisfaction were observed. Technological issues were minimal and did not impact content delivery or engagement. These results provide preliminary support for the efficacy of a telehealth-delivered rehabilitation programme in improving memory function and achieving memory-related goals for stroke survivors.

摘要

对于许多中风幸存者来说，记忆康复仍然是一个未满足的需求。远程医疗方法可能会提供解决方案，但需要证据支持远程治疗的有效性。使用非并发多基线设计，对 5 名患有慢性中风相关记忆障碍的个体进行随机干预。通过互联网视频会议单独提供了一个为期六周的补偿性记忆技能计划。在基线、干预和随访阶段每周测量自我报告的日常和前瞻性记忆失误频率的目标行为。每个阶段测量一次功能目标实现的次要结果，参与者设定两个个人康复目标。对数据进行视觉和统计分析。在干预或随访期间，五分之四的参与者的记忆功能改善在至少一项目标行为指标上具有统计学意义。水平变化的视觉证据表明所有参与者在随访中至少有适度的改善。通过随访，所有参与者都至少达到了一项功能目标。观察到高治疗依从率和参与者满意度。技术问题很小，不会影响内容交付或参与。这些结果为远程医疗提供的康复计划在改善记忆功能和实现中风幸存者记忆相关目标方面的功效提供了初步支持。水平变化的视觉证据表明所有参与者在随访中至少有适度的改善。通过随访，所有参与者都至少达到了一项功能目标。观察到高治疗依从率和参与者满意度。技术问题很小，不会影响内容交付或参与。这些结果为远程医疗提供的康复计划在改善记忆功能和实现中风幸存者记忆相关目标方面的功效提供了初步支持。水平变化的视觉证据表明所有参与者在随访中至少有适度的改善。通过随访，所有参与者都至少达到了一项功能目标。观察到高治疗依从率和参与者满意度。技术问题很小，不会影响内容交付或参与。这些结果为远程医疗提供的康复计划在改善记忆功能和实现中风幸存者记忆相关目标方面的功效提供了初步支持。