ReaDySpeech for people with dysarthria after stroke: protocol for a feasibility RCT

Background: Dysarthria, disordered speech production resulting from neuro-muscular impairment, is a common symptom after stroke. It causes significant problems for patients’ speech intelligibility, communication, psychological well-being, social engagement and stroke recovery. Rehabilitation for dysarthria is variable in quality, intensity and duration, which may be, in part, due to the lack of good quality evidence. An online therapy programme, ReaDySpeech, has the potential to improve quality, intensity and duration of speech rehabilitation and was considered in a proof-of-concept study to be acceptable to speech and language therapists and patients which warranted further evaluation. The present study aims to examine the feasibility of running a trial using the ReaDySpeech intervention.
Methods/Design: A feasibility, randomised controlled trial, will recruit a minimum of 36 people with post-stroke dysarthria who are more than one week post stroke. Participants will be externally randomised in a 2:1 ratio to receive either ReaDySpeech and usual care (24 participants) or usual care only (12 participants). This study is single blind with the researcher carrying out the baseline and outcome measures while blinded to treatment allocation. The primary objective is to assess the feasibility of conducting a larger phase III trial. Specific objectives are to determine: recruitment rate and reasons for non-recruitment; loss of participants to follow up; acceptability of randomisation; adherence to the intervention; delivery of ReaDySpeech and content; acceptability of outcome measures; success of blinding strategies; defining ‘usual’ care; and, the implications of the intervention for the patient/family/carer.
Discussion: This study will involve a regional, multi-centre, randomised controlled feasibility trial of a complex intervention in order to evaluate whether a phase 3 randomised controlled trial is feasible.