Evaluating the effects of telerehabilitation on literacy skills, aphasia severity and quality of life of people with post-stroke aphasia

Abstract

Aphasia, an acquired language disorder typically resulting from stroke, can significantly impact reading, writing, well-being and verbal communication abilities. This thesis investigated the efficacy of the Technology and Literacy Engagement after Stroke (TALES) programme, an online group-based intervention targeting functional literacy and social engagement in people with chronic aphasia. The research comprised a systematic review of telerehabilitation approaches for aphasia and two empirical studies evaluating the TALES programme. The systematic review of 31 studies found telerehabilitation to be a feasible and acceptable alternative to in-person therapy, with evidence of clinical benefit across many studies. However, few studies utilised robust trial designs to demonstrate efficacy. In the first empirical study, 6 participants with mild-moderate aphasia completed the 7-week TALES programme. Results showed statistically significant improvements in language function (WAB-R), reading and spelling (PALPA subtests), and communication confidence (COAST). The second study included 6 participants with a wider range of aphasia severities in an 8-week TALES programme. Significant improvements were observed in language function, literacy skills, and communication confidence. Qualitative analysis identified themes of positive experience and perceived benefits. Overall, this research demonstrated the potential of the TALES programme to improve functional literacy and communication confidence in people with chronic aphasia across various severity levels. The mixed-methods approach provided insights into the programme's impact, supporting its feasibility and efficacy. Future research directions include larger controlled trials and investigation of factors influencing long-term maintenance of gains.

Date of Award	21 Feb 2025
Original language	English
Awarding Institution	The University of Manchester
Supervisor	Paul Conroy (Main Supervisor) & Katherine Twomey (Main Supervisor)