A feasibility randomized controlled trial of ReaDySpeech for people with dysarthria after stroke.
Claire Mitchell, Audrey Bowen, Sarah Tyson and 1 others
PMID 29278019WHAT IT FOUND
Recruiting and keeping stroke patients with dysarthria was feasible, but only acute patients were enrolled.
The trial was not designed to test whether the online ReaDySpeech programme improves speech, so it does not show it works.
Key findings
01Forty of 74 eligible patients were recruited, and 37 of 40 completed all assessments.
02The study was not designed to test whether the groups differed in outcomes, and outcomes improved over time irrespective of allocation.
03Sixteen of 26 participants randomized to ReaDySpeech accessed the intervention, and lack of staffing was a reason for non-access.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The study was not designed to test whether the groups differed in outcomes. The groups were not balanced at baseline. The ReaDySpeech group had greater communication impairment, lower mood and quality of life, and more hospital recruitment. Assessor blinding failed. The assessor was unblinded in 11 cases. Only acute stroke patients were recruited. None were more than 13 weeks post stroke, so it says nothing about chronic dysarthria. Ten of 26 participants randomized to ReaDySpeech did not access it, and lack of staffing was a reason. Therapy intensity was low, and independent use was difficult in acute inpatient settings. Only four recruits had aphasia, so the paper does not show how the programme works for them.
Declared interests
The authors declared no potential conflicts of interest. The project was funded by the NIHR Doctoral Training Programme. One author is part funded by NIHR CLAHRC Greater Manchester and the Stroke Association. The funders had no role in study design, data collection, analysis, publication decision or manuscript preparation.
The easy way to misread this
Do not read this as evidence that ReaDySpeech improves speech after stroke. The study was not designed to test whether the groups differed in outcomes, groups were imbalanced at baseline, and assessor blinding failed.