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      Evaluating the Benefits of Aphasia Intervention Delivered in Virtual Reality: Results of a Quasi-Randomised Study

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          Abstract

          Introduction

          This study evaluated an intervention for people with aphasia delivered in a novel virtual reality platform called EVA Park. EVA Park contains a number of functional and fantastic locations and allows for interactive communication between multiple users. Twenty people with aphasia had 5 weeks’ intervention, during which they received daily language stimulation sessions in EVA Park from a support worker. The study employed a quasi randomised design, which compared a group that received immediate intervention with a waitlist control group. Outcome measures explored the effects of intervention on communication and language skills, communicative confidence and feelings of social isolation. Compliance with the intervention was also explored through attrition and usage data.

          Results

          There was excellent compliance with the intervention, with no participants lost to follow up and most (18/20) receiving at least 88% of the intended treatment dose. Intervention brought about significant gains on a measure of functional communication. Gains were achieved by both groups of participants, once intervention was received, and were well maintained. Changes on the measures of communicative confidence and feelings of social isolation were not achieved. Results are discussed with reference to previous aphasia therapy findings.

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          Most cited references 76

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          Social networks in adult life and a preliminary examination of the convoy model.

          This paper examines the social support networks of older adults. Based upon the Kahn and Antonucci (1980) life course social support model, a national sample of adults aged 50 and older (N = 718) was interviewed, generating support networks consisting of an average of 8.9 members. The respondents were asked questions of the structural (e.g., age, sex, closeness, years known, proximity, and frequency of contact) and functional (number and type of supports provided and received) characteristics of their social networks. These characteristics and relationships are described in detail.
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            Virtual Reality Therapy for Adults Post-Stroke: A Systematic Review and Meta-Analysis Exploring Virtual Environments and Commercial Games in Therapy

            Background The objective of this analysis was to systematically review the evidence for virtual reality (VR) therapy in an adult post-stroke population in both custom built virtual environments (VE) and commercially available gaming systems (CG). Methods MEDLINE, CINAHL, EMBASE, ERIC, PSYCInfo, DARE, PEDro, Cochrane Central Register of Controlled Trials, and Cochrane Database of Systematic Reviews were systematically searched from the earliest available date until April 4, 2013. Controlled trials that compared VR to conventional therapy were included. Population criteria included adults (>18) post-stroke, excluding children, cerebral palsy, and other neurological disorders. Included studies were reported in English. Quality of studies was assessed with the Physiotherapy Evidence Database Scale (PEDro). Results Twenty-six studies met the inclusion criteria. For body function outcomes, there was a significant benefit of VR therapy compared to conventional therapy controls, G = 0.48, 95% CI = [0.27, 0.70], and no significant difference between VE and CG interventions (P = 0.38). For activity outcomes, there was a significant benefit of VR therapy, G = 0.58, 95% CI = [0.32, 0.85], and no significant difference between VE and CG interventions (P = 0.66). For participation outcomes, the overall effect size was G = 0.56, 95% CI = [0.02, 1.10]. All participation outcomes came from VE studies. Discussion VR rehabilitation moderately improves outcomes compared to conventional therapy in adults post-stroke. Current CG interventions have been too few and too small to assess potential benefits of CG. Future research in this area should aim to clearly define conventional therapy, report on participation measures, consider motivational components of therapy, and investigate commercially available systems in larger RCTs. Trial Registration Prospero CRD42013004338
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              Speech and language therapy for aphasia following stroke.

              Aphasia is an acquired language impairment following brain damage that affects some or all language modalities: expression and understanding of speech, reading, and writing. Approximately one third of people who have a stroke experience aphasia.
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                Author and article information

                Contributors
                Role: Editor
                Journal
                PLoS One
                PLoS ONE
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                12 August 2016
                2016
                : 11
                : 8
                Affiliations
                [1 ]Division of Language and Communication Science, City University London, London, United Kingdom
                [2 ]Centre for Human Computer Interaction Design, City University London, London, United Kingdom
                University College London, UNITED KINGDOM
                Author notes

                Competing Interests: The authors have declared that no competing interests exist.

                • Conceived and designed the experiments: JM TB SW CW JG ND.

                • Performed the experiments: JG ND RT HG TB.

                • Analyzed the data: JM ND RT KH.

                • Wrote the paper: JM SW CW JG RT ND KH.

                Article
                PONE-D-16-06482
                10.1371/journal.pone.0160381
                4982664
                27518188
                © 2016 Marshall et al

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                Page count
                Figures: 1, Tables: 4, Pages: 18
                Product
                Funding
                Funded by: The Stroke Association
                Award ID: TSA 2011/2012
                Award Recipient :
                This work was funded by a research grant to JM, SW, and CW from The Stroke Association https://www.stroke.org.uk/ Award Number: TSA 2011/10. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
                Categories
                Research Article
                Social Sciences
                Sociology
                Communications
                Social Communication
                Biology and Life Sciences
                Neuroscience
                Cognitive Science
                Cognitive Psychology
                Language
                Biology and Life Sciences
                Psychology
                Cognitive Psychology
                Language
                Social Sciences
                Psychology
                Cognitive Psychology
                Language
                Engineering and Technology
                Human Factors Engineering
                Man-Computer Interface
                Virtual Reality
                Computer and Information Sciences
                Computer Architecture
                User Interfaces
                Virtual Reality
                Social Sciences
                Linguistics
                Speech
                Medicine and Health Sciences
                Otorhinolaryngology
                Laryngology
                Speech-Language Pathology
                Speech Therapy
                Biology and Life Sciences
                Behavior
                Verbal Behavior
                Verbal Communication
                Research and Analysis Methods
                Mathematical and Statistical Techniques
                Statistical Methods
                Analysis of Variance
                Physical Sciences
                Mathematics
                Statistics (Mathematics)
                Statistical Methods
                Analysis of Variance
                Medicine and Health Sciences
                Mental Health and Psychiatry
                Mental Health Therapies
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                All relevant data are within the paper and its Supporting Information files.

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