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Efficacy of a Digital Therapeutic for People With Dysarthria After Stroke

Primary Purpose

Dysarthria as Late Effect of Stroke

Status
Enrolling by invitation
Phase
Not Applicable
Locations
Korea, Republic of
Study Type
Interventional
Intervention
Mobile application
Treatment as usual
Sponsored by
Ewha Womans University Seoul Hospital
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Dysarthria as Late Effect of Stroke focused on measuring Dysarthria, Stroke, digital therapeutics, Speech Disorders, Language Disorders, speech rehabilitation, application, Post-stroke dysarthria

Eligibility Criteria

undefined - undefined (Child, Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Neurologically stable, as determined by the clinician.
  2. Onset of stroke within four weeks prior to randomization.
  3. Diagnosis of dysarthria caused by stroke as confirmed by a stroke specialty neurologist.
  4. Maintains enough cognitive function to use the speech therapy application without problems, as determined by a Mini-Mental State Exam score of 21 ≥ within 1 month prior to randomization.
  5. Capable of walking or moving alone or with the assistance of a walking aid (e.g., walkers, canes, or wheelchairs).
  6. Must have intact vision, hearing, communication skills, and motor skills, as well as comprehension sufficient to proceed with assessment, as judged by the clinician.

Exclusion Criteria:

  1. Unable to measure articulatory or orofacial functions due to organic causes/lesions in articulatory and cervical structure.
  2. Has comorbid neurological conditions that, in the opinion of the investigator, could impair study participation, such as dementia (Alzheimer's disease, vascular dementia, Central Nervous System Infection [e.g., Human Immunodeficiency Virus, syphilis], Creutzfeld-Jacob disease, etc.), Pick's disease, Huntington's disease, or Parkinson's disease.
  3. Has a Mini-Mental State Exam score of 20 or below at the time of screening.
  4. Has a Clinical Dementia Rating score of 1 ≥ or a Global Deterioration Scale score of 3 ≥ at the time of screening.
  5. Received dementia treatment within 3 months of screening.
  6. Takes medication that may impact cognitive function during the clinical trial period.
  7. Co-medication is prohibited during the entire trial period for the following medications: drugs for dementia treatment, Central Nervous System stimulants, anticholinergics, tricyclic antidepressants, typical antipsychotics, and sleeping pills (excluding rapid-acting sleeping pills).
  8. Co-medication is permitted if continued use of the following medications has been at a stable dose for 2 months prior to randomization: atypical antipsychotics, anxiolytics, antidepressants (excluding tricyclic antidepressants), thyroid hormone, and rapid-acting sleeping pills.
  9. Is uneducated or illiterate.
  10. Has been diagnosed with a serious mental illness such as severe depression, schizophrenia, alcohol addiction, or drug addiction.
  11. Unable to use D-ST01 due to severe speech impairment, as determined by the clinician.

Sites / Locations

  • Ewha Womans University Medical Center

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

No Intervention

Arm Label

Intervention

Control

Arm Description

The intervention group will receive treatment as usual along with the speech therapy app.

The control group will receive treatment as usual only.

Outcomes

Primary Outcome Measures

Speech intelligibility
Speech intelligibility is evaluated with a score of 0 (normal), 1 (intelligible, some differences noticeable), 2 (intelligible, noticeably different), 3 (intelligible with careful listening, some unintelligible), 4 (difficult to understand, many words unintelligible), 5 (usually unintelligible), or 6 (unintelligible).

Secondary Outcome Measures

The percent change in score on the Urimal Test of Articulation and Phonology 2 (UTAP2)
The percent change in score on the Urimal Test of Articulation and Phonology 2 (UTAP2)
Change in the speech mechanism test
Change in the speech mechanism test [ Time Frame: Baseline, 4weeks ] Speech mechanism screening tests will be used to measure the degree of dysarthria. The test consists of three categories; 1)evaluating the structure and function of the articulators, 2)phonation and articulation accuracy, and 3) articulation regularity and accuracy in the alternate motion rates and sequential motion rates.

Full Information

First Posted
November 14, 2021
Last Updated
June 17, 2022
Sponsor
Ewha Womans University Seoul Hospital
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1. Study Identification

Unique Protocol Identification Number
NCT05146765
Brief Title
Efficacy of a Digital Therapeutic for People With Dysarthria After Stroke
Official Title
Efficacy of a Digital Therapeutic for People With Dysarthria After Stroke; Pilot Trial
Study Type
Interventional

2. Study Status

Record Verification Date
June 2022
Overall Recruitment Status
Enrolling by invitation
Study Start Date
January 18, 2022 (Actual)
Primary Completion Date
June 30, 2022 (Anticipated)
Study Completion Date
June 30, 2022 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Ewha Womans University Seoul Hospital

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No

5. Study Description

Brief Summary
This pilot trial will establish the feasibility of a new digitized speech rehabilitation developed for patients with post-stroke dysarthria. For this study, participants will be instructed to use the speech therapy app for 30 minutes to 1 hour per day over a 4-week period.
Detailed Description
A total of 60 patients with post-stroke dysarthria will be recruited and randomly divided into intervention and control groups. Patients in the intervention group will be instructed to receive speech treatments including oro-motor exercise, phonation, articulation, resonance, syllable repetition, and reading exercise (App on mobile devices). Daily sessions will be provided during a 4-week period. Both groups will also receive treatment as usual. The aim of the study is to investigate the efficacy of mobile-based speech therapy in patients with dysarthria in the acute phase following stroke.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Dysarthria as Late Effect of Stroke
Keywords
Dysarthria, Stroke, digital therapeutics, Speech Disorders, Language Disorders, speech rehabilitation, application, Post-stroke dysarthria

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Model Description
Pilot trial
Masking
Participant
Masking Description
Outcome Assessor
Allocation
Randomized
Enrollment
60 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Intervention
Arm Type
Experimental
Arm Description
The intervention group will receive treatment as usual along with the speech therapy app.
Arm Title
Control
Arm Type
No Intervention
Arm Description
The control group will receive treatment as usual only.
Intervention Type
Device
Intervention Name(s)
Mobile application
Intervention Description
Device: Use of mobile application Participants will be instructed to use the speech therapy app for 30 minutes to one hour per day over a 4-week period.
Intervention Type
Other
Intervention Name(s)
Treatment as usual
Intervention Description
The patients will follow the treatment as usual, including conventional stroke therapy if needed based on the medical guidelines.
Primary Outcome Measure Information:
Title
Speech intelligibility
Description
Speech intelligibility is evaluated with a score of 0 (normal), 1 (intelligible, some differences noticeable), 2 (intelligible, noticeably different), 3 (intelligible with careful listening, some unintelligible), 4 (difficult to understand, many words unintelligible), 5 (usually unintelligible), or 6 (unintelligible).
Time Frame
Baseline, 4weeks
Secondary Outcome Measure Information:
Title
The percent change in score on the Urimal Test of Articulation and Phonology 2 (UTAP2)
Description
The percent change in score on the Urimal Test of Articulation and Phonology 2 (UTAP2)
Time Frame
Baseline, 4weeks
Title
Change in the speech mechanism test
Description
Change in the speech mechanism test [ Time Frame: Baseline, 4weeks ] Speech mechanism screening tests will be used to measure the degree of dysarthria. The test consists of three categories; 1)evaluating the structure and function of the articulators, 2)phonation and articulation accuracy, and 3) articulation regularity and accuracy in the alternate motion rates and sequential motion rates.
Time Frame
Baseline, 4weeks
Other Pre-specified Outcome Measures:
Title
National Institute of Health Stroke Scale (NIHSS)
Description
NIHSS will be used to assess stroke-related neurologic deficits. The NIHSS scale is made up of 11 different elements that evaluate specific abilities; level of consciousness (LOC), best gaze, visual field, facial palsy, motor arm, motor leg, limb ataxia, sensory, best language, dysarthria, extinction, inattention. The score ranges from 0 to 42; higher scores indicate more severe stroke symptoms.
Time Frame
Baseline, 4weeks
Title
Patient Health Questionnaire-9 (PHQ-9)
Description
The PHQ-9 is a nine-item self-reported questionnaire that is used to assess depressive symptoms. The score ranges from 0 to 27, with lower scores indicating less depressive severity.
Time Frame
Baseline, 4weeks
Title
Generalized Anxiety disorder-7
Description
GAD-7(Generalized Anxiety disorder-7) will be used to assess anxiety. The GAD-7(Generalized Anxiety disorder-7) is a seven-item self-reported questionnaire that evaluates anxiety symptoms. The score ranges from 0 to 21, with lower scores indicating lower anxiety symptoms.
Time Frame
Baseline, 4weeks
Title
Euro Quality of Life (EQ-5D)
Description
EQ-5D will be used to assess the quality of life. The EQ-5D is a self-report questionnaire that measures health-related quality of life. The questionnaire consists of five dimensions: mobility, self-care, ordinary activities, discomfort, and mood state related to anxiety or depression. The responses indicate three levels of severity ("no problems", "some problems", and "extreme problems") within each EQ-5D dimension.
Time Frame
Baseline, 4weeks
Title
Modified Computer Self-Efficacy Scale (mCSES)
Description
mCSES will be used to assess participants' perceptions of self-efficacy with respect to using a computerized system. The mCSES is a 10-item self-reported questionnaire. The score ranges from 0 to 100; higher scores indicate a stronger sense of personal competence.
Time Frame
Baseline, 4weeks

10. Eligibility

Sex
All
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Neurologically stable, as determined by the clinician. Onset of stroke within four weeks prior to randomization. Diagnosis of dysarthria caused by stroke as confirmed by a stroke specialty neurologist. Maintains enough cognitive function to use the speech therapy application without problems, as determined by a Mini-Mental State Exam score of 21 ≥ within 1 month prior to randomization. Capable of walking or moving alone or with the assistance of a walking aid (e.g., walkers, canes, or wheelchairs). Must have intact vision, hearing, communication skills, and motor skills, as well as comprehension sufficient to proceed with assessment, as judged by the clinician. Exclusion Criteria: Unable to measure articulatory or orofacial functions due to organic causes/lesions in articulatory and cervical structure. Has comorbid neurological conditions that, in the opinion of the investigator, could impair study participation, such as dementia (Alzheimer's disease, vascular dementia, Central Nervous System Infection [e.g., Human Immunodeficiency Virus, syphilis], Creutzfeld-Jacob disease, etc.), Pick's disease, Huntington's disease, or Parkinson's disease. Has a Mini-Mental State Exam score of 20 or below at the time of screening. Has a Clinical Dementia Rating score of 1 ≥ or a Global Deterioration Scale score of 3 ≥ at the time of screening. Received dementia treatment within 3 months of screening. Takes medication that may impact cognitive function during the clinical trial period. Co-medication is prohibited during the entire trial period for the following medications: drugs for dementia treatment, Central Nervous System stimulants, anticholinergics, tricyclic antidepressants, typical antipsychotics, and sleeping pills (excluding rapid-acting sleeping pills). Co-medication is permitted if continued use of the following medications has been at a stable dose for 2 months prior to randomization: atypical antipsychotics, anxiolytics, antidepressants (excluding tricyclic antidepressants), thyroid hormone, and rapid-acting sleeping pills. Is uneducated or illiterate. Has been diagnosed with a serious mental illness such as severe depression, schizophrenia, alcohol addiction, or drug addiction. Unable to use D-ST01 due to severe speech impairment, as determined by the clinician.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Tae-Jin Song, MD, PhD
Organizational Affiliation
Department of Neurology, Ewha University College of Medicine, Seoul, Republic of Korea
Official's Role
Principal Investigator
Facility Information:
Facility Name
Ewha Womans University Medical Center
City
Seoul
ZIP/Postal Code
07804
Country
Korea, Republic of

12. IPD Sharing Statement

Plan to Share IPD
No

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Efficacy of a Digital Therapeutic for People With Dysarthria After Stroke

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