April 16, 2018

Novel rehab approach receives Heart & Stroke funding

Dr. Dar Dowlatshahi and researchers at the Ottawa Hospital Research Institute have received three years of funding from Heart & Stroke to study the efficacy of an innovative tablet-based approach to promote language recovery after stroke.

RecoverNow, which has been funded by CPSR catalyst grants, will receive $291K from Heart & Stroke to test the new technology in Ottawa, Toronto and Calgary.

While most Canadians survive after stroke, nearly a third will have aphasia, a devastating condition that robs them of the ability to communicate. Losing the ability to communicate reduces quality of life.

Stroke patients struggle to access speech therapy resources in the critical early days of recovery. If patients cannot start speech therapy in the first two weeks after stroke– and many do not – the potential for maximum recovery is lost. In 2014, only 16% of stroke survivors accessed rehabilitation services in hospital, and of those, only 50% within two weeks of their stroke. Given the aging population and increase in stroke, RecoverNow seeks to find a better way to treat aphasia and promote recovery from stroke.

RecoverNow is a computer-based speech therapy concept designed to help stroke survivors recover while they are still in the hospital and still in bed. Stroke patients are provided with mobile tablets with pre-loaded and commercially available speech therapy “apps.” Patients then use the apps at their own leisure, under the remote supervision of speech therapists. The OHRI researchers have shown that patients are willing and able to try RecoverNow, regardless of their age and experience with computers (their first patient was 89 and used it for several hours a day). They now wish to prove that RecoverNow actually helps patients recover, and at a minimum cost to our health care system.

As part of the clinical trial, patients admitted to hospitals for stroke treatment in Ottawa, Toronto and Calgary will be offered RecoverNow in addition to any routinely offered care. Those who enrol in RecoverNow will be randomly assigned either a “speech therapy” tablet, or a “control” tablet, where they receive memory and graphics programs rather than speech programs. Both groups will be supported and remotely monitored by the research team to address any issues or questions. Patients will be asked to work on their tablets daily for 90 days. They will take their tablets with them after leaving hospital, whether home or to a specialized rehabilitation facility. They will remain in contact with the research team for support and advice, and to make their apps more challenging as they recover. At 90 days, researchers will examine the patients to see if there is a difference in language recovery between the two groups. The program as a whole will undergo an economic analysis to estimate the additional health-care cost of offering RecoverNow therapy to patients with stroke across Canada.

The RecoverNow concept is the first to “bring rehab to the patient.” Using existing technology, speech therapy starts  while patients are still in their beds receiving medical treatments for their stroke. Patients in acute-care hospitals spend over 60% of their time lying in bed, inactive and alone. This innovative concept allows patients to actively engage in recovery therapy during this “downtime”, especially their evenings and weekends where there is little in the way of therapy.

RecoverNow is a very cost-efficient because existing mobile technology and commercially available applications are used. And, because the treatment is mobile, the RecoverNow tablet can travel with the patients as they transition from hospital to rehabilitation facilities and home. Throughout this journey, patients maintain contact with their speech therapists with face-to-face video applications and texting.

“We believe RecoverNow can help stroke survivors regain their ability to communicate, reclaim their independence, and ultimately reintegrate into the community,” says lead researcher Dr. Dar Dowlatshahi of the Ottawa Hospital Research Institute. “We will also show that our therapy model is cost-effective and can, therefore, easily be offered across Canada, both in the hospital setting and at home.”