Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Aug 6:2020:2846046.
doi: 10.1155/2020/2846046. eCollection 2020.

Conversational Therapy through Semi-Immersive Virtual Reality Environments for Language Recovery and Psychological Well-Being in Post Stroke Aphasia

A Giachero  1   2 , M Calati  1 , L Pia  2 , L La Vista  1 , M Molo  1 , C Rugiero  1 , C Fornaro  1 , P Marangolo  1   3   4
Affiliations

Conversational Therapy through Semi-Immersive Virtual Reality Environments for Language Recovery and Psychological Well-Being in Post Stroke Aphasia

A Giachero et al. Behav Neurol. .

Abstract

Aphasia is a highly disabling acquired language disorder generally caused by a left-lateralized brain damage. Even if traditional therapies have been shown to induce an adequate clinical improvement, a large percentage of patients are left with some degree of language impairments. Therefore, new approaches to common speech therapies are urgently needed in order to maximize the recovery from aphasia. The recent application of virtual reality (VR) to aphasia rehabilitation has already evidenced its usefulness in promoting a more pragmatically oriented treatment than conventional therapies (CT). In the present study, thirty-six chronic persons with aphasia (PWA) were randomly assigned to two groups. The VR group underwent conversational therapy during VR everyday life setting observation, while the control group was trained in a conventional setting without VR support. All patients were extensively tested through a neuropsychological battery which included not only measures for language skills and communication efficacy but also self-esteem and quality of life questionnairies. All patients were trained through a conversational approach by a speech therapist twice a week for six months (total 48 sessions). After the treatment, no significant differences among groups were found in the different measures. However, the amount of improvement in the different areas was distributed over far more cognitive and psychological aspects in the VR group than in the control group. Indeed, the within-group comparisons showed a significant enhancement in different language tasks (i.e., oral comprehension, repetition, and written language) only in the VR group. Significant gains, after the treatment, were also found, in the VR group, in different psychological dimensions (i.e., self-esteem and emotional and mood state). Given the importance of these aspects for aphasia recovery, we believe that our results add to previous evidence which points to the ecological validity and feasibility of VR treatment for language recovery and psychosocial well-being.

PubMed Disclaimer

Conflict of interest statement

The authors declare that there is no conflict of interests regarding the publication of this paper.

Figures

Figure 1
Figure 1
ScenePlayer NeuroVR: “Supermarket”.
Figure 2
Figure 2
Normalized scores in the different subtests of the Aachen Aphasia Test (AAT) for the VR group. Legend: Pre-Treat: pretreatment; Post-Treat: posttreatment; TT: token test, REPET: repetition; WL = written Language; NAM: naming; Compr: comprehension; OR Compr: oral comprehension; W Compr: written comprehension; PT: normalized scores; Within-group ANOVA: ∗p ≤ 0.008.
Figure 3
Figure 3
Normalized scores in the different subtests of the Aachen Aphasia Test (AAT) for the control group. Legend: Pre-Treat: pretreatment; Post-Treat: posttreatment; TT: token test, REPET: repetition; WL = written language; NAM: naming; Compr: comprehension; OR Compr: oral comprehension; W Compr: written comprehension; PT: normalized scores; within-group ANOVA: ∗∗p ≤ 0.008.
Figure 4
Figure 4
Mean percentage of scores in the different subtests of the C.A.P.P.A. test, for frequency and severity, in the VR Group from the patient‘s perspective. Legend: Pre-Treat: pretreatment. Post-Treat: posttreatment; LA: language ability; SC: ability to self-correct; TT: turn taking; TM: topic management; within-group ANOVA: ∗∗p ≤ 0.008.
Figure 5
Figure 5
Mean percentage of scores in the different subtests of the C.A.P.P.A. test, for frequency and severity, in the control group from the patient's perspective. Legend: Pre-Treat: pretreatment; Post-Treat: posttreatment; LA: language ability; SC: ability to self-correct; TT: turn taking; TM: topic management; within-group ANOVA: ∗∗p ≤ 0.008.
Figure 6
Figure 6
Mean percentage of scores in the different subtests of the C.A.P.P.A. test, for frequency and severity, in the VR group from the caregiver's perspective. Legend: Pre-Treat: pretreatment; Post-Treat: posttreatment; LA: language ability; SC: ability to self-correct; TT: turn taking; TM: topic management; within-group ANOVA: ∗∗p ≤ 0.008.
Figure 7
Figure 7
Mean percentage of scores in the different subtests of the C.A.P.P.A. test, for frequency and severity, in the control group from the caregiver‘s perspective. Legend: Pre-Treat: pretreatment; Post-Treat: posttreatment; LA: language ability; SC: ability to self-correct; TT: turn taking; TM: topic management; within-group ANOVA: ∗∗p ≤ 0.008.
Figure 8
Figure 8
Mean percentage of scores in the different subtests of the WHOQoL questionnaire (Word Health Organization Quality of Life—WHOQOL group, 1998) for the VR group. Legend: Pre-Treat: pretreatment; Post-Treat: posttreatment; PHY: physical; SOC: social; PSYCH: psychological; ENVIR: environmental; within-group ANOVA: ∗∗p ≤ 0.008.
Figure 9
Figure 9
Mean percentage of scores in the different subtests of the WHOQoL questionnaire (Word Health Organization Quality of Life–WHOQOL group, 1998) for the control group. Legend: Pre-Treat: pretreatment; Post-Treat: posttreatment; PHY: physical; SOC: social; PSYCH: psychological; ENVIR: environmental; within-group ANOVA: ∗∗p ≤ 0.008.
See this image and copyright information in PMC

References

    1. Ali M., Lyden P., Brady M. Aphasia and dysarthria in acute stroke: recovery and functional outcome. International Journal of Stroke. 2015;10(3):400–406. doi: 10.1111/ijs.12067. - DOI - PubMed
    1. Hilari K., Byng S., Lamping D. L., Smith S. C. Stroke and aphasia quality of life scale-39 (SAQOL-39), evaluation of acceptability, reliability, and validity. Stroke. 2003;34(8):1944–1950. doi: 10.1161/01.STR.0000081987.46660.ED. - DOI - PubMed
    1. Cruice M., Hill R., Worrall L., Hickson L. Conceptualising quality of life for older people with aphasia. Aphasiology. 2010;24(3):327–347. doi: 10.1080/02687030802565849. - DOI
    1. Basso A., Forbes M., Boller F. Rehabilitation of aphasia. Handbook of Clinical Neurology. 2013;110:325–334. doi: 10.1016/B978-0-444-52901-5.00027-7. - DOI - PubMed
    1. Marangolo P., Caltagirone C. Options to enhance recovery from aphasia by means of non-invasive brain stimulation and action observation therapy. Expert Review of Neurotherapeutics. 2014;14(1):75–91. doi: 10.1586/14737175.2014.864555. - DOI - PubMed