IEEE Robotics & Automation Magazine - March 2023 - 85

In this study, we analyzed the feasibility, satisfaction, and
motivation of patients, and the clinical effect of the intervention
using this complex platform which,
among other functions, allows the administration
of speech and language home
therapy. Eight patients conducted a therapeutic
plan, including speech therapy,
using the remote asynchronous rehabilitation
system; seven patients were included
in the control group (CG) and followed a
traditional speech-therapy program. The
analysis of usage revealed that participants
made continuous and intensive use
of the platform. The results confirmed
the acceptability, perceived usefulness,
and ease of use of the proposed platform.
Clinical assessments showed that the system
administers speech and language
rehabilitation as effectively as traditional
therapy, allowing one to consider such an approach as a valid
alternative to standard face-to-face speech therapy.
functions seem to play a crucial role in the comprehension and
production of linguistic macrostructures and microstructures [3].
Considering the brain's multifunction "
SPEECH
AND LANGUAGE
THERAPY IS THE
GOLD STANDARD IN
APHASIA TREATMENT
AND IS RECOMMENDED
BY CURRENT CLINICAL
GUIDELINES FOR STROKE
TREATMENT.
„
INTRODUCTION
Language functions fall within the body function domain of
the International Classification of Functioning and Disability
and, more specifically, between the mental functions of language
and the functions of speech, which are closely related
to other cognitive and sensory abilities. Aphasia, as a selective
acquired disorder of language, occurs in one-third of
stroke cases [1]. This communication dysfunction also
represents a fundamental
prognostic factor for the
recovery of cognitive and
functional outcomes in
stroke survivors [2].
Furthermore, aphasia
following a stroke can be
associated with cognitive abilities,
such as attention, speed of
processing, working memory,
and other executive functions
[3]. It has been demonstrated
that these cognitive deficits
affect recovery and rehabilitation
of aphasia, being involved
in sentence comprehension
and speech production [4], [5].
There is also a link between
acquiring syntactically ambiguous
information and working
memory demands. Recent
studies suggest that working
memory, processing speed,
and other executive skills can
be enhanced with cognitive
training [1], [6]. The executive
ality, structural and functional connectivity,
plasticity, and cognitive abilities, we can
see it as an organ of communication, where
linguistic and cognitive networks are continuously
interconnected [7]. The definition
of aphasia as a cognitive disorder affecting
language and caused by a brain lesion of the
dominant hemisphere highlights the close
relationship between cognitive and speechtherapy
treatments. Left-hemispheric stroke
patients with aphasia may also have cognitive
deficits, particularly in working memory
and sustained attention, and the strong
relationship between these deficits and the
severity of aphasia is well known [8].
Speech and language therapy is the
gold standard in aphasia treatment and is recommended by
current clinical guidelines for stroke treatment. It effectively
promotes the recovery of functional and verbal communication
skills at the receptive and expressive levels. However,
many patients suffer from not receiving appropriate care
after discharge because of geographic barriers, transportation
problems, socioeconomic difficulties, and insufficient family
support [9].
Telehealth technology is a solution to provide intensive
care to patients with aphasia. Telerehabilitation (TR) provides
rehabilitation services to support people living in hard-toreach
areas, expands rehabilitation options through computer
programs, improves the quality of life, and reduces healthcare
costs by increasing the number of patients treated per
day. It also enables remote monitoring of rehabilitation progress,
adapting rehabilitation protocol interventions according
to the results achieved, synchronous and asynchronous
rehabilitation training mode, and sharing information with
patients and their families. However, there is a great need
for new, validated TR applications that incorporate methods
for facilitated exercise assignments to efficiently help people
with aphasia [1].
The use of telemedicine systems generally is escalating
among health-care providers worldwide. Also,
recent COVID-19-related restrictions, a great interest has been
dedicated to providing more innovative software and technologies
to support patients with home-based solutions. However,
studies on TR services focused on cognitive-language therapy
for stroke subjects are not sufficient to draw supportive conclusions.
Keck and Doarn compared remote language-therapy
methods and found that the asynchronous mode is more suitable
than the synchronous one, since it allows patients to manage
the activities autonomously, bypassing technological and
connection limits, especially when monitored and supervised
by professional speech/language pathologists [10].
According to a systematic review conducted on 103 articles
investigating the domain of speech/language and hearing
MARCH 2023 IEEE ROBOTICS & AUTOMATION MAGAZINE
85
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