Outcomes of an App-Based Intervention to Target Naming Among Individuals With Poststroke Aphasia: Virtual Randomized Controlled Trial
Kim, E., Laird, L., Wilson, C., Steward, S., Mildner, P., Möller, S., Schatz, R., Spang, R. P., Voigt-Antons, J.-N. & Rochon, E.
Published in JMIR Mhealth Uhealth , 2025
Abstract
People with aphasia present with language and communication deficits, most notably in lexical retrieval (naming). Although positive outcomes in naming have been observed following speech-language treatment, many individuals with aphasia continue to face impairments after the acute phase of rehabilitation. Mobile app–based therapies are increasingly being used by speech-language pathologists in the rehabilitation of people with aphasia as an adjunct to or in lieu of traditional in-person therapy approaches. These apps can increase the intensity of treatment and have been shown to result in meaningful outcomes across several domains. VoiceAdapt is a mobile therapy app addressing naming impairments, designed within a user-centered design framework. The VoiceAdapt app uses two evidence-based lexical retrieval treatments to engage people with aphasia to improve their naming abilities through interaction with the app. The purpose of this study was to conduct a randomized controlled trial to examine the preliminary clinical efficacy of training with VoiceAdapt on the language and communication outcomes of people with aphasia. A two-arm, waitlist-controlled, crossover group randomized controlled trial was conducted at two sites within Canada. During the intervention phase, participants completed 5 weeks of independent training with the app, which involved naming practice using Semantic Features Analysis and Phonological Components Analysis. The primary outcome measure was naming performance (Boston Naming Test); secondary outcomes included measures of overall language and naming (Western Aphasia Battery-Revised), communication (Communication Effectiveness Index), and quality of life (Stroke and Aphasia Quality of Life Scale-39). A total of 37 people with aphasia in the chronic stages (average 4.6 y postonset of aphasia) participated in this study. Participants used the app for an average of 20 hours over the 5-week intervention phase. Training with VoiceAdapt resulted in an increase of 1.6 points on the Boston Naming Test (Cohen d =0.3). Evidence for improved naming was also observed on trained items, as well as subtests of naming or word-finding on the WAB-R. Training with the app also resulted in a significant increase in participants’ perceptions of their communication quality of life (increase of 0.1 points; Cohen d =0.3), but no other measures (WAB-R Aphasia Quotient, Communicative Effectiveness Index) were significant. Individuals with aphasia who used the VoiceAdapt app for 5 weeks to target naming skills demonstrated measurable gains in naming and communication-based quality of life. Notably, these changes were observed in a remotely delivered program, in participants who were in the chronic stages of aphasia. These findings inform the profession on the use of app-based home therapy programs as an accessible, cost-effective option for individuals in the chronic stages of recovery who often have limited options for rehabilitation.
Cite as
Kim, E., Laird, L., Wilson, C., Steward, S., Mildner, P., Möller, S., Schatz, R., Spang, R. P., Voigt-Antons, J.-N. & Rochon, E. (2025). Outcomes of an App-Based Intervention to Target Naming Among Individuals With Poststroke Aphasia: Virtual Randomized Controlled Trial. JMIR Mhealth Uhealth. http://dx.doi.org/10.2196/67711
