HSE Neurolinguists Reveal What Makes Apps Effective for Aphasia Rehabilitation

Scientists at the HSE Centre for Language and Brain have identified key factors that increase the effectiveness of mobile and computer-based applications for aphasia rehabilitation. These key factors include automated feedback, a variety of tasks within the application, extended treatment duration, and ongoing interaction between the user and the clinician. The article has been published in NeuroRehabilitation.
Aphasia is a disorder characterised by complete or partial loss of the ability to speak and understand speech, caused by damage to areas of the brain responsible for language functions. The primary causes of aphasia include stroke, traumatic brain injury, inflammatory brain diseases, brain tumours, and dementia.
Aphasia significantly reduces a person's quality of life, prompting scientists to search for effective ways to restore the language functions impaired by the condition. With the widespread use of smartphones and tablets, a promising and rapidly evolving area of rehabilitation has emerged: serious games (SG) integrated into applications.
These are a special type of digital game designed not only for entertainment, but also to serve specific educational, training, or research purposes. In education, they support professional training, student learning, and foreign language acquisition. In healthcare, such games are used for patient rehabilitation.
Using a specially designed application, a person with aphasia can complete language training tasks and gradually recover their lost abilities. The effectiveness of such applications has already been demonstrated, but it remained unclear which specific tasks and features should be included, and how long users should engage with them to achieve optimal results.
Scientists from the HSE Centre for Language and Brain searched the PubMed and ScienceDirect databases and selected 18 studies which tested mobile and computer applications for aphasia rehabilitation.
The researchers focused specifically on cases where using an application produced remarkable results. For example, a patient who practiced naming 100 words improved to naming 150 words or was able to use the learned words not only in speech but also in writing. Sometimes, using serious games led to the development of related skills; for example, while training language functions, a person’s attention also improved.
In 14 of the 18 papers analysed (78%), patient use of the application resulted in positive effects. While most studies confirmed the effectiveness of the applications based on primary outcomes—ie improvement in the specific skills being trained—eight articles (44%) reported results that exceeded expectations, often showing that patients could apply the trained words in other contexts, such as writing. Additionally, two studies reported improvements in other higher cognitive functions.
The analysis revealed that the effectiveness of the applications was influenced by factors such as automated feedback, a diverse range of training tasks, extended treatment duration, and interaction between the patient and clinician. The latter is particularly important, as clinicians provide additional motivation and assess interim progress.
'At our centre, we are developing a game for aphasia rehabilitation. Reviewing existing studies will help us optimise its testing and incorporate the essential features needed for effective use. Many existing applications include few gamification elements and function more like digital workbooks with exercises. We aim to address this limitation to increase user engagement,' explains Georgii Gorshkov, Junior Research Fellow at the HSE Centre for Language and Brain.
The study was conducted with support from the Government of Moscow (Grant No. 1403-18/23).
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