Wednesday, 26 August 2020

Computerised speech and language therapy or attention control added to usual care for people with long-term post-stroke aphasia: the Big CACTUS three-arm RCT

 Dr Rebecca Palmer announces The Big CACTUS monograph has been published in Health Technology Assessment. This is a full report of the randomised controlled trial of self managed word finding therapy on a computer. Find details of the computer therapy, study protocol, detailed results, health economic evaluation, fidelity assessment, patient and public involvement and an in depth discussion of how computer therapy can contribute to delivery of speech and language therapy for aphasia. The report also contains links to resources used throughout the study.


The study found that offering therapy on a computer increased the amount of therapy practice people with aphasia achieved as compared to that available through usual face to face care leading to significant improvements in the ability to find personally relevant words. These benefits were maintained for at least 6 months after therapy. Importantly, the study showed that people were able to improve with therapy for many years after their stroke. The study highlighted that support in addition to the computer word finding practice is needed to help people to use their new words in everyday contexts. Cost effectiveness was uncertain, but the study indicated that the computer approach is more likely to be cost effective for people with mild and moderate aphasia. We hope this study will encourage uptake of computerised therapy to increase the opportunity for people with aphasia to reach their potential.
The study was funded by the NIHR HTA programme with additional support from the Tavistock Trust for Aphasia. We would like to thank the funders, Steps Consulting Ltd who designed and produced the software, and the many speech and language therapists, people with aphasia and their carers who participated in the study from across 21 UK NHS trusts.

Please view the full report here



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