Publications
-
Modell, Børge S.; Pacheco, Matheus M.; Opheim, Arve Isak; Hestetun-Mandrup, Ann Marie; Løvstad, Marianne & Øra, Hege Prag
[Show all 8 contributors for this article]
(2026).
A reduced sensor configuration for upper extremity monitoring after stroke.
Journal of NeuroEngineering and Rehabilitation.
doi:
10.1186/s12984-026-02149-6.
Full text in Research Archive
Show summary
Abstract Background Home rehabilitation for stroke survivors is crucial for promoting upper extremity (UE) movements, improving functional ability, and enhancing independence and quality of life. Wearable sensors enable monitoring of movement trends and progress during home rehabilitation. The feasibility of using sensors in the homes of stroke survivors depends both on user acceptability and the accuracy of the sensors in capturing the complexity of movement. The aim of this study was to identify a reduced and more practical sensor configuration that preserves the ability to capture movement complexity for monitoring UE movements in stroke survivors during daily activities at home. This was informed by aligning user acceptability data with movement complexity measures derived from a nine-sensor reference configuration in a home-like environment. Methods Eleven chronic stroke survivors were observed in a natural or simulated home environment while attempting to attach and detach sensors and wearing them while performing self-chosen activities of daily living. Nine inertial measurement unit sensors were placed on the participants’ UEs and sternum. Acceptability was assessed with a custom-made questionnaire consisting of 14 items scored on a 1–5 Likert scale, and five open-ended questions. Furthermore, information entropy was calculated to determine the minimal number of sensors needed to capture movement complexity. Results Total acceptability of wearing the 9 sensors was high, with a median score of 57 out of 70 (81%; IQR = 11), whereas usability was moderate, with a median score of 11 out of 20 (55%; IQR = 5.5). The usability challenges were related mostly to attaching and detaching sensors on the hands and non-affected UE. The minimal sensor configuration to capture behavior complexity consisted of three-to-four sensors, placed on the sternum, non-affected and affected forearms, with or without affected upper arm. Conclusions The 9-sensor configuration had high acceptability, but lower usability. A reduced configuration with three-to-four sensors was sufficient to maintain the accuracy of the sensors, while potentially increasing stroke survivors’ usability. In turn, this may increase the feasibility of wearing sensors at home for stroke survivors.
-
-
Brady, Marian C; Mills, Claire; Øra, Hege Prag; Novaes, Natalia; Becker, Frank & Constantinidou, Fofi
[Show all 18 contributors for this article]
(2025).
European Stroke Organisation (ESO) guideline on aphasia rehabilitation.
European Stroke Journal.
ISSN 2396-9873.
10(4),
p. 1189–1220.
doi:
10.1177/23969873241311025.
Full text in Research Archive
Show summary
Evidence of effective aphasia rehabilitation is emerging, yet intervention and delivery varies widely. This European Stroke Organisation guideline adhered to the guideline development standard procedures and Grading of Recommendations, Assessment, Development and Evaluation (GRADE) methodology. The resulting multi-disciplinary, evidence-based recommendations support the delivery of high-quality stroke-related aphasia rehabilitation. The working group identified 10 clinically relevant aphasia rehabilitation questions and rated outcomes’ relevance and importance. Following systematic searching, independent reviewers screened title-abstracts and full-texts for randomised controlled trials of speech-language therapy (SLT) for stroke-related aphasia. Results were profiled using PRISMA. Risk-of-bias was evaluated using the Cochrane Risk-of-Bias 1 tool. We prioritised final-value data. Where possible we conducted meta-analyses (RevMan) using random effects and mean, standardised mean differences (functional communication, quality of life, aphasia severity, auditory comprehension and spoken language outcomes) or odds ratios (adverse events). Using GRADE, we judged quality of the evidence (high-to-very low) and ESO recommendation strength (very strong-to-very weak). Where evidence was insufficient to support recommendations, expert opinions were described. Based on low-quality evidence we recommend the provision of higher total SLT dose (⩾20 h) and suggest higher SLT intensity and frequency to improve outcomes in aphasia rehabilitation. Similarly, we suggest the provision of individually-tailored SLT and digital and group therapy delivery models. Very low-level evidence for transcranial direct current stimulation (tDCS) with SLT informed the expert consensus that such interventions should only be provided in the context of high-quality trials. Evidence-based clinical-research priorities to inform SLT aphasia rehabilitation intervention choice and delivery are highlighted.
-
Holthe, Ingvil Laberg; Rohrer-Baumgartner, Nina; Svendsen, Edel Jannecke; Hauger, Solveig Lægreid; Forslund, Marit Vindal & Borgen, Ida Maria Henriksen
[Show all 13 contributors for this article]
(2022).
Feasibility and Acceptability of a Complex Telerehabilitation Intervention for Pediatric Acquired Brain Injury: The Child in Context Intervention (CICI).
Journal of Clinical Medicine.
11(9),
p. 1–23.
doi:
10.3390/jcm11092564.
Full text in Research Archive
Show summary
The current study is a feasibility study of a randomized controlled trial (RCT): the Child in Context Intervention (CICI). The CICI study is an individualized, goal-oriented and home-based intervention conducted mainly through videoconference. It targets children with ongoing challenges (physical, cognitive, behavioral, social and/or psychological) after acquired brain injury (ABI) and their families at least one year post injury. The CICI feasibility study included six children aged 11–16 years with verified ABI-diagnosis, their families and their schools. The aim was to evaluate the feasibility of the intervention components, child and parent perceptions of usefulness and relevance of the intervention as well as the assessment protocol through a priori defined criteria. Overall, the families and therapists rated the intervention as feasible and acceptable, including the videoconference treatment delivery. However, the burden of assessment was too high. The SMART-goal approach was rated as useful, and goal attainment was high. The parents’ ratings of acceptability of the intervention were somewhat higher than the children’s. In conclusion, the CICI protocol proved feasible and acceptable to families, schools and therapists. The assessment burden was reduced, and adjustments in primary outcomes were made for the definitive RCT.
-
Øra, Hege Prag; Kirmess, Melanie; Brady, Marian C.; Partee, Iselin Anne Cecilia; Hognestad, Randi Bjor & Johannessen, Beate Bertheau
[Show all 8 contributors for this article]
(2020).
The effect of augmented speech-language therapy delivered by telerehabilitation on post stroke aphasia – a pilot randomized controlled trial.
Clinical Rehabilitation.
ISSN 0269-2155.
34(3),
p. 369–381.
doi:
10.1177/0269215519896616.
Full text in Research Archive
Show summary
Pilot a definitive randomized controlled trial of speech-language telerehabilitation in poststroke aphasia in addition to usual care with regard to recruitment, drop-outs, and language effects. Pilot single-blinded randomized controlled trial. Telerehabilitation delivered from tertiary rehabilitation center to participants at their home or admitted to secondary rehabilitation centers. People with naming impairment due to aphasia following stroke. Sixty-two participants randomly allocated to 5 hours of speech and language telerehabilitation by videoconference per week over four consecutive weeks together with usual care or usual care alone. The telerehabilitation targeted functional, expressive language. Main measures: Norwegian Basic Aphasia Assessment: naming (primary outcome), repetition, and auditory comprehension subtests; Verb and Sentence Test sentence production subtest and the Communicative Effectiveness Index at baseline, four weeks, and four months postrandomization. Data were analyzed by intention to treat. No significant between-group differences were seen in naming or auditory comprehension in the Norwegian Basic Aphasia Assessment at four weeks and four months post randomization. The telerehabilitation group ( n = 29) achieved a Norwegian Basic Aphasia Assessment repetition score of 8.9 points higher ( P = 0.026) and a Verb and Sentence Test score 3 points higher ( P = 0.002) than the control group ( n = 27) four months postrandomization. Communicative Effectiveness Index was not significantly different between groups, but increased significantly within both groups. No adverse events were reported. Augmented telerehabilitation via videoconference may be a viable rehabilitation model for aphasia affecting language outcomes poststroke. A definitive trial with 230 participants is needed to confirm results.
-
Øra, Hege Prag; Kirmess, Melanie; Brady, Marian C.; Sørli, Hilde & Becker, Frank
(2020).
Technical Features, Feasibility, and Acceptability of Augmented Telerehabilitation in Post-stroke Aphasia—Experiences From a Randomized Controlled Trial.
Frontiers in Neurology.
11(671).
doi:
10.3389/fneur.2020.00671.
Full text in Research Archive
Show summary
Background: Post-stroke aphasia is a communication disorder where existing evidence favors intensive therapy methods. Telerehabilitation represents a service model for geographically remote settings, or other barriers to clinic attendance or to facilitate an augmentation of therapy across a continuum of care. Evidence to support efficiency, feasibility, and acceptability is however still scarce. Appraising aphasia telerehabilitation in controlled trials beyond its effectiveness, by investigating feasibility and acceptability, may facilitate implementation into clinical practice. Methods: In our pilot randomized controlled trial, we investigated the feasibility and acceptability of speech and language therapy by videoconference, in addition to usual care, in people with aphasia following stroke. To improve functional, expressive language, a tailored intervention was given 1 h per day, five times per week over four consecutive weeks. Feasibility measures included evaluation of technical setup using diary logs. Acceptability was investigated by examining adherence and satisfaction with therapy alongside evaluation of data safety and privacy. Results: Feasibility and acceptability data were collected in relation to 556.5 h of telerehabilitation delivered to 30 participants over a 2-years intervention period by three speech-language pathologists. Protocol adherence was high, with a tolerable technical fault rate; 86 faults were registered over 541 video sessions. Most (80%; n = 30) of the participants experienced zero to three faults. The main cause of technical failures was flawed internet connection, causing delayed or interrupted therapy. Total satisfaction with telerehabilitation was rated good or very good by 93.1% (n = 29) of participants and two of three speech-language pathologists. Within a moderate variance of technical failure, participants experiencing more faults were more satisfied. No serious events regarding security and privacy were reported. Our model is feasibly and ready to be implemented across a range of clinical settings and contexts. Conclusions: Synchronous telerehabilitation for post-stroke aphasia is feasible and acceptable and shows tolerable technical fault rates with high satisfaction among patients and pathologists. Within a low rate of faults, satisfaction was not negatively influenced by fault frequency. Access to clinical and technical expertise is needed when developing telerehabilitation services. Telerehabilitation may be a viable service delivery model for aphasia rehabilitation.
-
Øra, Hege Prag; Kirmess, Melanie; Brady, Marian C.; Winsnes, Ingvild Elisabeth; Hansen, Silje Merethe & Becker, Frank
(2018).
Telerehabilitation for aphasia - Protocol of a pragmatic, exploratory, pilot randomized controlled trial.
Trials.
19(208).
doi:
10.1186/s13063-018-2588-5.
Full text in Research Archive
Show summary
Background The Cochrane review on the effectiveness of speech and language therapy for aphasia following stroke suggests intensity of therapy is a key predictor for outcome. Current aphasia services cannot provide intervention at the intensity observed within trial contexts because of resource limitations. Telerehabilitation could widen access to speech-language pathologists (SLPs) in geographically remote contexts and reduce the time spent on travel by the therapist and patient. The current academic literature within this field is in its infancy, with few trials of speech and language therapy (SLT) delivered by videoconference. Our pilot randomized controlled trial (RCT) will explore feasibility aspects and effectiveness of telerehabilitation for aphasia in addition to standard SLT. Method/design Our study is a pragmatic, exploratory, pilot randomized controlled trial, where participants will be randomized to a telerehabilitation group or a control group. Both groups receive standard SLT (usual care) but the telerehabilitation group receives an additional 5 h of telerehabilitation per week over 4 weeks through videoconference. This additional telerehabilitation focuses on spoken language with an emphasis on word naming. We aim to include 40 patients in each group, with inclusion criteria being aphasia any time post stroke. Participants will be assessed blindly at pre-randomization (baseline), and 4 weeks and 4 months after randomization. The primary endpoint is naming ability 3 months after the completed intervention, measured by the Norwegian Basic Aphasia Assessment (NGA) naming subtest. Secondary endpoints include other subtests of the NGA, the VAST (Verb and Sentence Test) subtest sentence production, Communicative Effectiveness Index (CETI) and the Stroke and Aphasia Quality of Life scale (SAQOL-39). Experiences of patients and SLPs with telerehabilitation are assessed using questionnaires and semi-structured interviews. Statistical between group comparisons will be in line with an intention-to-treat analysis. Discussion This pilot RCT of intensive language training by videoconference will contribute new scientific evidence to the field of aphasia telerehabilitation. Here, we describe our trial which will explore the feasibility of telerehabilitation for aphasia as an intervention, our choice of primary and secondary outcome measures and proposed analyses. Our trial will provide information for the development and delivery of future definitive RCTs. Trial registration ClinicalTrials.gov, ID: NCT02768922 . Registered on 11 May 2016. Last updated on 17 November 2017.
View all works in NVA
-
-
Rasmussen, Mari Storli; Andelic, Nada; Selj, Joanna Nordhagen; Danielsen, Vilde Marie; Løvstad, Marianne & Howe, Emilie Isager
[Show all 30 contributors for this article]
(2024).
Self-management support program delivered in the sub-acute phase after traumatic injury-study protocol for a pragmatic randomized controlled trial.
Trials.
25(1),
p. 639–639.
doi:
10.1186/s13063-024-08492-0.
Full text in Research Archive
Show summary
Background Traumatic injuries, defined as physical injuries with sudden onset, are a major cause of distress and disability, with far-reaching societal consequences. A significant proportion of trauma survivors report persistent symptoms and difficulties after the injury, and studies show unmet health care needs. Self-management programs delivered in the sub-acute phase after traumatic injuries are scarcely evaluated. The aim of the present study is to evaluate the effectiveness of a self-management program (SEMPO), delivered 3–4 months after moderate-to-severe traumatic injury. Methods This study protocol describes a pragmatic randomized controlled trial (RCT) with two classical RCT arms (intervention and control) and an explorative self-selection arm. 220 patients will be recruited from Oslo University Hospital, the largest Trauma Referral Centre in Norway. Patients aged 18–72 years residing in the south-east region of Norway, admitted to the Trauma Centre directly or within 72 h after having sustained a moderate to severe traumatic injury, defined as a New Injury Severity Score > 9, having at least 2 days hospital stay, and reporting injury-related symptoms and impairment at discharge from the acute hospital will be included. Patients will be randomly assigned to either a classical RCT randomization arm (intervention or control arm) or to a self-selection arm. In the randomization arm, participants are further randomized into intervention or control group. Participants allocated to the self-selection arm will choose to partake either in the intervention or control arm. The primary outcome is the level of self-efficacy in trauma coping assessed 6 months after completion of the intervention, with a similar time point for the control group. Secondary outcomes include symptom burden, physical functioning and disability, return to work and health care utilization, health-related quality of life, and communication competency. In addition, patients will be asked to nominate one domain-related measurement as their preferred outcome measure. Discussion This RCT will determine the effect of a self-management program tailored to patients with moderate to severe physical trauma, and the self-selection arm incorporates the potential influence of patient treatment preferences on intervention results. If the intervention proves effective, cost-effectiveness and cost-utility analyses will be performed and thereby provide important information for clinicians and policy makers. Trial registration The study is registered in Clinical Trials with the identifier: NCT06305819. Registered on March 05, 2004.
-
Øra, Hege Prag; Kirmess, Melanie; Brady, Marian C & Becker, Frank
(2023).
Telerehabilitation for post-stroke aphasia - Results and experience from a randomised controlled trial on speech-language therapy by videoconference.
Full text in Research Archive
-
Øra, Hege Prag
(2023).
Telerehabilitation
in post stroke aphasia
Results and experience from a randomised controlled trial on
speech language therapy by videoconference.
Full text in Research Archive
-
Rohrer-Baumgartner, Nina; Holthe, Ingvil Laberg; Svendsen, Edel Jannecke; Røe, Cecilie; Egeland, Jens & Borgen, Ida Maria Henriksen
[Show all 21 contributors for this article]
(2022).
Rehabilitation for children with chronic acquired brain injury in the Child in Context Intervention (CICI) study: study protocol for a randomized controlled trial.
Trials.
23.
doi:
10.1186/s13063-022-06048-8.
Full text in Research Archive
Show summary
Background: Pediatric acquired brain injury (pABI) is associated with long-term cognitive, behavioral, social, and emotional problems, which may affect the quality of life, school, and family functioning. Yet, there is a lack of evidence-based community-centered rehabilitation programs for chronic pABI and these children do not systematically receive comprehensive rehabilitation. The Child In Context Intervention (CICI) study is a pragmatic randomized controlled trial (RCT) for children with chronic pABI, which aims to evaluate the effectiveness of an individualized and goal-oriented intervention targeting everyday functioning of the child and family. Methods: Children aged 6–16 years with MRI/CT-verified intracranial abnormalities will be included in the CICI study if they have persistent self- or parent-reported cognitive, emotional, and/or behavioral challenges 1 year or more after insult and attend school regularly. A total of 70 families will be randomized 1:1 to an intervention or a control group. The intervention consists of seven family sessions, one parent seminar, and four school sessions delivered over approximately 6 months. The parent seminar will be held in person, and the other sessions will mainly be video based. The children’s and families’ self-reported major challenges in everyday life will be targeted using SMART goals. Evidence-based strategies, when available, will be applied to achieve the goals, combined with psychoeducation. Goal attainment scaling (GAS) will be used to evaluate goal attainment. Data is collected at baseline and after approximately 6 and 9 months. External assessors are blinded to group allocation. Primary outcomes are parent-reported brain injury symptoms in children and parenting self-efficacy at 9 months of follow-up. Secondary outcomes include child-reported brain injury symptoms, quality of life, executive functioning in daily life, parent emotional symptoms, family functioning, and unmet family health care needs. A process evaluation will be conducted. Discussion: The current study provides an innovative approach to rehabilitation for children in the chronic phase of ABI and their families. This complex intervention may contribute to the development of evidence-based, high-quality rehabilitation for a large patient group, which is underrepresented in clinical research. It may also improve collaboration between specialized rehabilitation facilities, schools, and local health care services. Inclusion for the trial started in April 2021.
-
Holthe, Ingvil Laberg; Rohrer-Baumgartner, Nina; Svendsen, Edel Jannecke; Strand-Saugnes, Anine; Hauger, Solveig Lægreid & Forslund, Marit
[Show all 12 contributors for this article]
(2022).
Treating Chronic Symptoms of Pediatric Acquired Brain Injury Through a Telehealth Intervention:A feasibility Study of the Child in Context Intervention (CICI).
Full text in Research Archive
-
Holthe, Ingvil Laberg; Rohrer-Baumgartner, Nina; Svendsen, Edel Jannecke; Strand-Saugnes, Anine; Hauger, Solveig Lægreid & Forslund, Marit Vindal
[Show all 12 contributors for this article]
(2021).
Treating Chronic Symptoms of Pediatric Acquired Brain Injury Through a Telehealth Intervention: A Feasibility Study of
the Child in Context Intervention (CICI).
Full text in Research Archive
-
Øra, Hege Prag; Kirmess, Melanie & Becker, Frank
(2020).
Språktrening rett hjem - intensiv språktrening via videokonferanse.
Afasiposten.
ISSN 0803-2467.
p. 12–14.
Full text in Research Archive
-
Winsnes, Ingvild Elisabeth; Øra, Hege Prag; Kirmess, Melanie & Becker, Frank
(2017).
Aphasia telerehabilitation - A digital enterprise (experience from the SLT intervention).
Full text in Research Archive
-
-
Øra, Hege Prag; Kirmess, Melanie; Brady, Marian C.; Winsnes, Ingvild Elisabeth & Becker, Frank
(2016).
Aphasia telerehabilitation early post stroke.
Full text in Research Archive
View all works in NVA
Published
Feb. 8, 2024 1:01 PM
- Last modified
Oct. 2, 2025 3:42 PM
