Tablet‐Assisted Speech and Language Therapy for Acute Post‐Stroke Aphasia: A Randomized Clinical Trial ( LEXI Study)

Wischmann, Johannes; Brasch, Leanna; Franzen, Julia; Schwierz, Jennifer; Kovalenko, Oksana; Gutmann, Andrea; Erbert, Franziska; Bußmann, Luisa; Lauer, Julia; Dumberger, Claudia; Mandl, Alexander; Mehringer, Marie; Münsterer, Annette; Spitzer, Julia; Winterhalter, Lena; Frank, Vanessa; Rheinwald, Marika; Lehner, Katharina; Ammer, Franziska; Pfahler, Angelika; Lampart, Stefanie; Young, Charlotte; Young, Peter; Goettert, Barbara; Bitzan, Marcella; Rinder, Stephanie; Meier, Oliver; Feil, Katharina; Kellert, Lars (2025): Tablet‐Assisted Speech and Language Therapy for Acute Post‐Stroke Aphasia: A Randomized Clinical Trial ( LEXI Study). European Journal of Neurology, 32 (12): e70443. ISSN 1351-5101

Abstract

Background:
Aphasia after acute stroke is a frequent and disabling condition, impairing communication and quality of life. We investigated whether tablet-assisted Speech and Language Therapy (SLT) using the Neolexon application is superior to standard SLT in acute stroke patients.

Methods:
In this prospective, open-label, randomized, controlled clinical trial, patients with acute post-stroke aphasia were recruited from one stroke center and two neurorehabilitation clinics in Germany. Participants were stratified by aphasia severity and randomized to tablet-assisted SLT (n = 53) or standard SLT (n = 51), initiated during inpatient care and continued in rehabilitation (30 min/Day). The primary outcome was the change in the Bielefelder Aphasia Screening (BIAS) percentile rank from baseline to 90 days. Secondary outcomes included frequency and duration of self-training.

Results:
From 07/2021 to 09/2024, 4097 patients were screened and 104 randomized (mean age 74.4 ± 11.2 years; 51.9% female). No significant difference in BIAS change was found at 90 days (18 vs. 14). The trial was stopped early for futility. The intervention group engaged in self-directed training more frequently (37.7% vs. 21.6%) and trained longer (10 vs. 4 h). Subgroup analyses showed benefits of tablet-assisted SLT in patients with mild (β = 15.51; 95% CI −1.67 to 32.69) and moderate aphasia (β = 23.58; 95% CI −4.48 to 51.65), and those with a National Institutes of Health Stroke Scale of less than 5 (β = 21.69; 95% CI 5.54–37.84).

Conclusions:
Although underpowered to demonstrate overall superiority, tablet-assisted SLT showed potential benefits in patients with mild to moderate aphasia and less severe strokes in the acute setting.

• Dokumententyp: Artikel (Klinikum der LMU)
• Organisationseinheit (Fakultäten): 07 Medizin > Klinikum der LMU München > Neurochirurgische Klinik und Poliklinik
• DFG-Fachsystematik der Wissenschaftsbereiche: Lebenswissenschaften
• DFG: Gefördert durch die Deutsche Forschungsgemeinschaft (DFG) - 491502892