Comparison of Therapy Practice at Home and in the Clinic: A Retrospective Analysis of the Constant Therapy Platform Data Set.

Background: Computer-based therapies can provide an affordable and practical alternative by providing frequent intervention for stroke survivors with chronic aphasia by allowing the opportunity for home exercise practice, however more evidence is needed. The goal of this retrospective analysis was to compare the time course of therapy engagement when therapy was targeted in the clinic or at home by post-stroke individuals. We examined if home users of the therapy were compliant in therapy and if this documented practice time was associated with improved outcomes similar to clinic patients who practiced under the guidance of a clinician. Methods: A retrospective analysis of anonymously aggregated data collected for 3,686 patients with post-stroke aphasia over the course of four years (2013-2017) was conducted. Participants either received therapy delivered through Constant Therapy only at home (N = 2,100) or only in the clinic (N = 1,577). Constant Therapy includes over 70 evidence-based therapies for language and cognitive skills. This program was individualized for each patient with targeted tasks that dynamically adapted to each individual's progress. Results: Patients with <.60% accuracy were analyzed to determine how long it took them to reach >90% accuracy. Results showed that both home-therapy and clinic patients reached 90% accuracy on their tasks similarly (Median = 3 sessions), but the frequency of therapy was significantly different with 50% of home users receiving therapy at least every 2 days while 50% of clinic patients only had therapy once every 5 days (p < 0.001). Thus, home-therapy users were able to master tasks in a shorter time (median of 6 days) than clinic patients (median of 12 days) (p < 0.001). Conclusion: Outcomes of treatment are similar for home users and clinic patients indicating the potential usability of a home-based treatment program for rehabilitation for post-stroke aphasia.