# Telerehab for Aphasia (TERRA)

> **NIH NIH P50** · UNIVERSITY OF SOUTH CAROLINA AT COLUMBIA · 2024 · $897,286

## Abstract

Summary: Project 1
It is now commonly accepted that aphasia therapy in chronic stroke is effective for improving language
processing, and perhaps to a lesser extent, quality of life. Nevertheless, most persons with chronic aphasia in
the United States have very limited access to therapy. Although the reasons for this state of affairs are several,
two factors are particularly important: insufficient reimbursement for therapy services and lack of access to
local transportation to and from therapy. A way to tackle both of these problems is to provide aphasia therapy
at a lower cost and eliminate the need for transportation. Providing aphasia therapy via telemedicine (clinician
administered therapy across the internet) will provide cheaper therapy by eliminating the need for a physical
facility to provide services and by reducing the need for transportation to and from therapy for either the
clinician (home health) or the patient (outpatient clinic). The purpose of Project 1 is to conduct a phase II, non-
inferiority trial of telerehab for aphasia therapy (aphasia remote therapy; ART), which will be exclusively
administered by a speech-language pathologist. All participants (N=100) will be randomized to receive either
telerehab (ART) or in-clinic therapy (I-CT) using the same kind of therapy we are currently using in Project 1.
The outcome measure will focus on speech production and combines correct naming and correct words
produced per minute during discourse. The primary endpoint is change in the outcome measure at 6 months
compared to baseline. The non-inferiority margin will be set so that if ART leads to less than 50% improvement
than the improvement following I-CT, it will be considered inferior for therapy delivery. In addition to comparing
the difference in outcome for ART and I-CT, we will also explore factors that influence the efficacy of telerehab
for aphasia therapy. For this purpose, we use a theoretical framework that is typically used to study the
acceptance of and personal attitudes towards telemedicine. Moreover, we will test participants’ cognitive-
linguistic status and collect biographical information to study which participants may have difficulty with
telerehab and may be poor candidates in a future, phase III trial. If our trial finds that ART is non-inferior to I-
CT, it will provide strong motivation to proceed with a phase III trial on a therapy modality that could
significantly alter and improve access to aphasia therapy for a population that now is estimated to exceed 2
million individuals in North America.
In addition to conducting a very timely clinical trial on ART, the work proposed here will continue to expand our
database on aphasia therapy outcome that is being populated in the current phase of Project 1. Accordingly,
the synergy between the current and the proposed work in Project 1 will be maintained. Moreover, Project 1
will continue to provide data for Projects 3 and 4 to study brain health in relation to aphas...

## Key facts

- **NIH application ID:** 10817152
- **Project number:** 5P50DC014664-09
- **Recipient organization:** UNIVERSITY OF SOUTH CAROLINA AT COLUMBIA
- **Principal Investigator:** JULIUS FRIDRIKSSON
- **Activity code:** P50 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $897,286
- **Award type:** 5
- **Project period:** 2016-04-01 → 2026-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10817152

## Citation

> US National Institutes of Health, RePORTER application 10817152, Telerehab for Aphasia (TERRA) (5P50DC014664-09). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10817152. Licensed CC0.

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