Purpose Intensive speech-language therapy (SLT) delivered as telerehabilitation in combination with transcranial direct current stimulation (tDCS) may be an effective treatment option for people with primary progressive aphasia (pwPPA). However, such combined treatment approaches are technically challenging and feasibility for pwPPA has not yet been established. We aimed to involve stakeholders in the development of a novel approach combining remotely-supervised but independently self-administered home-based tDCS with an intensive aphasia telerehabilitation (naming and communicative-pragmatic therapy). Method Eight pwPPA and 16 caregivers participated in two semi-structured interviews to identify the needs, preferences, and perceived barriers and challenges with regard to SLT, telerehabilita-tion and tDCS, and the combination of all components. Based on the results, a step-by-step manual was developed and tested by means of home-based usability tests and follow-up inter-views involving four dyads. Interview data were transcribed and analysed qualitatively and quantitatively. Competency checklists used in the usability tests were analysed quantitatively. Results PwPPA and their caregivers provided valuable insights into all aspects of the planned treat-ment programme. Overall, the findings suggest a high level of acceptance and perceived need for an intensive telerehabilitation SLT approach combined with tDCS. Using the developed step-by-step manual and training, pwPPA were able to independently perform more than half of the actions required for telerehabilitation but needed assistance with technically more de-manding aspects of tDCS. To ensure feasibility, caregiver-assistance is needed to support pwPPA during technically challenging interventions. Conclusions This mixed-methods study identified needs and preferences of pwPPA and their caregivers with regard to speech-language telerehabilitation, as well as barriers and challenges regarding telerehabilitation and home-based tDCS. We demonstrate high acceptability and initial feasibil-ity of such combined programmes. Our findings highlight the importance of stakeholder in-volvement in intervention development, which will inform future development and optimisation of technologically demanding intervention programmes.
Competing Interest StatementThe authors have declared no competing interest.
Funding StatementThis work was funded by the Federal Ministry of Education and Research (BMBF; Grant Number 01KG2210).
Author DeclarationsI confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.
Yes
The details of the IRB/oversight body that provided approval or exemption for the research described are given below:
Ethics committee of University Medicine of Greifswald gave ethical approval for this work (158/22, BB 196/23).
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Data AvailabilityVideo and audio data are not publicly available due to ethical reasons. Anonymized transcripts of interviews are available from the corresponding author on reasonable request.
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