Evaluating the co-designed “kalmer” relaxation intervention for people with aphasia: a feasibility case series

Background: People with aphasia are at increased risk of developing anxiety and depression. There is a need for accessible psychological interventions to be evaluated for this clinical group. Relaxation is a promising treatment option. Aims: This case series study aimed to assess the feasibility of the “Kalmer” relaxation intervention. Methods and Procedures: Twelve participants with aphasia were recruited via online social media/websites for people with aphasia. After 4 weeks of baseline assessment which included for mood the Behavioural Outcomes of Anxiety Scale (BOA) and Stroke Aphasic Depression Questionnaire − 10 item (SADQ-10), participants accessed the relaxation intervention on Vimeo© for 5 weeks. Participants were encouraged to practice relaxation 5 times a week. Vimeo© analytics were collected to measure participants’ preferences and use of the intervention. Immediately post intervention and at 3- and 6-month follow up time points, BOA and SADQ-10 scores were collected again. The Reliable Change Index was used to determine the impact of the intervention. Outcomes and Results: Whilst recruitment was slow, once participants were enrolled the trial appeared feasible. Vimeo© analytics demonstrated participants engaged well in the treatment and preferred imagery-based relaxation recordings. Anxiety symptoms improved for 5/12 participants (42%) immediately post intervention and 7/11 participants (63%) at 3 and 6 month follow-up time points. Depressive symptoms improved for 6/12 participants (50%) immediately post intervention, 4/11 participants (36.3%) at 3-month follow-up and 5/11 participants (45.5%) at 6-month follow-up. Conclusions: The Kalmer relaxation intervention appears feasible and shows potential to reduce anxiety and depressive symptoms in people with aphasia. Considerations for future trials include the need for expanding both recruitment (e.g. community and hospital rehabilitation services) and methods of delivery for the intervention (e.g. DVD and in person groups).