Abstract
The delivery of tablet-based rehabilitation for individuals with post-stroke aphasia is relatively new, therefore, this study examined the effectiveness of an iPad-based therapy to demonstrate improvement in specific therapy tasks and how the tasks affect overall language and cognitive skills. Fifty-one individuals with aphasia due to a stroke or traumatic brain injury (TBI) were recruited to use an iPad-based software platform, Constant Therapy, for a 10 week therapy program. Participants were split into an experimental (N = 42) and control (N = 9) group. Both experimental and control participants received a 1 h clinic session with a clinician once a week, the experimental participants additionally practiced the therapy at home. Participants did not differ in the duration of the therapy and both groups of participants showed improvement over time in the tasks used for the therapy. However, experimental participants used the application more often and showed greater changes in accuracy and latency on the tasks than the control participants; experimental participants' severity level at baseline as measured by standardized tests of language and cognitive skills were a factor in improvement on the tasks. Subgroups of task co-improvement appear to occur between different language tasks, between different cognitive tasks, and across both domains. Finally, experimental participants showed more significant and positive changes due to therapy in their standardized tests than control participants. These results provide preliminary evidence for the usefulness of a tablet-based platform to deliver tailored language and cognitive therapy to individuals with aphasia.
Highlights
About 795,000 Americans suffer a new or recurrent stroke each year, which is the leading cause of serious long term disability in the US
Because the population after brain damage is invariably heterogeneous, initial scores on the Revised Western Aphasia Battery (R-WAB) Aphasia Quotient (AQ) and Cognitive Linguistic Quick Test (CLQT) Composite Severity were chosen as two measures of language and cognitive severity to examine as covariates on outcome
The experimental and control groups did not differ in terms of dosage, but the groups differed by compliance, with experimental participants completing more time than control participants
Summary
About 795,000 Americans suffer a new or recurrent stroke each year, which is the leading cause of serious long term disability in the US. Aphasia (or the impairment of language) is the effect of a brain injury, most often from a stroke in the left (and sometimes right) hemisphere of the brain. Even though there is improvement in language function in the first months after stroke, most individuals continue to present with aphasia (Pedersen et al, 2004) and likely require long-term aphasia rehabilitation. There is a large body of research suggesting that individuals with aphasia continue to improve their communication abilities with rehabilitation (Raymer et al, 2008; Allen et al, 2012; Teasell et al, 2012).
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