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- All Subjects: stroke
- Creators: Honeycutt, Claire
- Creators: Santello, Marco
- Creators: Lee, Hyunglae
- Status: Published
Does training in the upper extremity domain with startle translate to the speech domain post-stroke?
The aim of this study was to assess whether exposing individuals who are 6-month post-stroke with an upper extremity motor deficit and some form of speech impairment (aphasia and/or apraxia) to upper extremity training utilizing Startle Adjuvant Rehabilitation Therapy (START) would result in improvement in symptoms of speech impairment. It was hypothesized that while scores on Diadochokinetic Rate (a measure of apraxia) and Repetition (a measure of aphasia) would improve by timepoint with START as compared to the Control group, measures of aphasia including Spontaneous Speech, Auditory Verbal Comprehension, and Naming would not be different in scores by timepoint. Subjects were recruited from two separate ongoing studies consisting of three days of similar upper extremity training on certain functional tasks with and without START and the speech assessments utilized were pulled from the Western Aphasia Battery (Revised) and Apraxia Battery for Adults 2nd Edition. It was found that there were no statistically significant differences by timepoint in either condition for any of the speech assessments. This proof-of-concept study is the first to assess whether the StartReact effect, when applied to the upper extremity domain, will translate into measurable improvements in speech impairment despite the lack of any speech training.
This dissertation evaluates StartReact and the voluntary trials before and after exposure to StartReact during a point-to-point multi-jointed reach task to three different targets covering a large workspace. The results show that multi-jointed reach tasks are susceptible to StartReact in iwS and the distance, muscle and movement onset speed, and muscle activations percentages and amplitude increase during StartReact trials. In addition, the distance, accuracy, muscle and movement onsets speeds, and muscle synergy similarity indices to the norm synergies increase during the voluntary-initiated trials after exposure to StartReact. Overall, this dissertation shows that exposure to StartReact did not impair voluntary-initiated movement and muscle synergy, but even improved them. Therefore, this study suggests that StartReact is safe for more investigations in training studies and therapy.