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All Subjects: stroke
Creators: Rogalsky, Corianne

Does training in the upper extremity domain with startle translate to the speech domain post-stroke?

Description

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.

ContributorsTesman, Nathan (Author) / Honeycutt, Claire (Thesis director) / Rogalsky, Corianne (Committee member) / Barrett, The Honors College (Contributor) / Department of Psychology (Contributor) / School of Molecular Sciences (Contributor)

Created2023-05

She Said I Love You: The Effect of StartReact and Startle Adjuvant Rehabilitation Therapy in Post-Stroke Aphasia, Apraxia, and Dysarthria of Speech

Description

Stroke is the leading cause of long-term disability in the U.S., with up to 60% of strokescausing speech loss. Individuals with severe stroke, who require the most frequent, intense speech therapy, often cannot adhere to treatments due to high cost and low success rates. Therefore, the ability to make functionally significant changes in individuals with severe post- stroke aphasia remains a key challenge for the rehabilitation community. This dissertation aimed to evaluate the efficacy of Startle Adjuvant Rehabilitation Therapy (START), a tele-enabled, low- cost treatment, to improve quality of life and speech in individuals with severe-to-moderate stroke. START is the exposure to startling acoustic stimuli during practice of motor tasks in individuals with stroke. START increases the speed and intensity of practice in severely impaired post-stroke reaching, with START eliciting muscle activity 2-3 times higher than maximum voluntary contraction. Voluntary reaching distance, onset, and final accuracy increased after a session of START, suggesting a rehabilitative effect. However, START has not been evaluated during impaired speech. The objective of this study is to determine if impaired speech can be elicited by startling acoustic stimuli, and if three days of START training can enhance clinical measures of moderate to severe post-stroke aphasia and apraxia of speech. This dissertation evaluates START in 42 individuals with post-stroke speech impairment via telehealth in a Phase 0 clinical trial. Results suggest that impaired speech can be elicited by startling acoustic stimuli and that START benefits individuals with severe-to-moderate post-stroke impairments in both linguistic and motor speech domains. This fills an important gap in aphasia care, as many speech therapies remain ineffective and financially inaccessible for patients with severe deficits. START is effective, remotely delivered, and may likely serve as an affordable adjuvant to traditional therapy for those that have poor access to quality care.

ContributorsSwann, Zoe Elisabeth (Author) / Honeycutt, Claire F (Thesis advisor) / Daliri, Ayoub (Committee member) / Rogalsky, Corianne (Committee member) / Liss, Julie (Committee member) / Schaefer, Sydney (Committee member) / Arizona State University (Publisher)

Created2022

The Post Stroke Journey: A Survey Study of the Effects of Family Support and Psychological Factors on Rehabilitation Goals

Description

Stroke is the fifth most common cause of death in America and a leading cause of long-term adult disability, affecting more than 795,000 people a year ("American Stroke Association: A Division of the American Heart Association"). Many of these individuals experience persistent difficulty with the execution of daily tasks as a direct consequence of a stroke. A key factor in the successful recovery of a stroke survivor is rehabilitation. Rehabilitation sessions can start within two days of the stroke if the patient is in stable condition, and often continues long after their release from the hospital ("American Stroke Association: A Division of the American Heart Association"). The rehabilitation sessions are driven by a team of rehabilitation care professionals which includes, but is not limited to a physical therapist, occupational therapist, and speech-language pathologist. These professionals are available to the stroke survivor as resources to assist in developing and organizing ways to achieve independence as opposed to dependence. Ultimately, a stroke survivor’s family typically provides the most important long-term support during recovery and rehabilitation ("American Stroke Association: A Division of the American Heart Association"). However, there is very little research that focuses on the impact that local family can have on the stroke survivor’s establishment and achievement of goals throughout their recovery and rehabilitation. This study examines this gap in knowledge.

ContributorsGraves, Migail (Author) / Rogalsky, Corianne (Thesis director) / Schaefer, Sydney (Committee member) / College of Health Solutions (Contributor) / Barrett, The Honors College (Contributor)

Created2020-05