Validation of an iPAD based therapy for rehabilitation- Constant Therapy

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  • Kiran.SSL
  • Standardize and then individualize
  • Individualized patient level analysis
  • Changes on standardized tests

Our recent papers on this  topic include:

Des Roches, C., Balachandran, I., Ascenso, E., Tripodis, Y., S. (2015). Effectiveness of an impairment-based individualized treatment program using an iPad-based software platform. Frontiers in Human Neuroscience. doi: 10.3389/fnhum.2014.01015

Kiran, S. (2014). Tracking small and large scale fluctuations in language and cognitive performance: A longitudinal rehabilitation case study. International Journal of Physical Medical & Rehabilitation. Special Issue on Stroke Rehabilitation.2:3.

Kiran, S., Des Roches, C., Balachandran, I., & Ascenso, E. (2014). Development of an ipad based clinical decision making workflow for individuals with language and cognitive deficits. Seminars in Speech and Language. 35:38–50

View a recent poster of this work presented at the Mobile Health Rehabilitation Outcomes conference

Summary of this project: Effectiveness of an impairment-based individualized treatment program using an iPad-based software platform

The delivery of tablet-based therapy 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 were recruited to use an iPad-based software platform, Constant Therapy, for a 10 week treatment program. Participants were split into an experimental (N=42) and control (N=9) group. Both experimental and control participants received a one hour 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 treatment and both groups of participants showed improvement over time in the tasks used for the treatment. However, experimental participants used the application more often and showed greater changes in accuracy and latency measures 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 treatment 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.

In addition, we have also examined the relationship between levels of assistance and treatment scores on the ipad usage. View our recent poster on this work presented the 2014 Mobile Health Rehabilitation Outcomes Conference.

Summary of this project: Relationship between levels of assistance and treatment scores with aphasic individuals while using an iPad-based software platform

Annette Mitko1, Carrie Des Roches1, Swathi Kiran1

 

1Aphasia Research Laboratory, Sargent College, Speech, Language, and Hearing Sciences, Boston University, Boston, MA, USA

How do individuals with aphasia relearn to use strategies during therapy and how does that translate to improvement in treatment? This study investigates this relationship while using Constant Therapy, which is an iPad-based therapy program with over 30 tasks. Fifty-one individuals with aphasia due to a stroke or traumatic brain injury were recruited for a 10 week treatment program. The software tracked both accuracy and hint counts (i.e., what level of assistance is needed), such as repetition of audio stimuli. Total hint counts were examined by session with a simple regression analysis both by participant (including hint counts of zero) and by task (excluding hint counts of zero) which found that, for both participants and tasks, half showed a significant relationship between accuracy and hint use. Total hint counts were also examined by cluster analysis, which resulted in a general trend where the greater the hint use, the lower the participant’s accuracy, though interestingly, a couple of patients did show trends of higher accuracy with increased hint use. Additional analyses examining the relationship between accuracy and hint use over time specific to each task that each patient completed is ongoing. These results reveal that using cues can help overall accuracy but only to a certain extent and that overuse of cues can hinder accuracy.  Ultimately, the results demonstrate the need for individualizing and moderating levels of assistance employed during rehabilitation.

Sample pictures of the iPad dashboard:

Patient activity dashboard

Patient activity dashboard

iPad therapy task - Rhyming

iPad therapy task – Rhyming

iPad therapy task - Map Reading

iPad therapy task – Map Reading