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TOPICS IN STROKE REHABILITATION
Publishes Our Article:
"How to Succeed in Patient-Centered Aphasia Therapy and Measure Results"
 This article explores how Paul’s experience can be used as a guide for rehabilitation professionals, particularly speech-language pathologists to assist their stroke survivors in translating clinical sessions into functional communication and reintegration into the community
We systematically analyzed and divided Paul’s experience into five phases based on timeline and type of treatment. For each phase, we described the therapy, homework and tools. We assigned measures of progress or results that aligned with Paul’s goals and were noticeable to others.
To see the May-June 2011 issue of the journal "Topics in Stroke Rehabilitation," published by Thomas Land Publishers Inc. with our article, click here.
Measuring Progress
Most stroke survivors and families make significant progress in recovering from the stroke and returning to a daily routine. Sometimes the rate of progress is very slow or the internal improvements don't show, making it difficult to stay motivated and keep a positive attitude.
Setting goals, working to achieve them, and celebrating achievements--even small steps forward--can be a big help for the family as well as the survivor.
There are many ways to measure progress. Rehabilitation professionals have technical terms and measures that describe the specific areas of their focus, for example, degrees of flexion, or frequency of cueing. We found other measures more meaningful to us.
Physical measures for Paul's mobility included:
* Needing a wheelchair: After 6 months, he was able to walk a block or so without sitting, so we donated the wheelchair to Easter Seals
* Needing a cane: Paul uses a cane only in bad weather or if he expects difficult terrain. Lately, he's been using it as he recovers from back problems that affected his bad leg.
* Minutes walking without pain or fatigue. We saw this progress in how far Paul could walk around the neighborhood, how long he could walk through the mall, and how much walking as a tourist when we traveled
* Walking faster. A few years ago, Paul's physical therapist gave him a 6-month treadmill exercise routine that built up his walking speed from a measurable 1.8 miles per hour to 2.4 mph, according to the treadmill speed setting.
Other physical measures included amount of pain and movement in Paul's paralyzed arm.
Speech-language measures are a little more challenging to recognize, because achieving them is slower, and family members who see the person everyday have a little trouble noticing the improvements. We continue to be astonished when a new word or phrase pops out of Paul's mouth.
* Number of words Paul could say, and number of syllables (longer) words. Every few weeks, we made a list of words Paul was able to say, growing from about 10 when he left the hospital, to over 100 within the first year. This doesn't sound like a lot, but Paul had severe speech problems, and needed to retrain his tongue and lips to make basic sounds for letters and relearn how to sound-out words.
* Talking in complete noun-verb sentences. Paul knows what he wants to say, and we celebrated as he pulled words out to form sentences. Concrete nouns with action verbs were the first and easiest, for example, "Go to the store."
Paul started giving speeches to tell his story to others a few years after his stroke. The increasing length of the speeches, the larger audiences, and the lesser amount of time needed to learn new words and to practice became measures of progress. The proof was when he learned a 5-minute speech to give during a U.S. Senate press conference on Capitol Hill the night before! He couldn't say the long name of the bill he was supporting, so we cut it out of the speech. Ironically, the Senator who introduced the bill tripped over the title, too, and she is a politician with a golden tongue.
We captured the details of these goals, the steps and tools Paul used to achieve them, and the measures that showed his progress in a case-study article published in the May-June 2011 issue of the journal "Topics in Stroke Rehabilitation," published by Thomas Land Publishers Inc., click here.
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