Internationale Zeitschrift für Physikalische Medizin und Rehabilitation
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Detecting Small and Large Fluctuations in Language and Cognitive Performance: A Longitudinal Rehabilitation Case Study

Swathi Kiran

There are very few studies that longitudinally track the recovery of stroke survivors after their discharge from the hospital. In this case study, we report a longitudinal profile of an individual with post-stroke aphasia, who received continuous rehabilitation through an iPad based therapy delivery platform. One month after the onset of his stroke, this individual was able to practice therapy at home using the iPad software on a daily basis and continued to make daily gains in specific prescribed therapy tasks. During the course of his rehabilitation, however, he suffered a second stroke, which was detected by changes in performance on the therapy tasks. Subsequent to the second stroke, this individual resumed therapy practice and continued to make gains on language and cognitive functions. Over the course of a year, the patient logged in 291 days and practiced 31 language and cognitive tasks. This case study provides a unique opportunity to demonstrate for the first time that (a) it is possible to detect the onset of a (recurrent) stroke due to changes in language and cognitive performance in terms of accuracy and latency even before a confirmatory diagnosis, and (b) improvements in language and cognitive abilities are possible with systematic and continued practice. Detecting small and large fluctuations in language and cognitive performance in post-stroke aphasia: A longitudinal rehabilitation case study.