Optimizing Telepractice Selection and Implementation for Persons with Aphasia.

Telepractice is used to conduct many aspects of healthcare, including rehabilitation and research. However, information regarding how to identify optimal candidates and overcome barriers to participating in telepractice are limited. In the context of aphasia rehabilitation research, we developed two tools for optimizing telepractice: (1) the Participant Technology Questionnaire (PTQ), an aphasia-friendly tool for gathering information about potential telepractice participants; and (2) the Virtual-Appropriate Decision Approach (VADA), a framework for assessing and modifying methods that support virtual activities.

Discrepancies between self- and informant-ratings of functional abilities and objective cognition: predictors of bias in mild cognitive impairment.

Objective: Self- and informant-ratings of functional abilities are used to diagnose mild cognitive impairment (MCI) and are commonly measured in clinical trials. Ratings are assumed to be accurate, yet they are subject to biases. Biases in self-ratings have been found in individuals with dementia who are older and more depressed and in caregivers with higher distress, burden, and education.

Graph Trilateration for Indoor Localization in Sparsely Distributed Edge Computing Devices in Complex Environments Using Bluetooth Technology.

Spatial navigation patterns in indoor space usage can reveal important cues about the cognitive health of participants. In this work, we present a low-cost, scalable, open-source edge computing system using Bluetooth low energy (BLE) beacons for tracking indoor movements in a large, 1700 m2 facility used to carry out therapeutic activities for participants with mild cognitive impairment (MCI). The facility is instrumented with 39 edge computing systems, along with an on-premise fog server.

ASL MRI informs blood flow to chronic stroke lesions in patients with aphasia.

Response to post-stroke aphasia language rehabilitation is difficult to anticipate, mainly because few predictors can help identify optimal, individualized treatment options. Imaging techniques, such as Voxel-based Lesion Symptom Mapping have been useful in linking specific brain areas to language behavior; however, further development is required to optimize the use of structural and physiological information in guiding individualized treatment for persons with aphasia (PWA). In this study, we will determine if cerebral blood flow (CBF) mapped in patients with chronic strokes can be further used to understand stroke-related factors and behavior.

Methodologies for task-fMRI based prognostic biomarkers in response to aphasia treatment.

With the diversity in aphasia coupled with diminished gains at the chronic phase, it is imperative to deliver effective rehabilitation plans. Treatment outcomes have therefore been predicted using lesion-to-symptom mapping, but this method lacks holistic functional information about the language-network. This study, therefore, aims to develop whole-brain task-fMRI multivariate analysis to neurobiologically inspect lesion impacts on the language-network and predict behavioral outcomes in persons with aphasia (PWA) undergoing language therapy.

Motivation as a Predictor of Aphasia Treatment Outcomes: A Scoping Review.

Purpose: Motivation is a complex phenomenon that can influence a person's ability to make progress in treatment. We sought to understand how motivation is currently measured and utilized in aphasia rehabilitation by identifying treatment studies that (1) include measurement of motivation and (2) use motivation to predict treatment response.

Method: A scoping review was conducted by systematically searching PubMed, CINAHL, EBSCO, Ovid MEDLINE, and APA PsycInfo using the following search terms: (measurement OR treatment OR rehabilitation OR predict*) AND (motiv* OR engagement OR adherence OR compliance) AND (aphasia OR dysphasia).

Early within therapy naming probes as a clinically-feasible predictor of anomia treatment response.

This study investigated the relationship between early within-therapy probe naming performance and anomia therapy outcomes in individuals with aphasia. Thirty-four adults with chronic, post-stroke aphasia participated in the Aphasia Language Impairment and Functioning Therapy (Aphasia LIFT) programme, comprised of 48 h of comprehensive aphasia therapy. Sets of 30 treated and 30 untreated items identified at baseline were probed during impairment therapy which targeted word retrieval using a combined semantic feature analysis and phonological component analysis approach.

Knowledge About COVID-19 Symptoms, Transmission, and Prevention: The Relationship With Cognitive Status in Older Adults.

Advanced age poses an increased risk for cognitive impairment, and therefore, poor knowledge regarding the risks associated with COVID-19 may confer vulnerability. We administered a COVID-19 Knowledge Questionnaire to older persons to evaluate the association between knowledge regarding public health recommendations, and cognitive status as measured by the Montreal Cognitive Assessment (MoCA). Ninety-nine participants completed a 22-item questionnaire about COVID-19 symptoms, risks, and protective strategies, and they also completed the MoCA.

"Self-management has to be the way of the future": Exploring the perspectives of speech-language pathologists who work with people with aphasia.

Purpose: Healthcare models have incorporated self-management approaches to facilitate increased patient responsibility for chronic condition management. As aphasia is a chronic condition, self-management may be beneficial for people with aphasia; however, the possible impacts of the language disorder on self-management must be acknowledged and addressed. Speech-language pathologists would likely be principal providers of self-management support; therefore, their perspectives should be sought when considering development of aphasia self-management approaches.

"There are endless areas that they can use it for": speech-language pathologist perspectives of technology support for aphasia self-management.

Background: Aphasia is a debilitating acquired language disorder that often persists as a chronic condition. However, long-term support options are scarce, necessitating the consideration of alternative approaches. Chronic condition self-management approaches, which aim to build self-efficacy and empower people to take responsibility for the day-to-day management of their health condition, may benefit people with aphasia (PwA).

Communication partner perspectives of aphasia self-management and the role of technology: an in-depth qualitative exploration.

Purpose: "Self-management" empowers individuals to take responsibility for their healthcare through skill-building, personal growth, and self-efficacy related to chronic health condition management. Self-management approaches may benefit people with aphasia (PwA); however, PwA are often excluded from stroke self-management research and there is no published research reporting on aphasia-specific self-management programs. Communication partners (CPs) are involved in the rehabilitation and day-to-day lives of PwA, thus giving them unique insights and knowledge of PwA needs.

People with aphasia share their views on self-management and the role of technology to support self-management of aphasia.

Purpose: Self-management can lead to increased self-efficacy and improved quality of life for individuals with chronic conditions; however, there is little research exploring how self-management approaches can be used for chronic communication disorders, such as aphasia. Modifications to self-management approaches would be required to accommodate for aphasia; therefore, the input of people with aphasia (PwA) should be sought. The aims of the present study were: (1) To investigate and document the experiences and perspectives of PwA regarding self-management; (2) To explore how technology can be used to support aphasia self-management.

Not All Lesioned Tissue Is Equal: Identifying Pericavitational Areas in Chronic Stroke With Tissue Integrity Gradation T2w T1w Ratio.

Stroke-related tissue damage within lesioned brain areas is topologically non-uniform and has underlying tissue composition changes that may have important implications for rehabilitation. However, we know of no uniformly accepted, objective non-invasive methodology to identify pericavitational areas within the chronic stroke lesion. To fill this gap, we propose a novel magnetic resonance imaging (MRI) methodology to objectively quantify the lesion core and surrounding pericavitational perimeter, which we call tissue integrity gradation T2w T1w ratio (TIGR).

The Acute Effects of Different Exercise Intensities on Associative Novel Word Learning in Healthy Older Adults: A Randomized Controlled Trial.

Recent studies show positive effects of acute exercise on language learning in young adults with lower baseline learning abilities; however, this is yet to be investigated in older adults. This study investigated the acute effects of different exercise intensities on new word learning in healthy older adults with lower and higher baseline learning abilities. Sixty older adults (mean age = 66.

The effect of time since stroke, gender, age, and lesion size on thalamus volume in chronic stroke: a pilot study.

Recent stroke studies have shown that the ipsi-lesional thalamus longitudinally and significantly decreases after stroke in the acute and subacute stages. However, additional considerations in the chronic stages of stroke require exploration including time since stroke, gender, intracortical volume, aging, and lesion volume to better characterize thalamic differences after cortical infarct. This cross-sectional retrospective study quantified the ipsilesional and contralesional thalamus volume from 69 chronic stroke subjects' anatomical MRI data (age 35-92) and related the thalamus volume to time since stroke, gender, intracortical volume, age, and lesion volume.

Correcting Task fMRI Signals for Variability in Baseline CBF Improves BOLD-Behavior Relationships: A Feasibility Study in an Aging Model.

Blood Oxygen Level Dependent (BOLD) functional MRI is a complex neurovascular signal whose magnitude depends on baseline physiological factors such as cerebral blood flow (CBF). Because baseline CBF varies across the brain and is altered with aging, the interpretation of stand-alone aging-related BOLD changes can be misleading. The primary objective of this study was to develop a methodology that combines task fMRI and arterial spin labeling (ASL) techniques to sensitize task-induced BOLD activity by covarying out the baseline physiology (i.

Neuroplasticity and aphasia treatments: new approaches for an old problem.

Given the profound impact of language impairment after stroke (aphasia), neuroplasticity research is garnering considerable attention as means for eventually improving aphasia treatments and how they are delivered. Functional and structural neuroimaging studies indicate that aphasia treatments can recruit both residual and new neural mechanisms to improve language function and that neuroimaging modalities may hold promise in predicting treatment outcome. In relatively small clinical trials, both non-invasive brain stimulation and behavioural manipulations targeting activation or suppression of specific cortices can improve aphasia treatment outcomes.

A Preoperative Cognitive Screening Test Predicts Increased Length of Stay in a Frail Population: A Retrospective Case-Control Study.

Background: Frailty is associated with adverse perioperative outcomes including major morbidity, mortality, and increased length of stay. We sought to elucidate the role that a preoperatively assessed Mini-Cog can play in assessing the risk of adverse perioperative outcomes in a population at high risk of frailty.

Methods: In this retrospective case-control study, patients who were >60 years of age, nonambulatory, or had >5 documented medications were preoperatively assessed for handgrip strength, walking speed, and Mini-Cog score.

Self-Reported Body Weight Changes, Perceptions, and Weight Loss Techniques among Stroke Survivors.

Background: Little is known about the body weight goals and trends of stroke survivors, despite evidence that overweight and obesity can negatively influence poststroke rehabilitation outcomes. Thus, the purpose of this study was to identify self-reported body weight trends over time in stroke survivors and nonstroke controls (>50 years old) and describe the methods used to attempt to achieve body weight goals.

Methods: Self-reported body weight 1) at age 25 years, 2) 10 years prior to the current assessment, 3) 1 year prior to the current assessment, 4) current weight, and 5) age of heaviest body weight were collected from adults self-reporting a stroke in the 2011-2012 and 2013-2014 National Health and Nutrition Examination Surveys (stroke: N = 387 and nonstroke: N = 5085).

The Immediate Effects of Acute Aerobic Exercise on Cognition in Healthy Older Adults: A Systematic Review.

Background: Age-related cognitive decline is a worldwide challenge, highlighting the need for safe, effective interventions that benefit cognition in older adults. Harnessing the immediate and long-term pleiotropic effects of aerobic exercise is one approach that has gained increasing interest.

Objective: The aim of this review is to provide knowledge on the immediate effects of acute aerobic exercise on cognitive function of healthy older adults and to assess the methodological quality of studies investigating these effects.

The feasibility of delivering constraint-induced language therapy via the Internet.

Objective: This study is designed to determine the feasibility of the provision of an evidenced-based aphasia therapy, constraint-induced language therapy, via telerehabilitation. It describes the computer software that was developed specifically for the delivery of constraint-induced language therapy in the online environment and presents two case studies.

Methods: Two participants with chronic aphasia were assessed before and after a two-week intensive treatment block of constraint-induced language therapy delivered via Web-based videoconferencing.

Inattentive Delirium vs. Disorganized Thinking: A New Axis to Subcategorize PACU Delirium.

Assessment of patients for delirium in the Post Anesthesia Care Unit (PACU) is confounded by the residual effects of the varied anesthetic and analgesic regimens employed during surgery and by the physiological consequences of surgery such as pain. Nevertheless, delirium diagnosed at this early stage has been associated with adverse clinical outcomes. The last decade has seen the emergence of the confusion assessment method-intensive care unit (CAM-ICU) score as a quick practical method of detecting delirium in clinical situations.

Aerobic Exercise as an Adjuvant to Aphasia Therapy: Theory, Preliminary Findings, and Future Directions.

Purpose: This study investigated whether participation in aerobic exercise enhances the effects of aphasia therapy, and the degree to which basal serum brain-derived neurotropic factor (BDNF) concentrations fluctuate after the beginning of aerobic exercise or stretching activities in individuals with poststroke aphasia.

Methods: The study used a single-subject, multiple-baseline design. Seven individuals with chronic poststroke aphasia participated in 2 Blocks of aphasia therapy: aphasia therapy alone (Block 1), followed by aphasia therapy with the addition of aerobic activity via bicycle ergometer (n = 5) or stretching (n = 2) (Block 2).