10 therapy tasks practiced most frequently by survivors of stroke

Stroke can impact all aspects of life—movement, communication, thinking, and autonomic functions such as swallowing and breathing. Research shows that early and specialized stroke rehabilitation can help to optimize an individual’s physical and cognitive recovery and enhance quality of life. Here, we identify the Constant Therapy tasks used most often by those recovering from stroke.

The goal of stroke therapy: help people regain lost skills

According to the Centers for Disease Control, about 87 percent of all strokes are ischemic strokes, in which blood flow to the brain is blocked. According to the American Speech-Language-Hearing Association, individuals with aphasia or other cognitive-communication issues represent up to 20 percent of the adult caseload for speech-language pathologists in the United States. 

Typical goals of stroke therapy include:

• Restoring physical function and enhance the skills needed to perform daily activities
• Building strength, improving balance and regaining mobility
• Improving areas such as speech, language, cognition, or swallowing
• Developing new behavioral or compensatory strategies

Analysis: how is Constant Therapy being used with this population?

Constant Therapy uses artificial intelligence and data analytics to provide each user with a personalized brain exercise program targeting areas such as memory, attention, problem-solving, math, language, reading, writing, and many other skills. Research published in the Journal Frontiers in Human Neuroscience showed a significant improvement in standardized tests for survivors of stroke using the iPad-based rehabilitation technology of Constant Therapy.

An analysis of Constant Therapy users identified what tasks are assigned most frequently by clinicians working with survivors of stroke.

• We looked at data on 18,230 users who identified a diagnosis of stroke on the app.
• These 18,230 users completed an average of 572 tasks each
• Total tasks completed numbered 837,700.

The Constant Therapy tasks listed below are the 10 most frequently assigned by clinicians for their clients recovering from stroke.

The top 10 Constant Therapy exercises assigned by clinicians to patients recovering from stroke

1. Follow instructions you hear: Works on auditory memory and auditory comprehension through following directions. 
Individuals Assigned: 10,207
Percent of Users Identified As Recovering from Stroke 56%

 2. Find the same symbols: Cognitive skills such as attention can be affected after a stroke. Find the same symbols targets a variety of skills which includes attention, visuospatial processing, and executive functioning. 
Individuals Assigned: 9,216
Percent of Users Identified As Recovering from Stroke: 51%

3. Put steps in order: For people recovering from a stroke, executive functioning skills may be affected.  In this planning & organizing task, you are presented with steps of daily activities, and must drag these steps into the correct order. This is a great task for people working on sentence level reading comprehension too! 
Individuals Assigned: 8,814
Percent of Users Identified As Recovering from Stroke: 48% 

4. Match pictures: For people with cognitive, speech, or language disorders, this task helps visual memory by matching pictures displayed on a grid. For people recovering from a stroke who are working on word retrieval, they can also practice naming the pairs of pictures that they match.
Individuals Assigned: 7,629
Percent of Users Identified As Recovering from Stroke: 42%

5. Remember pictures in order (N-Back): This memory task specifically targets an aspect of working memory called updating. There are 3 levels of difficulty. In Level 1, you must remember the order of the pictures from 1 picture ago. In level 3 you must recall 3 pictures ago. Want more N-Back Tasks? Do Remember spoken word order (N-Back) and Remember written words in order (N-back), too!
Individuals Assigned: 7,213
Percent of Users Identified As Recovering from Stroke: 40%

6. Do clock math: Stroke can affect number skills, math skills, and word finding. This task helps improve time-based calculation skills by answering math questions associated with clocks.
Individuals Assigned: 6,701
Percent of Users Identified As Recovering from Stroke: 37%

7. Name Pictures: Helps improve word retrieval skills by speaking the name of presented images. There are 3 levels to this task, with each level increasing in word difficulty. Different cues include semantic, phonemic, graphemic, and whole word cues.
Individuals Assigned: 6,635
Percent of Users Identified As Recovering from Stroke: 36%

8. Repeat a pattern: This task works on attention, visual working memory, and visuospatial skills.
Individuals Assigned: 6,433
Percent of Users Identified As Recovering from Stroke: 35%

9. Understand voicemail: This functional task works on comprehension and memory of everyday language by answering questions about voicemails. Looking for a bigger challenge? Check out Infer from voicemail as well. 
Individuals Assigned: 6,085|
Percent of Users Identified As Recovering from Stroke: 33%

10. Remember the right card: This task works on attention, disinhibition, and processing speed. The patient is asked to remember a playing card and tap on that card whenever it is presented in a series of cards.
Individuals Assigned: 5,690
Percent of Users Identified As Recovering from Stroke: 31%

References

• Des Roches, C., Kiran, S. and Balachandran, I. (2015). Frontiers in Human Neuroscience, Effectiveness of an impairment-based individualized rehabilitation program using an iPad-based software platform, 2015 Jan 5. doi:  10.3389/fnhum.2014.01015.
• Centers for Disease Control and Prevention (2018). Stroke Facts.
• ASHA (2017). SLP Healthcare Survey: Caseload Characterisics.