Congruent vs. incongruent tasks in interdisciplinary stroke rehabilitation: a single-case report

Abstract

Purpose

Stroke survivors may experience challenges in multiple domains (e.g., speech-language, dexterity, mobility) and pursue services from multiple professionals. Clinicians typically provide rehabilitation services in back-to-back sessions (multidisciplinary). Alternatively, two or more clinicians can co-treat a stroke survivor in one session (interdisciplinary). This pilot project examined task congruency in interdisciplinary stroke care.

Method

A stroke survivor chronically challenged by non-fluent aphasia and right hemiparesis completed spoken-naming and upper-limb tasks simultaneously. The concurrent tasks were presented in two conditions: congruent (i.e., naming a pictured item while tracing the first letter of the name) and incongruent (i.e., naming a pictured item while tracing a non-symbolic shape). The sequence of the two conditions was: baseline probes, congruent practice (eight weeks), no practice (eight weeks), incongruent practice (eight weeks), and no practice (eight weeks). The entire treatment program was implemented as independent home practice utilizing a computer.

Results

The participant made significant improvements in naming and clinically meaningful gains in arm movements during the congruent condition, but not during the incongruent condition.

Conclusions

Data from this study suggest a potentially positive effect of simultaneous speech-language and upper-limb tasks. More research is warranted to further examine the role of task congruency in interdisciplinary stroke rehabilitation.

IMPLICATIONS FOR REHABILITATION

• Stroke survivors may chronically experience challenges in multiple domains (e.g., speech-language, dexterity, and mobility).

• Clinicians from multiple disciplines can collaborate and co-treat a stroke survivor within an interdisciplinary framework.

• During a co-treatment session, a stroke survivor can achieve greater gains by completing congruent tasks (e.g., saying the name of a pictured item while writing the first letter of the name with the impaired hand), compared to incongruent tasks (e.g., saying the name of a pictured item while tracing a non-symbolic shape with the impaired hand).

Keywords:

• Aphasia
• stroke
• hemiparesis
• interdisciplinary
• task congruency

Acknowledgements

Dr. Michael White and his colleagues at FTL Labs Corporation (Amherst, MA) provided a tabletop computer for the study. The authors would like to thank Ben and his wife.

Author contributions

YC took the lead in designing the study and writing the manuscript. AA, TF, TW, and RvE contributed to data collection, data analysis, manuscript preparation, and manuscript revisions.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was supported by the American Heart Association under the National Clinical Research Program [12CRP9010007].