Combined Aphasia and Robot-Assisted Arm Treatment for Chronic Stroke Survivors

项目总结/摘要 中风是美国残疾的主要原因，经常导致语言和运动障碍。 在专业、社会和家庭环境中造成参与障碍的缺陷。模态 康复方法将语言和运动领域的治疗分开，这有助于 中风恢复的时间和费用。共同治疗方法是可取的，既加强治疗， 效率和潜在的低成本，但我们可以在多大程度上促进（而不是抑制）复苏 通过跨领域联合治疗的方法尚未得到系统的探索。本课题 将针对命名障碍计算机化失语症治疗整合到机器人辅助上肢治疗中 同时保留每种治疗的关键方面。这项工作将提供一个基本的测试， 我们是否可以用一种单一的联合疗法来减少语言和运动领域的损伤， 治疗我们的长期目标是创造有效和高效的方法来恢复失语症， 语言和运动缺陷的慢性中风幸存者， 传统的康复领域。这一建议的核心假设是，我们可以减少 通过以保留每个领域的关键方面的方式组合治疗，来消除每个领域的损伤。 这一中心假设将通过追求三个具体目标来检验：1）确定是否 将失语症治疗与机器人辅助手臂治疗相结合， 慢性中风; 2）确定是否将失语症治疗与机器人辅助手臂治疗相结合 支持慢性中风的运动恢复; 3）探索失语症治疗与机器人治疗相结合是否可行， 辅助手臂处理特别地增强了与手臂运动相关联的词汇项的提取。 在前两个目标下，我们将直接测试联合治疗是否能减少 每个领域，朝着开发更大的II期临床试验的关键一步。第三个探索目标 测试是否结合手臂康复与失语症治疗，特别是提高回忆 与手臂相关的词汇能够激活未受损个体的运动皮层。拟议研究 代表了中风康复大背景下失语症治疗的创新方法， 结合语言和运动领域的治疗方法，促进慢性中风的康复。 这项研究意义重大，因为它测试了语言-运动组合在多大程度上 治疗可以增强单词提取，同时它是否支持运动治疗。该组合 治疗将构成II期试验的基础，作为未来R 01的一部分，以测试 与传统治疗方法相比。这一系列的研究是基于 跨领域的研究有可能导致中风康复的范式转变。

PROJECT SUMMARY/ABSTRACT Stroke is a leading cause of disability in the United States, frequently leading to both language and motor impairment that creates barriers to participation in professional, social, and family settings. The modal approach to rehabilitation separates treatment in language and motor domains, which contributes to the time and expense of stroke recovery. Co-treatment approaches are desirable to both enhance treatment efficiency and potentially lower costs, but the extent to which we can promote (and not dampen) recovery by combining treatment across domains has not been systematically explored. In this project, we integrate a computerized aphasia therapy targeting anomia into robot-assisted upper-extremity treatment while preserving the critical aspects of each treatment. This work will provide a foundational test of whether we can reduce impairment in both language and motor domains with a single combined treatment. Our long-term goal is to create effective and efficient approaches to aphasia recovery in chronic stroke survivors with both language and motor deficits by combining treatment across these traditionally-distinct rehabilitation domains. The central hypothesis of this proposal is that we can reduce impairment in each domain by combining treatments in a manner that retains the critical aspects of each. This central hypothesis will be tested by pursuing three specific aims: 1) determine the whether combining aphasia treatment with robot-assisted arm treatment can improve language outcomes in chronic stroke; 2) determine whether combining aphasia treatment with robot-assisted arm treatment supports motor recovery in chronic stroke; 3) explore whether combining aphasia treatment with robot- assisted arm treatment specifically enhances retrieval of lexical items associated with arm movement. Under the first two aims, we will directly test whether the combined treatment can reduce impairment in each domain, a critical step towards developing a larger Phase II clinical trial. The third exploratory aim tests whether the combining arm-based rehabilitation with aphasia treatment specifically enhances recall of arm-related words that activate motor cortex in unimpaired individuals. The proposed research represents an innovative approach to aphasia treatment within the larger context of stroke rehabilitation, combining therapeutic methods across language and motor domains to promote recovery in chronic stroke. The proposed research is significant because it tests the extent to which a combined language-motor treatment can enhance word retrieval and simultaneously whether it supports motor treatment. This combined treatment will form the basis of a Phase II trial as part of a future R01 powered to test the effectiveness of combined treatment compared to traditional approaches. This line of research based on combining treatment across domains has the potential to lead to a paradigm shift in stroke rehabilitation.