Date Presented 04/01/2022
Over the course of 5 years, a total of 31 people with aphasia (PWA) participated in an Intensive Comprehensive Aphasia Program (ICAP), which included 4 hours of OT a week. Using the Activity Card Sort, this research study examined what goals PWA chose to address. Of 151 goals, PWA most frequently chose high demand leisure (27%) and instrumental (27%) activities. This provides support for OT in ICAPs to address these occupations affected by stroke.
Primary Author and Speaker: Migena Guhacaj
Additional Authors and Speakers: Mary Hildebrand
PURPOSE: The Spaulding-Institute of Health Professions Comprehensive Aphasia Program (S-IHPs CAP) is an annual six-week community-based intensive treatment program designed to maximize recovery and participation in life activities for people with aphasia (PWA). The purpose of the present study is to examine what valued occupations PWA chose to address and to examine the effectiveness of occupational therapy (OT) in an intensive comprehensive aphasia program (ICAP).
DESIGN: This study encompasses a retrospective quantitative pretest-posttest design. Convenience sampling was used to recruit participants from the MGH Institute of Health Profession’s Impact Practice Center, Spaulding Rehabilitation Hospital, and other community resources. Eligibility criteria included the following: (1) The presence of aphasia affecting life participation, (2) age 18 years or older, (3) at least 6 months post stroke, (4) an English speaker able to participate in 8 hours of treatment, 4 days a week for 5 weeks, (5) able to independently manage personal and medication needs, (6) able to obtain transportation to and from the program, and (7) not participating in any other forms of therapy (Nicholas et al., 2021).
METHOD: Over the course of 5 years, a total of 31 PWA participated in intensive interprofessional treatment which included 4 hours of OT a week. The Activity Card Sort (ACS) was modified by the authors and used to determine participants’ goals. The Canadian Occupational Performance Measure (COPM) was then used to measure participants’ performance and satisfaction of their goals pre and post intervention.
RESULTS: Modified ACS domains revealed a total of 151 goals across domains; 27% within high demand physical leisure; 27% in instrumental; 17% in social goals, 17% in low demand leisure, and 12 % in the technology domain. Significant change was found in performance and satisfaction across all five domains (p < .01).
CONCLUSIONS: Frequent goals within high demand physical leisure activities and instrumental domains suggests PWA desire to address participation in sports and exercise in addition to communication. This provides support for occupational therapy in ICAPs to address the physical impairments caused by stroke. Significant gains in COPM scores across domains may suggest a potential benefit of occupational therapy within ICAPs to support PWA in improving their occupational performance and satisfaction.
IMPACT STATEMENT: Occupational therapy should be represented in ICAPs to support PWA in improving their occupational performance and satisfaction throughout their valued occupations.
Eriksson, G., Aasnes, M., Tistad, M., Guidetti, S., & Koch, V. L. (2012). Occupational gaps in everyday life one year after stroke and the association with life satisfaction and impact of stroke. Topics in Stroke Rehabilitation, 19(3), 244–255. https://doi.org/10.1310/tsr1903-244
Escher, A. A., Amlani, A. M., Viani, A. M., & Berger, S. (2018). Occupational therapy in an intensive comprehensive aphasia program: Performance and satisfaction outcomes. American Journal of Occupational Therapy, 72(3), 7203205110. https://doi.org/10.5014/ajot.2018.026187
Nicholas, M., Pittmann, R., Pennington, S., Hildebrand, M., Connor, L. T., Ambrosi, D., Savastano, M., Wagner, L. B. (2021). Outcomes of an interprofessional ICAP’s first five years. Manuscript submitted for publication