Faculty’s work to bridge the gap between practice and research is latest in series of initiatives designed to improve the lives of stroke survivors
When the Tedy’s Team Center of Excellence in Stroke Recovery was launched in early 2023, one of its key goals was to research the effects of stroke on areas like speech, language, and brain activity.
To jump start the initiative, four faculty members from the Department of Communication Sciences and Disorders have been named Tedy’s Team Research Fellows. CSD Assistant Professor Dr. Megan Schliep, mentored by PT Professor Dr. Prue Plummer; CSD Associate Professor Dr. Lauren Zipse; and the team of CSD Instructors Esther Ayuk and Suzanne Pennington, mentored by CSD Chair Dr. Marjorie Nicholas, have been awarded seed funding from the Institute that they will use to collect pilot data with the goal of using it to apply for external funding to advance their research.
“The goal is for the faculty to help advance the mission of the Tedy’s Team Center and bridge the gap between practice and research,” said Dr. Kimberly Erler, the Center’s inaugural director. “They will engage directly with stakeholders and seek input from stroke survivors and their care partners.”
The three grants are:
- “Identifying the moderating roles of psychosocial, physical activity, and communication factors on fall status after stroke using ecological momentary assessment.”
Schliep will use ecological momentary assessment (EMA) to collect real-time information several times a day via text message about stroke survivors’ daily activities, including what they are engaged in, where, with whom, and how they are feeling in the moment in regard to mood and ability to concentrate. The survey participants will include people with and without aphasia.
- “Scaling up: Piloting a home-practice version of Melodic Intonation Therapy.”
Zipse will develop and test a home-practice version of an established aphasia treatment called Melodic Intonation Therapy, and test whether home practice can be used successfully to increase treatment dosage. If home practice is effective, it can allow people with aphasia to receive more frequent treatment over a longer period of time than most get following a stroke.
- “Activating Life Participation: Tracking outcomes after an Intensive Comprehensive Aphasia Program (ICAP.)”
Ayuk and Pennington will design an aphasia-appropriate Behavioral Activation (BA) treatment program to address activity engagement after an ICAP program. Clients who recently completed the Spaulding Rehabilitation – Institute ICAP will be recruited for the project and will be followed for up to a year. Findings will provide insight into the effectiveness of their aphasia-adapted BA treatment program and highlight barriers and facilitators of activity engagement post-ICAP.
At the Institute, the ICAP program is called S-IHP’s CAP. It’s a 6-week intensive treatment program where students in the speech-language pathology and occupational therapy programs work with people with post-stroke aphasia designed to maximize their recovery and return to activities. The program is a collaboration with Spaulding Rehabilitation Hospital.
On a recent afternoon, Schliep, along with her project mentor, professor of physical therapy Prue Plummer, presented questions of her proposed survey to clients in the Aphasia Center at the Sanders IMPACT Practice Center, with which the Tedy’s Team Center collaborates. The clients all have aphasia, a condition that impairs the expression and understanding of language as well as reading and writing. As Schliep displayed each proposed question and response options on a monitor, the clients provided their thoughts on how each could be improved. A consistent comment involved response format, with clients noting that the inclusion of multiple formats, such as presenting both a 1-10 scale and pain emoji, would allow participants to respond more easily using an option with which they felt comfortable.
“The group’s insights were really reflective and will be extremely helpful for us,” said Schliep, who noted that more than 20 survey participants will be recruited from Spaulding. “This is the kind of feedback we needed.”
The Tedy’s Team Center of Excellence in Stroke Recovery was made possible thanks to a $1 million gift by Tedy’s Team, the charitable entity that uses running as a platform for stroke awareness and philanthropy. It was co-founded by former New England Patriot great Tedy Bruschi and his wife, Heidi, after Tedy suffered a stroke at the age of 31. Through his rehabilitation, Bruschi made a stunning return to professional football. The Bruschis are hoping fellow stroke survivors being assisted at the MGH Institute will have the same opportunity for a comeback as Tedy received.
During the first few months of the Center’s operation, it treated 70 stroke survivors who sought treatment for aphasia, physical therapy, occupational therapy, and nutrition/overall health. One client is Tony Spirito, who lost his ability to communicate and comprehend written or spoken language clearly and fully after having a stroke in 2004. Spirito, who has been working with faculty-supervised students for several years, has made significant strides since that time.
“I have come a long way since Day 1, when I could not utter nor understand a word, and there is still a long way to go,” said Spirito, who works with speech-language pathology students in the Aphasia Center. “My journey would not be nearly as steady and strong as it has been without this support. There is a magical mix that happens between the staff, students, and clients that just brings out the best in everyone. There is a lot of hard work and learning wrapped up with caring and celebration of achievements.”
In addition to the three research projects being funded, 17 research papers were published on stroke treatment and outcomes in journals on topics that included investigating treatments for deficits after stroke in motor and physical function and language, exploring the use of technology, clinical measures, and other client characteristics to assessing and predicting various outcomes after stroke such as motor recovery, language ability, falls, and participation, and developing educational and support interventions for caregivers of stroke survivors. The articles were published in journals that include Topics in Stroke Rehabilitation, Neurorehabilitation and Neural Repair, American Journal of Occupational Therapy, and Brain Sciences.
“I am particularly impressed by the breadth of topics covered in these papers,” said Associate Provost for Research, Dr. Nara Gavini, oversees these efforts. “This shows that the Institute is committed to a comprehensive approach to stroke research, addressing all aspects of the disease from prevention and treatment to rehabilitation and support.”
The third component of the Tedy’s Team Center mission is community outreach. Tedy Bruschi credited his recovery, in part, to knowing the signs of stroke which he says are not particularly well known. That spurred the creation of BE FAST, an acronym to help people quickly recognize its symptoms. It stands for Balance difficulties, Eyesight changes, Face dropping, Arm weakness, Speech difficulties, and Time to call 911.
Outreach initiatives, led by Community Outreach Coordinator Dr. Gwen Larsen, have included a Wellness Walk at the New England Aquarium for stroke survivors in partnership with the Coalition for Resilient and Inclusive Waterfront, a talk at ABCD in the North End in partnership with New Health on stroke awareness and prevention, participation in a health fair at New Health in Charlestown promoting stroke awareness and prevention, and being part of the Institute’s annual Community IMPACT Day. The Center’s first talk, “Rebuilding Identity After Stroke,” was held November 14, while on November 28 a social event was held for clients who have been assisted in the IPC and the Center.
“The Center has been instrumental in providing multifaceted and comprehensive treatment services to stroke survivors,” said Erler. “We are committed to sustaining these efforts, always striving to improve and innovate for the benefit of stroke survivors and the broader community.”
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