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Abstract
One third of stroke patients suffer from language disorders. Recently, Intensive Language Action Therapy (ILAT) emerged as a novel paradigm for aphasia rehabilitation. In the present study, we designed and developed a virtual reality (VR) based language rehabilitation tool by integrating ILAT's object request Language Action Game (LAG) in a Rehabilitation Gaming System (RGS), a novel paradigm for the rehabilitation of motor deficits after lesions to the central nervous system. RGS is an environment that provides multimodal, task specific training in virtual reality scenarios. Its special design consists of a motion detection system that monitors users' movements, which allows for an active interaction, as well as continuous evaluation of the performance. We address the question of whether aphasia rehabilitation designed within the VR environment of RGS can be effective. We report the results of a double-case pilot study where one acute and one chronic aphasic patient followed five RGS-ILAT therapy sessions. Before and after the treatment, we evaluated their language skills using the Communication Activity Log (CAL) and Western Aphasia Battery (WAB) scales. Results show that the patients learnt how to interact within the VR system. The CAL performance suggests that both patients and their therapist perceived improvements in communication skills after the intervention. Additionally, both approval and acceptance of the system were high. Based on this initial outcome we will provide the present RGS-ILAT with further advancements and evaluate the system with higher number of patients.
Keywords: Stroke, aphasia, Broca's aphasia, neurorehabilitation, language-action mechanisms, virtual reality
Introduction
Stroke is a neurological disease which causes the most common disabilities (1). 35-40% of stroke patients suffer serious language deficits, such as aphasia, which are often accompanied by anxiety, depression and social withdrawal (2). Traditional aphasia therapies mostly focus on repeating separate units ("dog", "car", "bottle"). The frequency ("door" vs. "cutlery") of the practiced lexicon gradually changes depending on the patient's progress (3). These methods usually do not put emphasis on the importance of intense language practice, adapted to the personal needs of each patient, within a meaningful context. Alternative treatment and rehabilitation methods are therefore required in order to achieve successful recovery.
Recently, the relation between language, action and its neural substrate has shed light onto the composite structure of the language processing...