Enhancing functional communication recovery of people with aphasia after a stroke: realising opportunities for enriching the communicative environment during routine rehabilitation

Simon Horton, Ciara Shiggins, Kathleen Lane

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Background: Studies in human and animal models indicate that recovery from stroke is enhanced by exposure to enriched environments and practice. People with aphasia (PWA) after stroke need to practice language in everyday situations for optimum recovery of communication function.

Objective: To establish whether opportunities to provide cost-neutral enriched environments for functional communication practice can be realised during routine stroke rehabilitation.

Methods: Video was used to record routine interactions between healthcare professionals (HCPs) and people with aphasia in in-patient and Early Supported Discharge stroke rehabilitation. We conducted semi-structured interviews with staff and patients. Datasets produced: 54 video-recordings of therapy and nursing interactions in diverse rehabilitation activities; interviews with 19 HCPs; and 9 PWA. Video and interview data were analysed using Activity-based Communication Analysis and inductive thematic analysis respectively.
Costs were derived from staff reports of changes to usual time taken for activities when communicating with PWA.

Results: Opportunities to provide communicatively enriched environments arose in both settings between PWA and staff from all professional groups. When realised these occasions increased experiential demands cognitively and socially on PWA and provided them with functional communication practice. However, opportunities were not consistently realised. Interviews suggested that time constraints, a lack of HCP training and low confidence in working with PWA may have contributed to these effects. There were small increases in staff time demands resulting from these interactions.

Conclusion : Opportunities to produce stimulating environments for functional communication practice can be realised during routine rehabilitation, but there are staff time cost and training implications.
Original languageEnglish
Publication statusPublished - 22 May 2017
EventInternational Congress on NeuroRehabilitation and Neural Repair - Maastricht, Belgium
Duration: 20 May 201522 May 2015


ConferenceInternational Congress on NeuroRehabilitation and Neural Repair


  • Stroke
  • Aphasia
  • Rehabilitation

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