Disclosures: Ian A. Logan, MD: Nothing to disclose

Case Description: During 2-week periods in 2017 and 2018, we piloted PIIRATE as an innovative use of inpatient rehabilitation. As part of the program, patients were admitted to the inpatient rehabilitation unit and received medical oversight of a rehabilitation physician, access to rehabilitation nursing care, recreation therapy and intensive speech therapy. Patients were seen for therapy 5 days each week, for up to 6 hours. A typical day of therapy consisted of 4 hours of speech therapy that was individualized based on their specific deficits, 1 hour of group speech therapy, and 1 hour of recreational therapy. Additional supervised community outings occurred once per week to practice learned skills.

Setting: Veterans Affairs Health Care System.

Patient: Three patients with aphasia secondary to ischemic or hemorrhagic stroke participated in a Program for Intensive Inpatient Rehabilitation Treatment and Education (PIIRATE).

Assessment/Results: At the completion of the 2-week program, all 3 patients demonstrated improvement in overall severity of their aphasia as evidenced by improved mean modality index score on the Comprehensive Aphasia Test. Communication efficiency improved in all 3 patients to slightly varying degrees as evidenced by improved spoken words per minute in 2 out of 3 patients and improved content information units in all 3 patients. Finally, all 3 patients reported improved self-perception of functional limitations of their speech and language impairment.

Discussion: Intensive inpatient speech therapy, for as little as 2 weeks, can provide meaningful improvements in post-stroke patients with chronic aphasia both on objective testing measures and in self-perception of their impairments.

Conclusion: High intensity inpatient speech therapy delivery models should be considered for individuals with post-stroke chronic aphasia, particularly those who have limited outpatient treatment options due to mobility or self-care impairments.

Level of Evidence: Level V

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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/novel-use-of-inpatient-rehabilitation-to-deliver-best-practice-treatment-for-chronic-aphasia-a-case-series/