IEEE Robotics & Automation Magazine - March 2023 - 89

cognitive processing based on the involvement of internal representations
(orthographic, semantics, and phonology), and the
output of the exercise (the answer). Each type of exercise, therefore,
insists on different structures of internal representation,
having a complete therapeutic effect on the significant aspects
of speech processing: motor-phonological and lexical-semantic
[5]. The speech-therapy sections started with simple instructions
and hints were provided as well.
Based on the target of the exercise, the interaction
between the patient and the System@Home follows these
main four steps:
1) The description of the exercise and the subjects to be recognized
are displayed at the top of the screen; the stimulus can
be: an image of an object (e.g., a dog, a ball, a computer) or a
scene (e.g., a dog running on the lawn); a
syllable, a word (e.g., " pen, " " glass, " " bottle, "
" phone " ), or a phrase (e.g., " a baby
laughs at his mother " ); or a sound (e.g., a
voice pronouncing a syllable, a word, or a
more complex phrase).
LANGUAGE
DOMAIN
2) At the top of the screen the system displays
two or more choices, only one of
which is correct.
3) The patient moves the cursor using gestures,
mouse, or keyboard to select his
or her answer.
4) A graphical metaphor of a counter (e.g.,
a growing bar, a growing laughing green
smile) representing the patient's completeness
and proficiency in performing
the exercise is displayed on the screen.
With these prerequisites, the specialists
can monitor the progress of the treatment
program carried out by the patients,
constantly reviewing and, if necessary,
modifying the planned rehabilitation
program treatment.
The delivery method involves the use of
the SmartCARE platform, through which
the patient performs the tasks previously
selected by the expert in relation to the
difficulties identified after the tests at the
beginning of the study. In this pilot study,
the exercises focused mainly on the area
of comprehension, especially receptive
language and naming. The area of production,
including repetition, writing, and
fluency, was worked on during a weekly
face-to-face video session scheduled by
the speech therapists.
PARTICIPANTS
Forty-eight out-patient individuals with
stroke were monitored at our institute's
Neuro-Rehabilitation Unit and its Day
Hospital Unit to determine their eligibility.
Auditory
Comprehension
of words (nouns,
verbs), syllables
Inclusion criteria were defined as follows: age ≥ 18 years;
unilateral ischemic or hemorrhagic stroke diagnosis; diagnosis
proven by computed tomography or magnetic resonance
imaging; stroke in chronic phase: distance from an
acute event more than six months; diagnosis of mild or
medium aphasia (ischemic or hemorrhagic nature, affecting
comprehension or production). Exclusion criteria were the
following: severe cognitive impairment or behavioral dysfunction
that does not make possible the understanding of
the planned activities and participation in the trial, the presence
of comorbidities that could affect the overall functioning
of the subject, or refusal to sign the informed consent.
Sixteen subjects who met the study inclusion and
exclusion criteria were recruited after signing the written
TABLE 1. Aphasia exercises list.
DOMAIN
EXERCISE
DESCRIPTION
Identification of an
auditory word
through images
(image identification)
Identification of
auditory/written
word in absence/
presence of images
Auditory/written
identification of
syllables in absence/
presence of images
Auditory/visual
coupling
Auditory
comprehension
of sentences
Comprehension
Reading
comprehension
of words
(nouns, verbs)
Identification of
auditory sentence
through corresponding
image
(sentence-image
matching)
Identification of
written word through
corresponding
image (word-image
matching)
Identification of
image through
written words
(image-word
matching)
Reading
comprehension
of sentences
Identification of a
written sentence
through corresponding
image
(sentence-image
matching)
Identification of
image of a scene
through written
sentence (scenewritten
sentences
matching)
STIMULI
(INPUT)
Sound of
a word
Sound of
a word
Sound
of a
syllable/s
Sound
of a
sentence
Sound
of a
sentence
RESPONSES
(OUTPUT)
Noun
image
Written
word
Written
syllable/s
Written
sentence
Image of
a scene
Written
word
Image of
a noun
Image of
a noun
Written
word
Written
sentence
Image of
a scene
Image of
a scene
Written
sentence
MARCH 2023 IEEE ROBOTICS & AUTOMATION MAGAZINE
89
IEEE Robotics & Automation Magazine - March 2023

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