| In 2001, stroke was the fourth leading cause of death in Canada, with an associated cost of about {dollar}4 billion to the Canadian economy, annually (Canadian Institute of Health Research, 2002). The aging population further compounds the burden of stroke on the health-care system. It is estimated that the incidence of stroke will increase by 31% within the next seven years, as a consequence of the aging population (Canadian Institute of Health Research, 2002).; Approximately 50 thousand stroke-related disabilities occur each year (Canadian Institute of Health Research, 2002). Although stroke is a leading cause of adult neurological disability, effective treatment approaches have not been developed. To date, outcome studies aimed at examining rehabilitation of cognitive functions in patients with acquired brain injury have not been encouraging, with little performance improvement directly attributable to the rehabilitation treatment (Park & Ingles, 2001). In addition, no published studies have been found that investigate how Patients with a Stroke in rehabilitation perform when given novel tasks.; Many Patients with a Stroke have impaired strategic or controlled processing. This impairment makes it difficult to perform novel actions accurately (Shallice & Burgess, 1993). The present research examines the role of verbal scaffolding, a step-by-step, verbally mediated, and structured rehabilitation process, in facilitating the acquisition of new action tasks in Patients with a Stroke (Park & Ingles, 2001). The results from the present research support the hypothesis that verbal mediation in the scaffolded training condition facilitates novel naturalistic action task performance by Patients with a Stroke. The Patients with a Stroke (n = 18), recruited from two rehabilitation facilities, learned the novel naturalistic action tasks in fewer trials, made fewer errors, but required more time to perform the tasks than the Patients with a Stroke in the unscaffolded training condition. The influence of the scaffolded and unscaffolded training conditions on the control participants (n = 16), matched by age, gender, and years of education with the Patients with a Stroke, did not yield any demonstrable differences in performance.; The performance of the Patients with a Stroke by hemisphere was also considered, however no differences in total trials, number of errors or total time were observed between the left-hemisphere (n = 8) and right-hemisphere-damaged (n = 10) Patients with a Stroke in either training condition. A secondary contribution of the present research was to evaluate the Kaplan-Baycrest Assessment of Neuropsychological Status (K-BANS; Leach, Kaplan, Rewilak, Richards, & Proulx, 2000) with Patients with a Stroke; however, this assessment instrument was not found to be sensitive to the cognitive impairments in the present sample of Patients with a Stroke.; This thesis will contribute to the development of a new approach to rehabilitation using novel action sequences, which will increase patient independence, and decrease the burden on health care systems. |
