How ASPAYM CyL Uses NeuronUP to Address All the Center’s Specialties

Raquel Vicente Fernández y Onil Gutiérrez Martín, del equipo de ASPAYM CyL en Burgos, presentan en este artículo la experiencia de ASPAYM Castile and León con NeuronUP en el trabajo de diferentes especialidades.

Presentation of ASPAYM Castile and León

ASPAYM Castile and León is a neurorehabilitation center where we offer specialized and personalized care to people who have suffered brain injury, whether due to an accident, illness or injury. We have a multidisciplinary team of qualified professionals in which we all work closely together to design and implement recovery programs tailored to each patient’s needs.

This year, our Burgos branch celebrated its tenth anniversary. Since our opening in 2015, the organization has worked to improve the quality of life of people with disabilities in the province, establishing itself as a benchmark in neurological rehabilitation and comprehensive care.

Professional team of ASPAYM CyL in Burgos

In our neurorehabilitation center we have a highly specialized multidisciplinary team. The coordinated work of our different disciplines allows us to approach rehabilitation in a comprehensive way, focused on the person and their needs.

Our team consists of: 

• Speech-language therapists: responsible for the evaluation and treatment of language disorders, speech, voice, communication and swallowing. Intervention is essential in cases of aphasia, dysarthria, dysphagia or other disorders derived from neurological injuries.
• Physiotherapists: specialists in the recovery of movement, strength, balance and gait. They use specific techniques to treat motor and neuromuscular alterations, promoting functional independence.
• Occupational therapists: work so that the person can return to performing their activities of daily living (such as dressing, washing or cooking), using functional interventions, environmental adaptations and assistive products.
• Neuropsychologists: evaluate and treat cognitive (memory, attention, executive functions…) and behavioral disorders. They also provide emotional support, accompanying the person and their family in the process of adaptation and coping.
• Social workers: act as a link between the family, social and health environments. They offer guidance on social resources, support in managing benefits and advice on processes of social and work reintegration.

In addition, we have a day center specialized in neurorehabilitation. In this space daily therapeutic activities, cognitive, physical and functional interventions, accompaniment and constant stimulation are promoted in a safe and motivating environment.

Specialties of ASPAYM CyL in Burgos

Below we detail not only the different disciplines that make up ASPAYM Castile and León in the Burgos branch but how each one integrates NeuronUP into their daily practice. 

Speech Therapy

In our speech therapy service we use NeuronUP as a complementary tool to enhance therapeutic intervention, especially in cases of aphasia and dysarthria.

Before starting, the specific areas of difficulty for each patient are identified, such as comprehension, expression, naming, articulation, reading and writing, verbal fluency… Based on the results, we design training adapted for each patient. NeuronUP offers us a variety of exercises that we can select and modify to work on aspects such as memory, attention, language and oral motor skills. 

In cases of aphasia, for example, we can work on the recovery of vocabulary, comprehension and expression. In dysarthrias we focus on improving articulation and orofacial motor coordination through activities that stimulate fine motor skills and coordination.

Since the platform offers an interactive and playful environment, patients are motivated to actively participate in their recovery process, which is essential to maintain interest and consistency in the sessions.

Occupational Therapy

From our Occupational Therapy Department we use NeuronUP as a support tool for our usual treatment with patients with acquired brain injury (ABI). 

After the initial assessment we are able to identify which occupational areas have been affected, specify in which tasks the person needs support or rehabilitation and analyze which abilities are impairing our user’s functionality. 

It is here that NeuronUP allows us, through its multiple programmable activities, to enhance the cognitive and perceptual abilities involved in activities of daily living (ADLs) by providing us, through learning environments:

1. The possibility of offering a meaningful therapeutic experience.
2. To provide a more realistic context (especially when intervention in the natural context is not possible or when we are working prior to being able to generalize it).
3. And to improve participation in instrumental activities of daily living. 

It is a great ally to work on perceptual impairments such as attentional hemineglect, and learning of non-use of the affected side, for example.

Activities of Daily Living (ADLs): definition, classification, and exercises

It offers good patient adherence to treatment because of:

1. The variety of exercises available; 
2. Its pseudo-gamified nature;
3. Because of the possibilities to adapt the complexity of tasks (through sizes, times, number of stimuli…); 
4. And for the possibility it provides to monitor progress which are then shared with users and families.

Physiotherapy

From the field of Physiotherapy, it is possible to reinforce cognitive functions essential for motor execution, such as attention, memory, planning and executive functions, among others. This approach helps to provide continuity to the interventions carried out by other disciplines.

After an acquired brain injury, the ability to perform dual-task activities — understood as the simultaneous execution of two tasks with different and independent objectives — is often compromised, particularly affecting the level of attention devoted to each of them. 

In this context, the NeuronUP platform offers the possibility of specific dual-task training, prioritizing the cognitive activity over postural control.

It also allows working on other relevant aspects such as head orientation, maintenance of the midline, gaze fixation and eye-hand coordination. All of this is carried out in a playful environment, with the possibility of adapting the level of difficulty according to the individual needs of each patient.

Clinical case of integration of the AAC with NeuronUP for the treatment of aphasia

Below, we present the case of a patient with the initial diagnosis of global aphasia transitioning to severe Broca’s aphasia. Because of this, the patient’s communicative area is highly affected, especially in initiation and spontaneity. Their speech is nonfluent, with pauses to search for words and anomia. Grammar is very simple; the style is telegraphic.

There has been prolonged work using an augmentative and alternative communication system (AAC) as a support tool with the aim of compensating for verbal expression difficulties derived from neurological injury, enabling the patient to communicate functionally. We seek to preserve and enhance the patient’s communicative ability; to that end, we integrate a combined intervention with NeuronUP. 

By working this way:

• We reinforce communicative intent: even if the patient cannot say the word, they continue participating in the conversation through the AAC.
• We stimulate vocabulary acquisition: by using the word in the AAC while working with NeuronUP, we reinforce the word-meaning association.

Thanks to the work with the platform new vocabulary emerges that we take advantage of to review and expand in the AAC.

Currently we have selected some activities that I detail below as communicative stimuli:

• Activities aimed at strengthening the relationship between concepts and their visual representations, supporting vocabulary recall and facilitating expression.
• Construction of simple sentences: exercises that allow ordering words to form coherent sentences, favoring the organization of expressive language in a visual and structured way.
• Selection of the correct response: the user must select the appropriate word or image according to the presented context.
• We include attention and functional memory activities.

Some NeuronUP activities are:

• Matching Nouns to Images, worksheets aimed at working on vocabulary where users have to match each noun with the image that represents it.
• Organize Your House, worksheets to train Place Orientation. They consist of locating where various objects would be in the house.
• Half-hidden Objects, worksheets to work on visual gnosis and semantic memory where users must recognize partially obscured objects and select those that meet the requested requirement.
• Objects, places and professionals, worksheets to train Place Orientation and shopping, where users have to relate various objects to the places where they are obtained and the professionals in charge.
• Household Objects. These are also worksheets to work on Place Orientation. In this case, users must locate where various objects would be in the house.
• Name objects with phonological cues, worksheets aimed at training naming which consist of naming objects with the help of phonological cues.
• Correct Image Name, discrimination worksheets where you must exclude the word that corresponds to the presented image. 
• Among others.

After a period of intervention using the combined approach between the AAC and the NeuronUP platform, an improvement in the functional communicative ability of our patient with severe Broca’s aphasia has been observed. The following has been evidenced:

1. Greater communicative initiative, 
2. an increase in accuracy when selecting words or images, 
3. greater participation in communicative tasks, both in therapeutic and everyday settings, 
4. as well as a reduction in communicative frustration. 

The integration of the AAC with NeuronUP in speech therapy provides a therapeutic synergy that significantly favors the communicative rehabilitation of patients with aphasia. From the speech therapy area of ASPAYM Burgos we recommend its implementation as a therapeutic strategy in cases of expressive language disorders.

Conclusion

We firmly believe in the value of coordinated work and in the use of innovative tools that help us provide individualized, effective, and evidence-based care, which is why we use NeuronUP as a key support platform in our intervention.

If you liked this article about how ASPAYM uses NeuronUP to work across all the center’s specialties, you will probably be interested in these NeuronUP articles:

“This article has been translated. Link to the original article in Spanish:”
Cómo utiliza ASPAYM CyL NeuronUP para trabajar todas las especialidades del centro