Modularity in rehabilitation of working memory: A single-case study

摘要

The objective of the present study was to assess the specificity of rehabilitation on different subdomains of working memory. A 38-year-old female with chronic (4 years) stroke suffered from an impairment of the three subdomains of working memory (modality-specific storage systems for verbal and visuo-spatial information and the central executive). She was given an experimental rehabilitation programme, using a multiple-baseline across behaviour design. After two baseline measures three months apart, the first training stage focused on the phonological loop, the second on the visuo-spatial sketchpad, and the third on central executive functions. Verbal aspects of working memory improved significantly after the first training stage, while visuo-spatial tests improved after the second training stage. Central executive functions improved mainly after the third training stage. Modularity effects were not as pronounced for less specific ecological outcome measures, such as the Working Memory Questionnaire, which improved throughout the trial, irrespective of the training condition. This case study suggests that there are both domain-specific and generalisation effects in rehabilitation of working memory, and that rehabilitation should be adapted and tailored to each individual patient's impairments.