Over time, Ms. Purvis, the speech therapist, stepped up the exercises: arrange numbers in descending order, repeat a sentence in reverse order. She created more noise and distraction to approach Ms. Lewis’s busy work environment. She held the door open, turned on the television news, and ended up having sessions in the bustling physical therapy gym.
Amid the buzz of treadmills, exercise bikes, and the conversations of other patients, Mrs. Lewis worked earnestly to arrange the playing cards in ascending order by suit and turn over numbers spelled with a “T,” such as “two.” At the same time, Mrs. Purvis would recite words and Mrs. Lewis would try to raise her hand if one started with ‘B’.
“You missed 12, which is a lot more than you normally miss,” Ms Purvis said.
‘Yes,’ sighed Mrs. Lewis, her fingers trembling.
Two days later, asked to start at 1 and repeatedly add 9 and subtract 4 until she reached 130, Ms. Lewis stopped and slowly stopped.
“Oh my God,” she exclaimed after she was done. “That one was more difficult.”
But later, she accurately recalled four quotes recited early in the session, including, “Rubber bands last longer when refrigerated.”
“It was a challenge,” she told Ms Purvis. “I don’t feel super discouraged, though.”
Because in some patients, physical or cognitive exertion exacerbates symptoms, said Dr. Roth that the AbilityLab urges patients to “push themselves as much as possible, but no further.”