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Speech pathologist helps stroke survivors recover
June 10, 2015(Missouri) In this special Stroke...series, four Lake Regional Health System care providers — an emergency department nurse, a neurologist, a physical therapist and a speech therapist — share important tips for surviving a stroke with maximum health and ability.
Lake Regional Speech Pathologist Laura Davis finds much fulfillment in helping stroke survivors regain lost abilities.
“It’s a great job,” she said. “I like helping people who have had a stroke get back as much of their lives and abilities as they can. I also like helping them come to terms with differences in their abilities after a stroke.”
At Lake Regional, most stroke patients begin speech therapy within the first 24 hours of their stroke. Speech therapists work with stroke patients in the hospital and in the hospital’s skilled nursing facility. They also visit home health patients and provide outpatient services, both at Lake Regional Hospital and at Lake Regional’s clinics.
Rewiring the Brain
Speech therapy for stroke survivors works because of neuroplasticity, or the brain’s ability to rewire itself after an injury.
“Therapy helps survivors with this rewiring,” Davis said. “Stroke survivors can build new connections in and around the damaged area, or even in similar areas on the opposite side of the brain, to give stroke survivors back lost abilities.”
The abilities speech pathologists help survivors recover include swallowing, speech, language and cognition.
Swallowing
More than half of stroke survivors have trouble swallowing. Called dysphagia, this disorder can lead to food or liquid entering the airway and lungs, which can cause choking and possibly pneumonia. Dysphagia can also lead to inadequate nutrition.
When stroke patients arrive at Lake Regional, Davis and her fellow speech therapists complete a swallowing evaluation.
“At first, treatment might just be a modified diet, to keep the patient safe,” Davis said. “In some patients, their swallowing will improve on its own in the first few days after the stroke. If it doesn’t, we begin exercises that will help them improve strength and coordination of swallowing muscles.”
Speech
Stroke survivors with speech deficits may know what they want to say but struggle with the physical act of speaking, either because the stroke affected the part of the brain that controls their coordination of speech movements (apraxia of speech) or because the stroke injured the nervous system, resulting in changes in muscle tone (dysarthria). As a result, the person might speak more slowly, struggle to position their mouths or distort certain sounds.
“Speech is a very complex act that involves the lungs, vocal cords, tongue, palate, lips and cheeks,” Davis said. “All of these muscles need to coordinate together, rapidly, to produce speech. When stroke damages the brain connections in charge of speech movements, patients have to rebuild strength and efficiency of movement through exercise.”
Strokes also can affect the brain’s language areas, making it difficult for stroke survivors to find words, construct sentences, understand what others are saying, and read or write words or sentences. This inability to use or comprehend words is called aphasia.
“Therapy to treat language deficits focuses on language organization,” Davis said. “For example, we might ask patients to organize a group of words into a sentence. At first, we might give them the words on pieces of paper that they can move around. If they are writing, we might ask them to write the words into an organized sentence. There are many strategies we can use to customize the treatment to the patient’s abilities.”
Cognition
Some strokes impact people’s thinking, or cognition, making it more difficult for them to solve problems, remember new information, keep details straight or focus with distractions.
“In therapy, we focus on high-level attention tasks,” Davis said. “We might ask them to alternate between two activities, or we might give them activities that require selecting out important information. Sometimes, we ask them to do activities where there is background noise. The goal in all of these activities is to improve their focus, which is necessary for all cognitive tasks.”
Mustering Motivation
Overcoming the effects of stroke requires determination and hard work, which can be hard to muster during a health crisis. It’s part of her job, Davis said, to motivate her patients.
“We want to learn about them, what motivates and interests them, so we can provide the best, most meaningful therapy,” she said. “We also encourage them and help them see that their efforts are worthwhile.”
As a Level II Stroke Center, Lake Regional Health System offers comprehensive stroke care and recovery, including treatment from board-certified neurologists, specially trained Emergency Department physicians and staff, around-the-clock emergency imaging services, a skilled nursing facility located in the hospital, rehabilitation services and home health services. Learn more at lakeregional.com/StrokeCenter.
(Source: lakenewsonline.com)