Rehabilitation of speech therapy after stroke: How to regain speech and communication

4.6/5 - (46 votes)

PROGRAM CLINT, YOUR CEREBRAL COACH

MEMORY COACHING REMOTELY

COGNITIVE REHABILITATION AFTER STROKE

Cerebrovascular Accident (CVA) is one of the leading causes of death and disability worldwide. They can have serious consequences for the speech and communication of affected individuals. Speech therapy after a CVA is therefore crucial to help patients restore their communicative skills and improve their quality of life.

The consequences of a CVA for speech and communication

A CVA can affect speech and communication in various ways. One of the most common consequences is dysarthria, which is a speech disorder caused by weakness or paralysis of the muscles used for speaking. This can make it difficult to understand speech and can lead to a weak or monotone voice.Another common disorder is aphasia, which affects a person's ability to understand and use language. There are different types of aphasia, such as Broca's aphasia, which makes it difficult to produce words, and Wernicke's aphasia, which makes it difficult to understand language.

Different types of speech therapy after a CVA

There are various types of speech therapy available for people who have had a CVA. Traditional speech therapy consists of targeted exercises to improve speech, comprehension, and verbal expression. Another approach is computer therapy, which uses specially designed computer programs to help patients improve their communication.Another option is group therapy, where patients work in a group with a speech therapist to enhance their communicative skills. Finally, there are also mobile apps and online tools that can be used for speech therapy at home.

Preliminary evaluation and diagnosis for speech therapy

 Before starting speech therapy after a CVA, it is important to conduct a thorough evaluation to determine the specific needs of the patient. This may include tests of speech and language, evaluations of verbal and written comprehension, as well as assessments of oral motor skills.Once the diagnosis is made, the speech therapist can create a personalized treatment plan to help the patient improve their communication. This may include specific exercises to enhance articulation, phonation, and verbal comprehension.
◆ ◆ ◆

Treatment of dysarthria and aphasia after a CVA

Dysarthria is a speech disorder that can be treated with exercises aimed at strengthening the muscles used for speaking. This may include exercises for articulation, breathing, and muscle strengthening.Aphasia, on the other hand, can be treated with exercises aimed at improving verbal comprehension and expression. This may include exercises for reading, writing, and conversation.

Exercises to improve articulation and phonation

To improve articulation and phonation, it is important to adopt a systematic and regular approach, integrating specific exercises that focus on the various aspects of speech production. Here is a detailed expansion of the exercises for articulation and phonation, with concrete examples:

Exercises to improve articulation

Articulation involves the clarity with which sounds are produced, involving the precision of the movements of the tongue, lips, palate, and vocal cords. Here are targeted exercises:
  • Exercises for the pronunciation of sounds :
    • Repetition of phonemes : Practice the isolated repetition of difficult sounds, starting slowly and then increasing speed.
    • Syllables and compound words : Build syllables and words from the targeted phonemes, emphasizing the precision of pronunciation.
  • Exercises for the movement of the tongue and lips :
    • Tongue movements : Perform specific movements of the tongue (for example, pointing it to the nose and then to the chin) to strengthen the musculature and dexterity.
    • Facial gymnastics : Perform mimetic exercises, such as broad smiling, pouting lips, or puffing cheeks, to improve control over the facial musculature.
  • Exercises for coordination of breath-speech :
    • Blowing on feathers : Use feathers or small papers to practice breath control during speaking.
    • Reading aloud : Read texts aloud and ensure to take pauses to breathe, emphasizing the clarity of each word.

Exercises to improve phonation

Phonation involves the production and modulation of voice sounds, which requires good coordination between breathing, vocal cords, and resonators.
  • Exercises for strengthening the vocal cords :
    • Vocalises : Sing scales or vocalises on different sounds (such as "ma", "me", "mi", "mo", "mu") to train the flexibility and strength of the vocal cords.
    • The baby’s cry : Imitate the up-and-down cry of a baby to strengthen the vocal cords without straining.
  • Exercises for breathing :
    • Diaphragmatic breathing : Practice breathing through the diaphragm to improve voice support.
    • Following the breath : Use a straw to blow into water, observing the air bubbles to control airflow.
  • Exercises for voice modulation :
    • Pitch modulation : Vary the pitches of the voice while reading or telling a story, to work on modulation and expressiveness.
    • Melodic singing : Sing simple songs to explore different scales and tonalities, promoting a richer and more modulated voice.

Tips for practice

  • Regularity : The key to success is regularity. Practice these exercises daily, even for short periods.
  • Hydration : Keep the vocal cords hydrated by drinking enough water, especially before and after the exercises.
  • Warm-up : Start with breathing exercises and relaxation of the facial muscles and throat before moving on to more specific exercises.
  • Recording and listening : Recording yourself during the exercises helps to become aware of your own voice production and progress.
  • Professional advice : If difficulties persist, consulting a speech therapist or voice coach can provide specialized and personalized help.
 

Techniques to stimulate verbal expression and comprehension

 To stimulate verbal expression and comprehension, as well as to facilitate non-verbal communication and gesture rehabilitation, there are various techniques and strategies. Here is an expansion of these aspects, with practical tips for speech therapy at home.

Techniques to stimulate verbal expression and comprehension

For verbal expression :
  • Guided repetition : The patient repeats words and sentences to improve articulation precision and speech fluency. This technique can gradually become more complex, from simple words to more complex sentences.
  • Reading aloud : Encourage reading various texts to practice pronunciation and intonation. This can include books, newspaper articles, or poems.
  • Guided conversation : Use predefined themes to encourage the patient to express themselves, while guiding the conversation to stimulate specific language structures or targeted vocabulary.
  • Role-playing : Simulate social or professional situations to practice speaking in a more realistic context, which promotes better verbal fluency and more confidence.
For verbal comprehension :
  • Reading comprehension exercises : Read short passages and answer questions about the content to improve comprehension and text analysis.
  • Listening activities : Listen to recordings or stories and identify the main ideas and specific details to strengthen active listening skills.
  • Question-and-answer game : Ask questions about familiar topics or about content that has been viewed/listened to together to practice comprehension and the ability to respond.

Non-verbal communication and gesture rehabilitation

  • Mime exercises : Use mime activities to encourage expression through gestures, which improves non-verbal communication.
  • Facial expression training : Practice in front of a mirror to regain control and diversity of facial expressions by mimicking specific emotions or following tutorials.
  • Gesture rehabilitation : Perform targeted exercises to improve coordination and fluency of body movements, which is crucial for gestures and body language.

Home speech therapy: tips and tricks

  • Create a special space : Set up a quiet and comfortable corner, free from distractions, to regularly practice speech and communication exercises.
  • Establish a routine : Determine specific times of the day for practice, to build a routine and encourage regularity.
  • Set clear goals : Establish realistic and measurable goals with the patient, and celebrate progress to stimulate motivation and engagement.
  • Involve the family : Involve family members in the therapy for emotional and practical support, and encourage communication in daily life.
  • Use technology : Integrate specific educational apps and games for speech therapy to make practice more interactive and enjoyable.
By integrating these techniques and strategies into a holistic approach, it is possible to make significant progress in improving verbal expression, comprehension, and non-verbal communication. The key to success lies in the regularity of practice, ongoing support, and adapting the exercises to the specific needs of each patient. 
◆ ◆ ◆

Expected results and resources for speech therapy after Stroke

Speech therapy after Stroke plays an essential role in the rehabilitation process, providing patients with the opportunity to overcome challenges related to speech, communication, and sometimes swallowing. Here is a thorough exploration of the expected outcomes of this therapy, as well as the available resources to support patients and their families:

Expected Outcomes of Speech Therapy after Stroke

  • Improvement of Verbal Communication : One of the main goals is to improve the patient's ability to express themselves verbally, by working on clarity, fluency, and precision of speech.
  • Strengthening of Comprehension : The therapy also aims to improve verbal comprehension, so that patients can better follow conversations and respond appropriately.
  • Rehabilitation of Reading and Writing : Specific exercises are used to help patients regain their reading and writing skills, which are essential for effective communication.
  • Improvement of Non-verbal Communication : The therapy may include strategies to enhance the use of non-verbal communication, such as gestures and facial expressions, especially if speech is severely affected.
  • Compensation strategies : Patients learn techniques to compensate for persistent communication difficulties, such as using technological aids or communication books.
  • Psychological and Emotional Support : The therapy provides support to address frustrations and emotional challenges related to communication difficulties, contributing to better psychological well-being.

Resources for Speech Therapy after Stroke

  • Speech Therapists and Health Professionals : Speech therapists play a key role in evaluating speech and language skills after a Stroke and in setting up customized rehabilitation programs. Other professionals, such as occupational therapists, can also contribute to overall rehabilitation.
  • Rehabilitation Programs : Many hospitals and rehabilitation centers offer specialized programs for Stroke survivors, with speech therapy being an important component of rehabilitation.
  • Technological Tools and Applications : Applications and software specifically designed for speech rehabilitation after a Stroke can complement traditional therapy, providing practical and interactive exercises.
  • Support Groups : Participation in support groups can provide a space for sharing and mutual understanding among Stroke survivors, who share experiences and coping strategies.
  • Organizations and Associations : Organizations dedicated to Stroke care provide educational resources, support, and sometimes advisory services for survivors and their families.
  • Educational Material : Guides, books, and educational videos can help patients and their families understand the impact of a Stroke on communication and navigate the rehabilitation process.
It is crucial for Stroke survivors and their families to be actively involved in the rehabilitation process and to make use of the available resources. The goal is not only to improve communication but also to enhance autonomy and quality of life. Speech therapy after a Stroke, with the right support, can lead to significant improvements, marking an important step in the journey towards recovery. 

The role of the social and family environment in rehabilitation after a Stroke

The recovery of communicative skills after a Stroke is not only dependent on the exercises performed during sessions with the speech therapist. The patient's family and social environment play a decisive role in the success of rehabilitation. Emotional support, regular stimulation, and daily interactions not only promote the patient's progress but also strengthen their motivation and self-confidence.

Why the environment is essential

  • Emotional support and regular encouragement foster the patient's engagement in their rehabilitation.

  • Natural and daily interactions allow for practicing speech in concrete contexts, outside of structured exercises.

  • A caring and well-informed environment helps to reduce frustration and the sense of isolation that aphasia or dysarthria patients may experience.

Adapting the living environment to promote communication

  • Create a quiet space, free from television or distracting noises, to facilitate concentration and understanding.

  • Use visual aids such as pictures, illustrated cards, or whiteboards to support the exchange.

  • Establish simple daily routines for verbal exchange: ask a ritual question, discuss a daily activity, and even encourage short answers.

Concrete involvement of loved ones in rehabilitation

  • Speak slowly, articulate clearly, and use simple vocabulary while respecting the adult's dignity.

  • Take the time to listen to the answers without interrupting, even if the patient is searching for their words.

  • Support the words with gestures, facial expressions, or visual objects to facilitate understanding.

  • Suggest customized games or cognitive exercises, for example, by using applications like the CLINT program to stimulate language skills in a playful way.

Simple daily activities to stimulate communication

  • Read a short article or story together, and then briefly discuss it.

  • Keep a progress diary in which you note new words or well-structured sentences.

  • Engage in verbal board games or quizzes to stimulate oral exchange within the family.

  • Watch a broadcast or short film and ask simple questions about the content to promote expression.

AND TO GO FURTHER DEEPER


How useful was this post?

Click on a star to rate it!

Average rating 0 / 5. Vote count: 0

No votes so far! Be the first to rate this post.

We are sorry that this post was not useful for you!

Let us improve this post!

Tell us how we can improve this post?

🛒 0 My cart