Human Performance and Rehabilitation Centers, Inc.

Speech Therapy After Stroke

Stroke Overview

Strokes are caused either by a blockage of the blood vessels in the brain or by bleeding in or around the brain, and they can happen to anyone of any age at any time. Patients have the best shot at recovering from the effects of a stroke when they are evaluated quickly and thoroughly by a team of medical professionals, including a Speech-Language Pathologist (SLP). A stroke can cause cognitive communication and swallowing deficits, and an SLP will diagnose and treat these specific conditions.

Speech Therapy After Stroke

An SLP creates a tailored treatment plan for each patient that focuses on improving the skills that the stroke has diminished. The brain is organized such that an injury to one side of the brain affects the opposite side of the body. Depending on what areas are affected, an SLP will deploy certain therapies and strategies. The SLP’s goal is to:

    • Improve the patient’s ability to understand and/or produce language;
    • Improve speech production if there is difficulty due to weakness or motor planning;
    • Determine whether there is a need for an alternative/augmentative device to supplement a patient’s verbal communication;
    • Increase awareness of deficits in order to help self-monitoring in the hospital, home and community;
    • Implement compensatory strategies or modify the patients work/school environment to meet their needs;
    • Make recommendations that involve positioning issues, feeding techniques, specific therapeutic techniques and diet consistency changes; and,
    • Educate the patient, their family members or caregivers about the therapy path forward.

The recovery and rehabilitation process is different for each patient. An SLP will work with a team of other health care professionals to help a patient transition back into the community and to reclaim the skills to live as independently as possible. Everyone’s common goal should be restoring a patient’s quality of life.

Remember, there is life after stroke, and early therapy increases the chance that life will be as fulfilling as possible.

Additional resources:

National Stroke Association – www.stroke.org
American Speech Language Hearing Association (ASHA) – www.asha.org
National Institute of Health – www.stroke.nih.gov

As the World Turns: Using Therapy to Resolve Vertigo

Overview

The sensation of spinning, or vertigo, can be a common problem especially among older adults. Vertigo is usually a condition called Benign Paroxysmal Positional Vertigo, (BPPV), an inner ear malfunction treated in a therapy setting. Vertigo is not detected in an MRI.

BPPV, the most common form of vertigo, is a mechanical failure of the inner ear. Calcium carbonate crystals (otoconia) that are embedded in a part of the ear called the utricle dislodge and float to places where they cause problems. When enough of these crystals settle in the fluid of the ear canals, they trick the brain into thinking the head is moving when it isn’t. That’s where the sensation of spinning comes from.

Treating Vertigo

Our first step is to determine if a patient has BPPV. We do this by performing a Dix-Hallpike Test in which we ask the patient to lie in a supine position while we carefully roll the head until it triggers vertigo. If a patient has BPPV, a bout of vertigo will create a detectable “error message” in the eye movement. Both eyes will turn rapidly in a torsional fashion which also intensifies the sensation of spinning.

Ultimately, the eye movements are the key to a BPPV diagnosis and helps us pinpoint exactly where the crystals have migrated. Our next step is to gently maneuver the head using specific protocols. Your therapist should be well-trained in this intervention, which uses gravity to naturally guide the crystals from their offending location back to the utricle. The most common type of maneuver is called an Epley Maneuver, and it can take less than five minutes to perform. Many patients will feel instant relief, and others will see progress in a day or two.

Patients who suffer from BPPV have often spent months or years trying to get a clear diagnosis. Seeing a therapist first can bring an end to both frustration and discomfort.