From the Guidelines
Approximately 40% of patients with minor stroke require follow-up by speech therapy in the chronic phase of the stroke. This percentage is based on the prevalence of communication disorders, including aphasia and dysarthria, which can occur in as many as 40% of poststroke patients 1. Speech therapy needs in the chronic phase often address persistent communication difficulties that weren't fully resolved during acute rehabilitation.
Key Considerations
- Early screening for communication disorders is important, even in patients with minor strokes, as some deficits may not be immediately obvious during hospital discharge but can significantly impact quality of life and functional independence later.
- Regular reassessment during follow-up appointments can help identify patients who would benefit from speech therapy intervention in the chronic phase, particularly those with strokes affecting the left hemisphere language centers or brain regions involved in motor speech production.
- The goals of speech-language treatment are to facilitate recovery from communication difficulties, assist patients in developing strategies to compensate for communication disorders, and counsel and educate people in the patient’s environment to facilitate communication 1.
- Aphasia treatment can result in maximizing gains during the period of spontaneous recovery and developing compensatory strategies during the chronic phase, while dysarthria treatment may involve direct intervention of the affected subsystem or development of compensatory behaviors 1.
From the Research
Patients with Minor Stroke Requiring Follow-up by Speech Therapy
- Approximately one third of people who have a stroke experience aphasia, which may require follow-up by speech therapy 2
- There is no direct evidence on the percentage of patients with minor stroke requiring follow-up by speech therapy in the chronic phase of the stroke
- However, studies suggest that speech and language therapy can be beneficial for patients with aphasia following stroke, with improvements in functional communication, reading, writing, and expressive language 2
- The effectiveness of speech therapy for patients with minor stroke may depend on the intensity, duration, and frequency of the therapy, as well as the individual patient's characteristics and needs 2, 3
Speech Rehabilitation for Dysarthria after Stroke
- Dysarthria is a common consequence of stroke and can have a detrimental influence on communication and quality of life 4
- Speech-language pathologists play an important role in the evaluation and rehabilitation of stroke survivors who present with dysarthria 4
- Management strategies for dysarthria focus on optimizing communication through compensatory strategies as well as providing physiologic support 4
- There is limited evidence on the specific percentage of patients with minor stroke requiring follow-up by speech therapy for dysarthria, but speech rehabilitation treatments can be effective in improving communication and quality of life 3, 4
Limitations and Future Research
- Further research is needed to determine the optimal approach to speech therapy for patients with minor stroke, including the intensity, duration, and frequency of therapy 2, 3
- Advanced imaging techniques may be able to identify patients with minor stroke who are likely to benefit from speech therapy, but more research is needed to fully understand the role of imaging in guiding treatment decisions 5