From the Guidelines
Approximately 40% of patients with major stroke require follow-up by speech therapy in the acute phase of the stroke. This percentage is based on the prevalence of communication disorders, such as aphasia and dysarthria, which can occur in as many as 40% of poststroke patients 1. The need for speech therapy is determined through standardized assessments that evaluate language comprehension, expression, reading, writing, and swallowing function.
Key Considerations
- Speech therapy evaluation should ideally begin within 24-72 hours of stroke onset for patients who demonstrate communication difficulties or swallowing problems (dysphagia)
- Early intervention is crucial as it helps identify patients at risk for aspiration pneumonia and facilitates the development of appropriate communication strategies
- Patients with aphasia, dysarthria, apraxia of speech, or dysphagia are the primary candidates for speech therapy services during the acute phase
- The duration and intensity of speech therapy will vary based on individual needs, with some patients requiring continued therapy throughout their rehabilitation journey. The goals of speech and language treatment are to facilitate the recovery of communication, assist patients in developing strategies to compensate for communication disorders, and counsel and educate people in the patient’s environment to facilitate communication, decrease isolation 1.
From the Research
Speech Therapy in Acute Phase of Stroke
- Approximately one third of people who have a stroke experience aphasia, which affects some or all language modalities: expression and understanding of speech, reading, and writing 2.
- The exact percentage of patients with major stroke requiring follow-up by speech therapy in the acute phase is not explicitly stated in the provided studies.
- However, it is mentioned that approximately 21-40% of stroke patients sustain permanent aphasia, which may require speech therapy 3.
- Studies have shown that speech and language therapy can result in clinically and statistically significant benefits to patients' functional communication, reading, writing, and expressive language 4, 2.
- High-intensity speech therapy has been found to be beneficial for cognitive recovery in older patients with acute stroke, with 53% of eligible stroke patients receiving high-intensity speech therapy 5.
Benefits of Speech Therapy
- Speech therapy can improve functional communication, reading, writing, and expressive language in patients with aphasia following stroke 2.
- Early provision of speech therapy can lead to better speaking ability at one month post-stroke and at one year post-stroke 4.
- High-intensity speech therapy can result in significantly higher cognitive Functional Independence Measure efficiency scores compared to control groups 5.
Considerations for Speech Therapy
- The effectiveness of speech therapy may depend on factors such as the intensity, duration, and frequency of therapy, as well as the individual patient's characteristics and severity of aphasia 4, 2.
- High-intensity and high-dose interventions may not be acceptable to all patients, and may result in a higher dropout rate 2.