Stroke is a serious health concern in Australia, affecting a substantial portion of the population. The latest figures from the Stroke Foundation reveal that over 445,000 Australians are living with the aftermath of a stroke, and each year, around 56,000 new strokes occur. Stroke is one of the leading causes of death and disability in the country. To improve survival rates and outcomes, it's critical for stroke survivors to have rapid access to treatment and ongoing rehabilitation services. So, what is a stroke and how can speech pathologists support stroke survivors?
What is a Stroke?
A stroke, or cerebrovascular accident (CVA), is a medical emergency that occurs when blood flow to a part of the brain is disrupted. This interruption in blood flow deprives brain tissue of essential oxygen and nutrients, leading to the death of brain cells within minutes. Strokes are classified into two main types, Ischemic Stroke and Haemorrhagic Stroke.
Ischemic Stroke
This is the most prevalent type, accounting for about 87% of all strokes. Ischemic strokes occur when blood flow to the brain is blocked by a blood clot. These clots can form in the brain’s arteries (thrombosis) or travel from other parts of the body, such as the heart (embolism).
Thrombosis: This occurs when a blood clot forms in one of the arteries that supply blood to the brain, causing a blockage.
Embolism: This type happens when a blood clot or other debris forms elsewhere in the body, often in the heart, and travels through the bloodstream to the brain, where it lodges in a narrower artery.
Haemorrhagic Stroke
This type occurs when a blood vessel in the brain bursts, leading to bleeding (haemorrhage) either within or around the brain.
Causes of haemorrhagic stroke include:
Aneurysms: A weakened area in a blood vessel that balloons out and can burst.
Arteriovenous Malformations (AVMs): Tangled blood vessels connecting arteries and veins, which can rupture and cause bleeding.
Transient Ischemic Attack (TIA): Often referred to as a mini-stroke, a TIA is a temporary episode of stroke-like symptoms. Although it doesn’t cause permanent damage, a TIA indicates a higher risk of a full-blown stroke in the future.
Recognising the Signs of a Stroke
Knowing the signs of a stroke is crucial, as prompt action can save lives. The FAST acronym is a helpful tool for remembering the key symptoms:
Face Drooping: One side of the face may droop or feel numb. Ask the person to smile and see if their smile is uneven.
Arm Weakness: One arm may become weak or numb. Ask them to raise both arms and see if one arm drifts downward.
Speech Difficulty: Speech may become slurred or hard to understand. Ask the person to repeat a simple sentence and see if they can do it correctly.
Time to Call 000: If you notice any of these symptoms, even if they go away, call emergency services immediately.
Other symptoms to be aware of include sudden confusion, trouble seeing in one or both eyes, difficulty walking, dizziness, loss of balance or coordination, and a severe headache with no known cause.
Effects of Stroke
Each stroke is different, and each person affected by stroke will have different problems and different needs. There are a variety of factors that determine the effects of a stroke and that impact recovery.
Some problems people may experience after a stroke include:
Weakness on one side of the body, including arms, legs and/or facial muscles.
Problems controlling or coordinating movements (also arms and legs).
Ignoring one side of your body, also known as neglect.
Difficulties swallowing food, drink, or saliva.
Personality and behaviour changes.
Having uncontrollable outbursts of emotion without cause, also known as emotional lability.
Problems with thinking, memory, and insight.
Difficulty with senses (eg. smell, touch, taste, sight and hearing).
Problems speaking and understanding, or with reading and writing.
Vision changes.
Fatigue.
Incontinence.
Stroke Rehabilitation with a Speech Pathologist
Speech Pathologists are integral to the rehabilitation of stroke survivors. Their specialised skills help address a range of communication and swallowing disorders that can arise from stroke-related brain damage. We work as part of a multidisciplinary team, including neurologists, occupational therapists, physical therapists, and dietitians. This collaborative approach ensures that all aspects of the patient's recovery are addressed, from mobility and daily functioning to nutrition and emotional wellbeing. Here’s how Speech Pathologists contribute to recovery.
Assessment
The first step in stroke rehabilitation is a thorough assessment by a speech pathologist. This involves evaluating:
Speech Production: Assessing how clearly and fluently the patient speaks.
Language Skills: Measuring their ability to understand and express language.
Cognitive-Communication: Checking cognitive functions such as memory, attention, problem-solving, and executive functions.
Swallowing Function: Identifying any difficulties with swallowing, a condition known as dysphagia.
Treatment and Therapy
Based on the assessment, speech pathologists develop personalised treatment plans, which may include:
1. Speech Therapy
Articulation and Phonology: Helping patients produce sounds correctly to improve clarity of speech.
Fluency: Addressing issues like stuttering that may have developed or worsened post-stroke.
Voice Therapy: Working on improving pitch, volume, and quality of voice.
2. Language Therapy
Aphasia Therapy: Aphasia, a common condition after a stroke, affects the ability to speak, understand, read, or write. Therapy focuses on improving these communication skills through various exercises and techniques.
Cognitive-Communication Therapy: Enhancing skills such as memory, attention, and problem-solving, which are vital for effective communication.
3. Swallowing Therapy
Dysphagia Management: Using specialised exercises and techniques to improve swallowing function, ensuring safety and reducing the risk of aspiration (food or liquid entering the airway).
Rehabilitation Strategies
Speech pathologists employ a variety of strategies to support stroke survivors:
Individualised Exercises: Tailored activities designed to strengthen specific areas of deficit.
Technology: Utilising apps and computer programs designed to improve speech and language skills.
Augmentative and Alternative Communication (AAC): For patients with severe communication difficulties, AAC devices provide alternative means of communication.
Family and Caregiver/Communication Partner Training: Educating family members on how to support and communicate effectively with the stroke survivor.
Recovery after a Stroke
The involvement of speech pathologists is crucial in helping stroke survivors regain their communication and swallowing abilities.
Effective speech therapy can lead to significant improvements in:
Communication: Helping patients express their needs and understand others better.
Social Interaction: Reducing feelings of isolation and enhancing social participation.
Nutritional Health: Ensuring safe swallowing and maintaining good nutritional status.
We're here for you.
Strokes can dramatically affect an individual’s ability to communicate and swallow, significantly impacting their overall quality of life. Speech pathologists play a vital role in the rehabilitation process, offering specialised assessment and therapy to help stroke survivors regain these essential functions.
Through personalised treatment plans, innovative technology, and interdisciplinary collaboration, speech pathologists support stroke survivors in their recovery journey, enabling them to reconnect with their loved ones and the world around them. Their work not only aids in physical recovery but also promotes emotional and social well-being, highlighting the critical importance of their role in stroke rehabilitation in Australia.