Keterangan
Stroke is one of the leading causes of death and disability in India. Speech and Swallowing disorders are common after stroke. The onset time of swallowing rehabilitation following stroke has an important role in the recovery of dysphagia and preventing complications. A stroke can also affect the muscles in the mouth and throat, making it a challenge to talk clearly. These side effects can make speaking, and reading more difficult. Therefore rehabilitation post stroke is an important skill to be owned by doctors, physios and nurses.
Ringkasan
- The presentation covers post-stroke rehabilitation, focusing on speech and swallow disorders. Stroke is defined as an acute neurological dysfunction due to ischemia or hemorrhage. Aphasia, affecting 35-40% of stroke patients, is an acquired neurogenic language disorder impacting expression and comprehension via speech, writing, and gestures. Language comprehension involves levels of arrival, knowing, and association, while motor speech function involves emotional, automatic, and propositional levels.
- Neuroanatomy of language functions is widespread across both hemispheres, with key areas including Broca's and Wernicke's areas, connected by the arcuate fasciculus, all supplied by the middle cerebral artery (MCA). Bedside assessments for aphasia encompass evaluating spontaneous speech (fluency, neologisms), comprehension, repetition, naming, writing, and reading. Specific scales like Boston Diagnostic Examination and Functional Communication Profile provide comprehensive assessments.
- Aphasia is classified into fluent and non-fluent types, including Broca's, Wernicke's, conduction, global, transcortical motor/sensory/mixed, and anomic aphasias. Non-fluent aphasias involve effortful speech, while fluent aphasias involve connected speech lacking meaning. Each type involves different brain areas and affects spontaneous speech, comprehension, repetition, naming, reading, and writing differently.
- Apraxia is the inability to perform skilled movements without motor, sensory, or coordination loss. Verbal apraxia impacts forming intelligible words, while motor/ideomotor apraxia involves difficulties with purposeful movements. Understanding these conditions is crucial for planning effective therapy, adapting communication strategies, and modifying exercises based on the patient's specific deficits.
- Disarthria is a motor speech impairment affecting articulation, respiration, phonation, resonance, and prosody. It's classified based on neuroanatomical structures, including flaccid, spastic, ataxic, and hyper/hypokinetic types. Management focuses on restorative and compensatory strategies to improve speech intelligibility and functional communication.
- Dysphasia is difficulty swallowing, often presenting as coughing, choking, or food regurgitation. It involves three stages: oral, pharyngeal, and esophageal. Swallow screenings by nurses can identify aspiration risks, while detailed evaluations by speech pathologists, including FEES or MBS, are essential. Management includes swallowing therapy, dietary modifications, and tube feeding when necessary.
Contoh Sertifikat
Tentang Pembicara
Dr. Prajakta
Fisioterapis di Rumah Sakit Saifee, Mumbai
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