From this article you will learn: how speech recovery occurs after a stroke, what speech disorders can be, and how much they are reversible. What you need to do to maximize the speed and full recovery of speech.
content of the article:
- Why recovery depends on speech disorders varieties
- General Terms and
- events How does
- restoration Help logopedist
- Useful exercises
- Additional methods
- forecast
speech disorders - one of the most common manifestations and consequences of both ischemic and hemorrhagic strokes. Experts call this disorder aphasia. It can be different in degree of severity, duration and reversibility - from easy short-term complications with the pronunciation of individual words to complete and lifelong absence of speech after a stroke.
How well speech is restored and whether the patient generally speaks after a stroke depends on three factors:
- How much the brain regions responsible for speech function are affected - the more extensive the stroke, the heavier aphasia.
- On the timeliness and completeness of treatment and rehabilitation measures: the earlier complex treatment has been initiated and fully implemented, the better the recovery.
- Which center of speech is affected, and what kind of aphasia in the patient - motor aphasia is best treated, and the sensory often is irreversible, persisting for life( for details about the types of aphasia - later in the article).
It is possible to restore normal speech after a stroke, even if it was completely lost. But it's hard to predict how complete recovery will be for a particular patient. The rehabilitation process can last from a few days to several years, requires regular and intensive work for the sick and close.
To be treated better under the control of specialists: neurologist, rehabilitologist and speech therapist.
Why
depends on the type of speech disorders The most important speech centers of the brain( Broca and Wernicke) are located in the frontotemporal region of the left hemisphere( in right-handed people).
When different parts of the brain are affected, different verbal disorders occur. Depending on this, the following types of aphasia are distinguished:
- Sensory - the center of Wernicke is affected in the area between parietal and temporal lobes. A person does not understand, does not create meaningful speech, and therefore can not conduct a dialogue or a story, although the pronunciation of individual words not related to each other is not violated.
- Motor - Broca's center is affected in the area between the frontal and temporal lobes. The loss of speech is caused by the inability to pronounce words - a person understands the speech he is speaking and wants to say, but he can not do it.
- Semantic - the ability to understand and pronounce complex in sense and sound speech constructions is lost, but the ability to speak with simple sentences is retained.
- Amnestic - a person can normally speak, but forgets individual names and words, so during a conversation he can not say them.
Sensory speech disorders are the most dangerous and poorly restored - the primitive ability to pronounce separate unrelated words can remain for life. Motor aphasia is better eliminated - even if the patient completely lost speech, it can recover completely.
General rules and activities
To restore speech after a stroke, a set of measures is required:
- Early treatment for medical assistance( in the first hours after the onset of the disease).
- Medical support.
- Classes with a speech therapist.
- Special exercises that restore pronunciation.
- Supportive therapies: physiotherapy, surgery, stem cell therapy.
Of great importance is the environment in which the patient is. His relatives and environment should contribute to the recovery processes. After all, in fact, an adult who has lost his speech, like a small child, must learn to speak anew.
For this you need:
- Calm environment, excluding stress, excitement, loud noises and noise.
- Interest and desire to restore verbal abilities.
- Constant communication - even if the patient does not respond at all to treatment and speech, he should hear it. Talk with the patient, among themselves, and over time the brain will not only perceive, but also reproduce independently what he hears.
- The rehabilitation process should consist of several successive stages responsible for the gradual restoration of different abilities - understanding of speech, pronunciation of sounds, words, phrases, sentences, meaningful expanded speech, improvement of pronunciation.
- The duration of rehabilitation stages can be different( days, weeks, months and even years).
- You can not dwell on the result.
How is the recovery of
important It is important to understand that speech restoration, like any lost brain function caused by stroke, takes time. The rehabilitative process with sensory aphasia is more frequent( in 72%) slowly and gradually, step by step, when the ability to talk expands with each day or month. With motor aphasia, spontaneous speech recovery is more frequent( in 65%) in the form of jerks - a person does not achieve any treatment results for several weeks, after which there is a marked improvement( for example, he can not say anything at all, and after a few months he immediately speaks with sentences).
The maximum recovery of speech occurs in the first year after a stroke, but lasts up to 3-5 years. After this period, the violations remain for life.
Rehabilitation of speech functions should be persistent, but systematized. You can not overexert as well as not intensively work on yourself. It is best to alternate periods of active activities( pronunciation exercises, work with a speech therapist) with rest.
Duration of the sessions increase gradually - from a few minutes in the first days after stabilization of the patient to 1-2 hours after 4-5 weeks. This rule extends even to such activities as listening to speech, music and watching TV programs - they also need to be time limited and alternate with periods of rest.
Be sure to contact a specialist - speech therapist, neuropathologist, rehabilitologist. With their help speech will recover better and faster.
CT scan of ischemic stroke in the Wernicke zone. A - focus of ischemic stroke in the first hours;B - hemorrhagic stroke transformation for 3 days. .
speech therapist. Before the speech can be restored after a stroke, the patient is consulted by a physician speech therapist-aphasiologist. The specialist will determine the nature of aphasia and will make an individual rehabilitation program taking into account the existing violations. With this approach, about 25-30% of patients with pronounced speech disorders are already starting to talk to the hospital discharge. Elements of classes should be continued independently at home, but periodically( weekly or monthly) visit a speech therapist to correct rehabilitation activities.
The basic methods and principles of the speech therapist, which must be taken into account when self-rehabilitation at home:
- Determine the response to a loud and quiet voice.
- Gradual build-up, complexity of loads and tasks.
- From simple to complex - only after mastering less complex functions( understanding and pronunciation of sounds) you can begin to master more complex speech structures( words, sentences).
- It is compulsory to follow not only the pronunciation, but also the understanding of the meaning of the spoken words.
- It is obligatory to take into account the patient's interest in the studied topic - to talk about what is interesting to the patient.
- Use the technique - start the phrase yourself, and the patient ends it.
- Use musical techniques - the patient's singing of favorite songs helps to restore spoken language more quickly.
- The combination of drawing with pronunciation training is something that the patient can not pronounce, he must draw.
All these techniques have a positive effect on the restoration of the speech centers of the brain.
A communication card helps patients with aphasia to communicate with others. Click on the image to enlarge Useful exercises for
All patients with aphasia after a stroke should perform special restorative exercises, regardless of its type. This is due to the fact that in 85-90% of aphasia has a mixed character - sensory-motor. Therefore, exercises that improve the performance of the muscular apparatus involved in pronunciation are shown to all patients.
Effective techniques and exercises:
- Fold and maximally extend the lips in the form of a tube( by the type of a kiss) and hold in this position for 5-7 seconds. Repeat 5-10 times.
- Lower lip grab the top and pull it up as far as possible. Relax and repeat the action 5-10 times.
- Upper lip grab the bottom and pull it down as far as possible for 3-5 seconds. Repeat 5-10 times.
- Open your mouth, head and neck, pull forward, pull the tongue out of your mouth as much as possible. Hold this position for a few seconds. Return to the normal position and repeat the exercise 5-10 times.
- 5-10 times lick the upper and then the lower lip first from right to left, then from right to left.
- Several times, lick your lips with tongue in a circle( upper and lower) in both directions.
- Twist the tongue in the form of a tube, thrust in this position from the oral cavity.
- With your mouth closed, put your tongue up and try to reach out to the hard, and then to the soft sky.
- Close your mouth in such a way that your lips are closed and your teeth are open. Perform circular movements with the tongue between the lips and teeth first in the left side, then in the right-hand direction.
- Flick your tongue against the hard sky so that the sound resembles the sound of a running horse.
- Put the tongue out of your mouth as far forward as possible and make a hissing sound( like a snake).
- Close your mouth and try to smile, opening your lips and showing all your teeth. Repeat the smile, but do not open your lips and show your teeth.
- Stick out the tongue and try to reach up one by one to the tip of the nose and down to the chin.
- Perform an air kiss, accompanied by a loud smack.
Remember that any of the exercises should be performed more than once, but several times( 5-10 times during one session).
Aphasia exercises Additional methods
The work on perception and pronunciation of speech is the most important, but not the only part of speech restoration. If necessary, must be used:
- Drug therapy - drugs that restore blood circulation and brain cells( Ceraxon, Trental, Pyracetam, Cerebrolysin).
- Physiotherapy - electropulse therapy, myostimulation, acupuncture, massage of the tongue and mimic muscles and other techniques.
- Surgical operations - vascular and neurosurgical interventions that improve blood circulation and the functioning of brain cells.
Forecast
The most severe speech disorders occur with extensive strokes affecting the frontotemporal-parietal area( the middle cerebral artery pool) in the left hemisphere of the brain in right-handed or right-handed hemispheres in left-handed people. On average, provided all the recommendations of specialists are followed by surviving patients, speech lost after a stroke is restored:
- After severe strokes - 55%.
- With stroke of moderate severity - 76%.
- For mild forms of the disease - 92%.
If you do not engage in rehabilitation, the overall probability of recovery is only 15%.