oral and facial exs

[anagha]

hi physios

please suggest some oral and facial exs that would help my pt with stroke on rt side. including his face and difficulty in speech.
please...

[Canuck Physio]

Originally Posted by anagha

hi physios

please suggest some oral and facial exs that would help my pt with stroke on rt side. including his face and difficulty in speech.
please...

Hello,

I believe normally in the UK speech and language therapists (SLT) are normally responsible for improving speech. If a physiotherapist were to work on exercises it would likely be useful to work alongside a SLT in order to best benefit the patient.

Regards

[Geert]

Hello

Since your patient has had a stroke, I suspect he/she has an asymmetry in the lower half of the right face (central facial nerve paresis).
Problems I expect are (among others)
- asymmetry when lifting the nose
- asymmetry when smiling
- problems with holding air in the right cheek
- asymmetry when pushing the lips forward (kissing)
- asymmetry when uncovering the upper teeth (when brushing the teeth)
- asymmetry when moving the lower lip over the lower teeth

Observe these movements in your patient and write down the exercises were there is an impairment. Put the patient in front of a mirror and show her the correct exercise. This is an easy home programme for the patient.

In your therapy session, you can manually facilitate the correct movements in the face. Try it on a colleague and you will see what to do. Basically it's the same thing as with an upper or lower extremity.
This also means that you should also assess sensation in the face, and sensory and motor performance of the other parts of the facio oral tract (tongue, lower jaw, hard and soft palate, etc.).

Speech difficulties can be caused by problems in the parts responsible for producing speech like vocal cords, tongue, lips, etc. This is then called dysarthria.
Or the speech impairment is caused by the cortical/subcortical centres involved in producing language. This is then called dysphasia. Whereas in the first one their speech sounds different, in patients with dysphasia there is an impairment in the understanding or production of speech. A speech and language therapist should be contacted in this case as dyspahsia requires a different approach from dysarthria.

Hope this helps.
Good luck!