On April 3, over 20 participants gathered virtually to engage in an online lecture about the vital role of speech-language therapy in stroke rehabilitation. The session was led by Eva Stübel, a speech and language therapist (SLT) from Heidelberg, Germany, supported by her colleague Olivia Zelasny. The lecture focused on how strokes can cause problems with talking and swallowing – and what can be done to help.
Eva opened with an introduction to the five main areas SLTs address: speech, language, voice, swallowing, and hearing. In stroke care, the most common problems include dysarthria, which means slurred or slow speech; apraxia of speech, meaning a person has trouble planning how to move their mouth to speak; aphasia, which is difficulty understanding or using language; and dysphagia, which is trouble swallowing. Stübel highlighted that these disorders are not only prevalent but potentially life-threatening if untreated – particularly dysphagia, which can lead to aspiration pneumonia, one of the leading causes of death after stroke.
The majority of the session focused on dysphagia, its clinical signs, and management strategies. Participants learned about the mechanics of swallowing, the crucial role of cranial nerves, and how impairments can affect different phases – from oral preparation to esophageal transport. Using videos of real cases, Eva demonstrated the difference between healthy and disordered swallowing, showing how even silent aspiration – when food or liquid enters the airway without any outward signs – can endanger patients.
A major takeaway from the session was the importance of early screening. Eva advocated for standardized assessments such as the Yale Water Swallow Test and the GUSS (Gugging Swallowing Screen), which help evaluate swallowing safety across different food consistencies. These tools are important for ensuring stroke patients receive appropriate diets and avoid complications. She also emphasized the power of interdisciplinary teamwork and clear documentation, encouraging nurses, therapists, and caregivers to collaborate closely. Oral hygiene, too often overlooked, was highlighted as a critical factor in reducing aspiration pneumonia risk.
Eva and Olivia are actively working on adapting screening protocols to better suit the needs of clinics in Nepal and similar contexts. Their future plans include follow-up surveys, simplified training tools, and additional focused webinars on dysphagia therapy techniques.
The lecture closed with a lively Q&A session, where participants discussed implementation challenges, sought clarification on medical terms, and shared gratitude for the information shared in the session. It’s clear that speech-language therapy is not just about recovery – it’s about restoring dignity, connection, and quality of life to those navigating the aftermath of stroke.
