Speech-language Pathology Approaches to Neurorehabilitation in Acute Care During COVID-19: Capitalizing on Neuroplasticity.

2021 
Neurologic manifestations associated with a COVID-19 diagnosis are common and often occur in severe and critically ill patients. In these patients, the neurologic symptoms are confounded by critical care conditions, such as acute respiratory distress syndrome. Patients with dual diagnoses of COVID-19 and neurologic changes such as myopathy, polyneuropathy, and stroke are likely at a higher risk to experience deficits with swallowing, communication, and/or cognition. Speech-language pathologists are an integral part of both the critical care and neurological disorders multi-disciplinary teams, offering valuable contributions in the evaluation, treatment, and management of these areas. Patients in intensive care units (ICUs) who require mechanical ventilation often experience difficulty with communication and benefit from early speech-language pathology intervention to identify the most efficient communication methods with the medical team and caregivers. Moreover, patients with neurologic manifestations may present with cognitive-linguistic impairments such as aphasia, increasing the need for communication-based interventions. Difficulties with voice and swallowing after extubation are common, often requiring frequent treatment sessions, possibly persisting beyond ICU discharge. After leaving the ICU, patients with COVID-19 often experience physical, cognitive, and mental health impairments collectively called post-intensive care syndrome. This is often a lengthy road as they progress toward full recovery, requiring continued speech-language pathology treatment after hospital discharge, capitalizing on the principles of neuroplasticity. This article is protected by copyright. All rights reserved.
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