Objective To evaluate the safety of nasogastric tube (NGT) removal and change to oral feeding with a food thickener for acute stroke patients in whom a videofluoroscopic swallow study (VFSS) confirmed thin liquid aspiration. Methods We retrospectively examined data of 199 patients with first stroke who were diagnosed with dysphagia from 2011 to 2015. Swallowing function was evaluated using VFSS. Patients included in this study were monitored for 4 weeks to identify the occurrence of aspiration pneumonia. The penetration-aspiration scale (PAS) was used to assess VFSS findings. The patients were divided into thin-liquid aspiration group (group 1, n=104) and no thin-liquid aspiration group (group 2, n=95). Results The feeding method was changed from NGT feeding to oral feeding with food thickener (group 1) and without food thickener (group 2). The PAS scores of thin and thick liquids were 6.46±0.65 and 1.92±0.73, respectively, in group 1 and 2.65±0.74 and 1.53±0.58, respectively, in group 2. Aspiration pneumonia developed in 1.9% of group 1 and 3.2% of group 2 (p=0.578), with no significant difference between the groups. Conclusion We concluded that removing the NGT and changing to oral feeding with a food thickener is a safe food modification for acute stroke patients with thin liquid aspiration. Therefore, we recommend that VFSS should be conducted promptly in acute stroke patients to avoid unnecessary prolonged NGT feeding.

ObjectiveTo demonstrate the efficacy of the balance control trainer (BCT), developed for training patients with balance problems, as a balance assessment tool in subacute stroke patients.MethodsA prospective cross-sectional study was carried out on 38 subacute stroke patients in their first episode of a stroke, and having the ability to maintain a standing position without aid for at least 5 minutes. Patients were assessed using the BCT (BalPro) 43.7±35.7 days after stroke. The balance was assessed using the Berg Balance Scale (BBS), the Timed Up and Go Test (TUG), a 10-meter walking test (10mWT), a 6-minute walking test (6MWT), and the Korean version of the Modified Barthel Index. The correlation and validity between the BCT and various balance assessments were analyzed.ResultsStatistically significant linear correlations were observed between the BCT score and the BBS (r=0.698, p<0.001). A moderate to excellent correlation was seen between the BCT score and 11 of the 14 BBS items. The BCT scores and other secondary outcome parameters (6MWT r=0.392, p=0.048; TUG r=–0.471, p=0.006; 10mWT r=–0.437, p=0.012) had a moderate correlation.ConclusionBalance control training using the BCT (BalPro) showed significant statistical correlation with the BBS, and could therefore be a useful additional balance assessment tool in subacute stroke patients.

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