Dysphagia in Stroke: A New Solution

Abstract

Dysphagia is extremely common following stroke, affecting 13%–94% of acute stroke sufferers. It is associated with respiratory complications, increased risk of aspiration pneumonia, nutritional compromise and dehydration, and detracts from quality of life. While many stroke survivors experience a rapid return to normal swallowing function, this does not always happen. Current dysphagia treatment in Australia focuses upon prevention of aspiration via diet and fluid modifications, compensatory manoeuvres and positional changes, and exercises to rehabilitate paretic muscles. This article discusses a newer adjunctive treatment modality, neuromuscular electrical stimulation (NMES), and reviews the available literature on its efficacy as a therapy for dysphagia with particular emphasis on its use as a treatment for dysphagia in stroke. There is a good theoretical basis to support the use of NMES as an adjunctive therapy in dysphagia and there would appear to be a great need for further well-designed studies to accurately determine the safety and efficacy of this technique.

Accuracy of endoscopic and videofluoroscopic evaluations of swallowing for oropharyngeal dysphagia

“…Oropharyngeal dysphagia due to motor or sensory disorders of the upper aerodigestive tract is called functional dysphagia. This condition increases the risk of pneumonia, malnutrition, and dehydration, resulting in increased mortality, morbidity, and impaired quality of life for patients who suffer from it . Therefore, a timely and valid diagnosis is crucial to decrease these complications using rehabilitation and preventive interventions.…”

“…To decrease the complications associated with oropharyngeal dysphagia, objective and accurate tests are needed to better select dietary, behavioral, and rehabilitation interventions for dysphagic patients, thus stressing the relevance of knowledge about the diagnostic accuracy of VFSS and FEES . This evaluation should be conducted primarily for variables that have shown better reproducibility and greater association with dysphagia outcomes, specifically those related to the safety of swallowing …”

Investigação da queixa de disfagia em pacientes afásicos

“…It is known that from the post-CVA patients, 25-50% complained of dysphasia 18 , and some authors even suggest higher probabilities occurrence 8 . Specific studies about the epidemiology aspects and natural history of dysphasia associated with acute brain-vascular conditions suggest an incidence of around 50% for swallowing disorders 19,20 . It is noted, however, that despite these studies agree in numbers with the current, they are all different when it comes to analysis, because they assessed only patients with dysphasia after have suffered CVA regardless the occurrence or not of other disorders unlike from this study that had as sample selection criteria the co-occurrence of aphasia.…”

Application and effects of neuromuscular electrical stimulation in the rehabilitation of oropharyngeal dysphagia: a literature review

“…2.3 Dysphagia rehabilitation has combined functional exercises with electrodes deployed in the head and neck area especially to optimize and aid the laryngeal excursion. 4 …”