Functional Outcome in Acute Stroke Patients with Oropharyngeal Dysphagia after Swallowing Therapy

Abstract

Dysphagia after stroke is associated with mortality and increased pulmonary complications. Swallowing therapies may decrease pulmonary complications and improve patients' quality of life after stroke. This study used clinical swallowing assessments and videofluoroscopy (VFS) to assess the functional recovery of acute stroke patients with dysphagia after different swallowing therapies. We enrolled 29 acute stroke patients with dysphagia and randomly divided them into 3 therapy groups: traditional swallowing (TS), oropharyngeal neuromuscular electrical stimulation (NMES), and combined NMES/TS. All patients were assessed using the clinical functional oral intake scale (FOIS), 8-point penetration-aspiration scale (PAS), and functional dysphagia scale (FDS) of VFS before and after treatment. There were no differences in the clinical parameters and swallowing results of the FOIS and VFS before swallowing treatment among the 3 groups (P > .05). TS therapy and combined therapy both had significant swallowing improvement after therapy according to the FOIS and 8-point PAS (P < .05). When comparing the results of the VFS among the 3 groups, we found significant improvements in patients eating cookies and thick liquid after combined NMES/TS therapy (P < .05). In acute stroke patients with dysphagia, combined NMES/TS therapy is the most effective swallowing therapy in taking solid diets and thick liquids.

<p>Effectiveness of Neuromuscular Electrical Stimulation on Post-Stroke Dysphagia: A Systematic Review of Randomized Controlled Trials</p>

“…The sample size of the participants in the included studies was ranged from 29 to 135 individuals, both in the experimental and control groups. 34,35 Interventions Studies comparing the effectiveness of nNMES, and/or conventional swallowing therapy with controlled group; conventional swallowing therapies, and/or placebo/sham stimulations were considered. The treatment duration ranged from 10-60 minutes for each session, 35,36 2-5 times per week 33,34,37 for a 2-6 week period.…”

“…Of all included studies, 6 studies evaluated swallowing function by using PAS. 30,[34][35][36]38,39 Four studies evaluated swallowing function by using VFDS, 30,32,38,40 and only three studies used FDS. 34,35,38…”

Profile of Swallowing Disorders in Acute Stroke in Brazzaville

“…As in most studies, the mean age of our patients was high at 69.1±13.8 years [22,28,33]. The frequency of swallowing disorders in elderly patients is well known, due to neurological or otorhinolaryngological affections [28,32,[34][35][36][37]. The male predominance of our patients is explained by the more frequent consumption of tobacco and alcohol by men in the Congo, as a risk factor for stroke [38].…”

Effects of electrical stimulation combined with dysphagia therapy in elderly individual with oropharyngeal dysphagia: a case study

“…It is an effective method for inducing antero-superior movement of the hyoid, which has a direct impact on the airway protection mechanism, and can help decrease aspiration7 ) . This supports the results of the present study.…”