The effects of ADL on recovery of swallowing function in stroke patients after acute phase

Abstract

This study aimed to examine the association between the degree of recovery from dysphagia and changes in functional independence measure (FIM) items in stroke patients after acute phase by conducting a historical cohort study, because none explains the effects of activities of daily living (ADL) on recovery of swallowing function. Study patients included hospitalised stroke patients after acute phase in whom dysphagia was confirmed (n = 72). Change in nutritional intake method score was examined for association with age, days from stroke onset to admission, length of hospital stay and change in FIM score. Moreover, to examine characteristics of patients who were removed from tube feeding, all patients who required tube feeding at the time of admission were divided into two groups comprising those who required tube feeding at discharge and those who did not. A significant and positive association was observed between change in nutritional intake method and FIM for all items other than self-care of bathing, locomotion of stairs and problem solving. Patients who were removed from tube feeding were significantly younger than those who required tube feeding at the time of discharge (P < 0.041) and also showed significantly higher FIM scores for transfer and all cognitive FIM items at the time of admission (P < 0.05). This study demonstrated that nutritional intake methods improve in conjunction with FIM improvements in patients with dysphagia following the acute phase of stroke. Our results suggest that the age and cognitive function may influence the recovery of patient ability of oral intake.

Texture‐modified diets are associated with decreased muscle mass in older adults admitted to a rehabilitation ward

“…Older adult patients with poor ADL are thought to have declined eating ability, according to the results of this current study. Previous studies reported that dysphagic patients often show poor ADL, similar to the present results . Additionally, it is known that sarcopenia can be caused by inactivity .…”

“…Previous studies reported that dysphagic patients often show poor ADL, similar to the present results. 26,27 Additionally, it is known that sarcopenia can be caused by inactivity. 24,28 Considering the possibility that patients who consume TMD might be diagnosed with sarcopenic dysphagia, it is convincing that both low FIM score and decreased SMI are related to TMD.…”

Re-initiation of Oral Food Intake Following Enteral Nutrition Alters Oral and Gut Microbiota Communities

“…While essential for enjoying meals, oral food intake may also play an important role in preventing respiratory infections such as pneumonia. Several studies have reported that orally fed patients have higher activity of daily living (Nakayama et al, 2014) and quality of life (Hong and Yoo, 2017) than tube-fed patients, highlighting the physiological and psychosocial benefits of oral food intake. In previous studies comparing the oral flora of patients fed via the two routes, the proportion of pathological bacteria such as Streptococcus agalactiae was increased in patients fed through a tube (Leibovitz et al, 2003;Takeshita et al, 2011).…”

Association between Oral Frailty and Geriatric Conditions

“…Through effective rehabilitation, almost all elderly patients are able to fully recover activities of daily living (ADL), and are then discharged back to their homes. A cross-sectional study showed that there is a significant relationship between improvement of swallowing function and recovery of ADL in stroke patients [18]. On the other hand, sometimes elderly patients cannot fully improve functional performance even after receiving the same rehabilitation, although the exact reason is still not elucidated.…”