Rehabilitation Treatment Outcomes among Stroke Patients with Dysphagia (original) (raw)
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Geriatrics
The international approach to the assessment and management of dysphagia in the acute phase post stroke is little studied. A questionnaire was sent to clinicians in stroke services that explored the current practice in dysphagia screening, assessment, and management within the acute phase post stroke. The findings from four (the UK, the US, Canada, and Australia) of the 22 countries returning data are analysed. Consistent approaches to dysphagia screening and the modification of food and liquid were identified across all four countries. The timing of videofluoroscopy (VFS) assessment was significantly different, with the US utilising this assessment earlier post stroke. Compensatory and Postural techniques were employed significantly more by Canada and the US than the UK and Australia. Only food and fluid modification, tongue exercises, effortful swallow and chin down/tuck were employed by more than fifty percent of all respondents. The techniques used for assessment and management ...
Effects of early intervention of swallowing therapy on recovery from dysphagia following stroke
Iranian Journal of Neurology, 2015
Background: Dysphagia is common after stroke. The onset time of swallowing rehabilitation following stroke has an important role in the recovery of dysphagia and preventing of its complications, but it was either highly variable or was not stated in previous trials. The aim of this study was investigation effects of onset time of swallowing therapy on recovery from dysphagia following stroke. Methods: Sixty dysphagia patients due to stroke range of age 60-74 (67.1 ± 3.8), participated in this randomized clinical trial study. The patients allocated in Early, Medium and Late groups, on the base of initiation of swallowing therapy after the stroke. After basic clinical and video fluoroscopic swallowing study assessments, traditional swallowing therapy was initiated 3 times per week for 3 months. The outcome measures were North-Western dysphagia patient check sheet, functional oral intake scale, video fluoroscopy, and frequency of pneumonia. Statistical analysis was done by repeated mea...
The Effects of Dysphagia on Quality of Life in Stroke Survivors
Middle East Journal of Rehabilitation and Health Studies
Background: Oropharyngeal dysphagia is a common problem in stroke survivors. Dysphagia and its complications have negative effects on quality of life in stroke survivors. Objectives: This study aimed to investigate the impacts of dysphagia on quality of life in Iranian stroke survivors and to determine potential relationships between demographic variables and the domains of quality of life. Methods: Sixty stroke survivors (aged 60 - 75 years old) with a diagnosis of dysphagia participated in this cross-sectional study. The swallowing function of patients was evaluated by Mann Assessment Swallowing Ability (MASA). The Persian version of the Dysphagia Handicap Index (DHI) was used to determine the impacts of swallowing disorder on the quality of life. Results: The mean total and SD of DHI was 73.03 ± 10.16. There was no statistically significant relationship between sex; age, time post-onset of stroke, and DHI total score as well as its subscales (P > 0.05), whereas there was a rel...
European Stroke Journal
Post-stroke dysphagia (PSD) is present in more than 50 % of acute stroke patients, increases the risk of complications, in particular aspiration pneumonia, malnutrition and dehydration, and is linked to poor outcome and mortality. The aim of this guideline is to assist all members of the multidisciplinary team in their management of patients with PSD. These guidelines were developed based on the European Stroke Organisation (ESO) standard operating procedure and followed the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach. An interdisciplinary working group identified 20 relevant questions, performed systematic reviews and meta-analyses of the literature, assessed the quality of the available evidence, and wrote evidence-based recommendations. Expert opinion was provided if not enough evidence was available to provide recommendations based on the GRADE approach. We found moderate quality of evidence to recommend dysphagia screening in all stroke ...
A multi-centre prospective study on functional outcomes and post-stroke oropharyngeal dysphagia
2018
AUC area under the (receiver operating characteristic) curve AZ academisch ziekenhuis BOHSE Kayser-Jones Brief Oral Health Status Examination BSSD Belgian Society for Swallowing Disorders bv. bijvoorbeeld CEBAM Centre for Evidence-Based Medicine CI confidence interval CINAHL Cumulative Index to Nursing and Allied Health Literature COM Communication COSMIN COnsensus-based standards for the selection of health status Measurement INstruments CSE clinical swallowing examination CT computed tomography CTT classical test theory CVA cerebrovasculair accident Dent Dentures df degrees of freedom DHI Deglutition Handicap Index d.i. dit is DIF differential item functioning doi digital object identifier DP dental pain DRS Dysphagia Research Society DSWAL-QoL Dutch version of the Swallowing Quality-of-Life Dys patients suffering from dysphagia DysLC patients with dysphagia accompanied by language impairment and/or cognitive disorders EATDES Eating desire EATDUR Eating duration e.g. for example Embase Excerpta Medica Database EORTC QLQ-PR25 European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-prostate specific 25-item ESSD European Society for Swallowing Disorders Ext extreme Ext (+ext/÷ext) extreme (with extremes/without extremes) FAT Fatigue
Incidence of Dysphagia in Acute Stroke Patients: An Early Screening and Management
International Journal of Phonosurgery & Laryngology, 2021
Original research language pathologist in which various maneuvers could be elicited on patients to assess which method would be more helpful in improving their symptom. During FEES, we closely monitored SPO 2 (oxygen saturation) of our patients. The three scales considered were penetration aspiration scale, secretion rating scale, and residue rating scale. According to the severity of score, patients were given compensatory and rehabilitative swallowing therapy. • Stroke severity was assessed by NIHSS score. • Location of stroke was done on the basis of computed tomography (CT) scan of the brain. The primary aim of our study was to assess the incidence of dysphagia in acute stroke patients and analyze the benefits of early screening and management. Statistical Analysis Data were expressed as number (%) and compared using Wilcoxon signed-rank test. The two groups (patients with dysphagia vs • Fiber-optic endoscopic evaluation of swallowing (FEES): 3 We performed this procedure along with our speech and
Dysphagia in stroke: Development of a standard method to examine swallowing recovery
The Journal of Rehabilitation Research and Development, 2006
This study began development of a standard method that uses the videofluoroscopic swallow study for evaluation of swallowing recovery after stroke based on a definition of dysphagia derived from three domains: bolus timing, bolus direction, and bolus clearance. Two experiments were conducted: one that defined normal versus disordered swallowing based on the range of scores in a sample of healthy adults (n = 13), and one that applied these thresholds to nine stroke patients to identify the presence of dysphagia. Results indicate that acute and protracted dysphagia may be more accurately detected by identifying abnormalities on multiple objective measures of swallowing rather than on laryngeal penetration or aspiration alone. Results indicate that our selected measures and use of healthy control subjects to establish normal thresholds may eventually contribute to the definition and differentiation of dysphagic and nondysphagic patients. Further research with a broader sample of healthy controls and stroke patients is mandatory.
Post-stroke dysphagia: A review and design considerations for future trials
International journal of stroke : official journal of the International Stroke Society, 2016
Post-stroke dysphagia (a difficulty in swallowing after a stroke) is a common and expensive complication of acute stroke and is associated with increased mortality, morbidity, and institutionalization due in part to aspiration, pneumonia, and malnutrition. Although most patients recover swallowing spontaneously, a significant minority still have dysphagia at six months. Although multiple advances have been made in the hyperacute treatment of stroke and secondary prevention, the management of dysphagia post-stroke remains a neglected area of research, and its optimal management, including diagnosis, investigation and treatment, have still to be defined.
Post-stroke dysphagia: frequency, risk factors, and topographic representation: hospital-based study
2021
Background The frequency of dysphagia varies considerably across literature. Post-stroke dysphagia is a common cause of increased morbidity and length of hospitalization. This study aimed to estimate the frequency, risk factors of dysphagia following first-ever ischemic or hemorrhagic stroke and its neuroradiological correlation. Methods Two hundred fifty patients (180 ischemic and 70 hemorrhagic strokes) with first-ever stroke were recruited within 72 h of onset. Detailed history, neurological examination, and computed tomography and/or magnetic resonance were done for each patient. Severity of stroke was evaluated by the National Institutes of Health Stroke Scale (NIHSS). Swallowing function was assessed by water swallowing test (WST) and dysphagia outcome severity scale (DOSS). Results Ninety-eight (39.2%) of all stroke patients had dysphagia, 57 (31.7%) of ischemic group, 41 (58.6%) of hemorrhagic group. The mean age of ischemic group with dysphagia was older than ages of non-dy...
Portuguese Journal of Public Health, 2022
Dysphagia is frequent after stroke, and it increases the risk of respiratory infection, dehydration and malnutrition, resulting in worse outcomes. Different clinical guidelines present recommendations for the assessment and management of dysphagia in stroke patients in a scattered way. These best practice recommendations address seven clinical questions on the assessment and management of dysphagia in stroke patients, gathering the best-updated evidence. A systematic literature review using the PICO strategy was performed. The recommendations draft was then appraised by a multidisciplinary panel of experts (nutritionists, physiatrists, speech-language pathologists and rehabilitation nurses) in a total of 3 Delphi rounds. A minimum of 80% consensus was established, and the final version offers a total of 21 recommendations for use in clinical practice for stroke patients. These clinical recommendations are an overview of the most recent evidence combined with experts’ consensus and t...