The effect of early intervention of swallowing therapy on recovery from oropharyngeal dysphagia in stroke patients: a cross sectional study
Early swallowing rehabilitation
Background: Dysphagia is a widely recorded morbidity after stroke. It is associated with respiratory complications, increased risk of aspiration pneumonia, nutritional compromise and dehydration, and detracts from quality of life. The time of initiation of rehabilitation for dysphagia in stroke patients has an important role in recovery from dysphagia and preventing its complications. Unfortunately, this time point has been highly variable.
Aim: to investigate the effect of the onset time of swallowing therapy on improving swallowing safety, return to oral intake, and reducing aspiration pneumonia following a stroke.
Methods: Thirty-nine patients with dysphagia due to acute cortical and subcortical stroke. Patients were allocated based on the time of presentation and initiation of swallowing therapy after the stroke into early initiation group (3 days after stroke); (2) intermediate group (2 weeks after stroke); and (3) late group (1-month after stroke). Patients were assessed before starting swallowing rehabilitation and at the end of the study after 2 months by fiberoptic endoscopic evaluation of swallowing, functional oral intake scale, Mann Assessment of Swallowing Ability, and chest x-ray. Patients received swallowing rehabilitation sessions 3 times per week for 2 months. Statistical analysis was carried out.
Results: At the end of the study there was a significant difference in the swallowing function and results of the MASA (p < 0.001) and fiberoptic endoscopic evaluation of swallowing, before and after swallowing treatment among the 3 groups. As for the early intervention group, improvement of swallowing safety and oral intake were better than other groups. Pneumonia frequency in the early group was lower than in other groups.
Conclusion: Our data suggest that intervention for dysphagia management at the proper time can improve swallowing safety, oral intake and reduce pulmonary complications.