Analysis of the Level of Dysphagia, Anxiety, and Nutritional Status Before and After Speech Therapy in Patients with Stroke

Abstract

Introduction: The rehabilitation in oropharyngeal dysphagia evidence-based implies the relationship between the interventions and their results. Objective: Analyze level of dysphagia, oral ingestion, anxiety levels and nutritional status of patients with stroke diagnosis, before and after speech therapy. Method: Clinical assessment of dysphagia partially using the Protocol of Risk Assessment for Dysphagia (PARD), applying the scale Functional Oral Intake Scale for Dysphagia in Stroke Patients (FOIS), Beck Anxiety Inventory (BAI) and the Mini Nutritional Assessment MNA®. The sample consisted of 12 patients, mean age of 64.6 years, with a medical diagnosis of hemorrhagic and ischemic stroke and without cognitive disorders. All tests were applied before and after speech therapy (15 sessions). Statistical analysis was performed using the chi-square test or Fisher's exact test, McNemar's test, Bowker's symmetry test and Wilcoxon's test. Results: During the pre-speech therapy assessments, 33.3% of patients had mild to moderate dysphagia, 88.2% did not receive food orally, 47.1% of the patients showed malnutrition and 35.3% of patients had mild anxiety level. After the therapy sessions, it was found that 33.3% of patients had mild dysphagia, 16.7% were malnourished and 50% of patients had minimal level of anxiety. Conclusion: There were statistically significant evolution of the level of dysphagia (p = 0.017) and oral intake (p = 0.003) post-speech therapy. Although not statistically significant, there was considerable progress in relation to the level of anxiety and nutritional status.

Combined systematic screening for malnutrition and dysphagia in hospitalized older adults: a scoping review

“…The professional groups carrying out the screenings were reported in only 6 studies (Nursing staff/study nurse: Cabre et al 2010; Carrión et al 2015; Mateos-Nozal et al 2017; Shimazu et al 2020; SLT: Crary et al 2006; Moncayo-Hernandéz et al 2023) [ 10 , 43 – 46 , 49 ]; 7 studies used exclusively self-reported tools (Manas-Martinez et al 2018; Matsuo et al 2017; Popman et al 2016; Tran et al 2021; Vidal Casariego et al 2020; Wakabayashi & Matsuhima 2016; Wham et al 2017) [ 41 , 47 , 50 , 57 , 58 , 60 , 67 ] and the remaining 14 did not specify the profession [ 13 , 42 , 48 , 51 – 56 , 59 , 61 , 68 – 70 ].…”

“…Both describe the screening process as part of routine patient care and report on specific measures derived from the screening results, such as a referral to swallowing of nutritional specialists or a recommendation on texture for oral nutrition. Five studies reported that screening was systematically repeated, either after an intervention, after a certain amount of time or right before discharge [ 51 , 55 , 56 , 68 , 69 ]. Table 5 provides an overview of the subsequent intervention following positive screening results.…”

Nutritional assessment and post-procedural complications in older stroke patients after insertion of percutaneous endoscopic gastrostomy – a retrospective study

“…OD is identified as a major contributor to malnutrition according to a resolution of the Council of Europe ( 19 ) and some other investigators ( 20 – 22 ). Therefore, it is impertinent to identify patients who are at risk of malnutrition and to initiate appropriate nutritional treatment.…”