Assessment of the effects of dysphagia therapy in patients in the early post-stroke period: a randomised controlled trial

Abstract

Aim: This study aimed to evaluate the effects of dysphagia therapy in patients in the early post-stroke period. Clinical rationale: Dysphagia can be one of the consequences of stroke. This problem often leads to complications in the early stages of stroke, including aspiration pneumonia. Although individual reports on dysphagia exist in the literature, no comprehensive guidelines for dysphagia therapy are available. Material and methods: This randomised controlled trial included 60 patients with swallowing difficulties after ischaemic stroke (30 each in the study and control groups; age range: 55-65 years) who were admitted to a hospital stroke subunit. Patient rehabilitation period covered 15 days (seven days a week), with therapy for the first 10 days provided during patient hospitalisation and then outpatient physiotherapy during the subsequent five days. The procedure, including providing education about safe food and liquid consumption to patients and their caregivers, was performed in both patient groups. An original dysphagia treatment method was employed in the study group. Statistical average, standard deviation, and statistical error before and after therapy were determined in the study and control groups. The significance of differences in results between the study and control groups was assessed using the Mann-Whitney U test. Results: The applied therapy for dysphagia improved the swallowing function and selected motor functions of patients after stroke. In the study group, ineffective (delayed) and absent swallowing reflex was observed in 13 patients (44%) before therapy and in one patient (3%) after therapy. The rate of effective swallowing reflex increased from 57% to 97%. Statistically significant differences in swallowing reflex were observed between the study and control groups after therapy (p = 0.00001). Conclusions: A comprehensive therapy for dysphagia is effective and can reduce serious complications of swallowing disorders in clinical practice. Clinical implications: The results of this study could improve the clinical treatment of dysphagia.

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“…The prevalence rates of dysphagia vary due to differences in the definition of dysphagia, method of assessing swallowing function, timing of swallowing assessment after stroke, and number and type of patients with stroke studied [11]. Early therapy for dysphagia is effective and can reduce serious complications [12]. For patients with persistent dysphagia, more effective treatments are needed to reduce morbidity and mortality.…”

Further publication enhancements discussed during the current Editorial Board meeting of the Polish Journal of Neurology and Neurosurgery (Neurologia i Neurochirurgia Polska)

“…The second most downloaded article was a research paper submitted by authors from the Municipal Hospital in Nysa and the Opole University of Technology, both institutions located in Poland. This manuscript described a randomised controlled trial of the effects of dysphagia therapy in stroke patients [3]. The third, fourth and fifth most downloaded articles were invited reviews.…”

“…[2][3][4][5][6]. The most frequently downloaded article was an invited review written by authors from the University of Rzeszow in Poland.…”

Poststroke recovery: a frontier for intervention trials

“…Early swallowing evaluation has been shown to improve poststroke dysphagia. In 2019, the PJNNS published the results of a randomised controlled trial showing that comprehensive therapy for dysphagia is effective and can reduce serious complications of swallowing disorders in patients who have experienced ischaemic stroke [1].…”