The Japanese Journal of Dysphagia Rehabilitation
Online ISSN : 2434-2254
Print ISSN : 1343-8441
Original Paper
Effects of a Dysphagia Rehabilitation Program, Which Begins in the Acute Stage of Stroke, on the Early Acquisition of Oral Intake Ability
Tamami KOYAMAYutaka KOGANEIMotoko KATOH
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JOURNAL FREE ACCESS

2012 Volume 16 Issue 1 Pages 20-31

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Abstract

[Purpose] In the acute stage of stroke, risk management, including the prevention of disuse syndrome and complications such as pneumonia, is necessary. Systematic and comprehensive dysphagia rehabilitation is also necessary in order to quickly acquire an oral intake ability and subsequent self-care ability. In this study, we examined the effectiveness of a dysphagia rehabilitation program which had been performed since fiscal 2007, with the goal of carrying out an effective program for acute stroke patients.

[Method] This study included 367 acute stroke patients (223 males and 144 females; mean age: 71±12.8), who underwent eating function therapy between April 2006 and March 2009. The characteristics of the subjects and the results of dysphagia rehabilitation (number of subjects who switched from tube feeding to oral intake, number of days from admission to the beginning of dysphagia rehabilitation, number of days from admission to oral intake, incidence of pneumonia during hospitalization, swallowing ability grade score at discharge, mean length of stay) were compared for each fiscal year. The changes before and after program implementation and all influencing factors were also examined. The statistical analyses were performed using SPSS for Windows 13, and the statistical significance level was set to less than 5%.

[Results] The number of subjects who switched to oral intake increased after the program (93.4% in fiscal 2007 and 2008) as compared to that before the program (83.1% in fiscal 2006). The length of hospitalization until oral intake decreased after the program (6.8 days vs. 14 days). The incidence of pneumonia during hospitalization also decreased after the program (2.8% vs. 13%). The swallowing ability grade score at discharge improved after the program (8.8 vs. 7.6), and the patients who could eat ordinary meals at discharge increased. A logistic regression analysis revealed that the program decreased the incidence of pneumonia during hospitalization, and improved the swallowing ability grade at discharge.

[Conclusion] In the acute stage of stroke, dysphagia rehabilitation carried out according to the comprehensive program from the first day of hospitalization facilitates the reacquisition of oral intake ability. It also prevents pneumonia and improves the swallowing ability function at discharge.

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© 2012 The Japanese Society of Dysphagia Rehabilitation
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