Abstract
Aim: The purpose of this study was to evaluate the effect of intensive dysphagia rehabilitation on poststroke dysphagia in elderly hospitalized patients.
Methods: This study was conducted in 14 hospitals. Patient selection criteria included aged 65 years or older, newly admitted to hospital in the recovery rehabilitation unit, first onset of dysphagia by poststroke within 60 days from onset, and food intake level scale (FILS) ≤ 7. Eligible patients were randomly assigned in a 1:1 ratio to receive either intensive dysphagia rehabilitation (1 h/day) or standard dysphagia rehabilitation for 1 month. Several endpoints including FILS, food form, repetitive saliva swallowing test, modified water swallow test, presence of nasogastric tube and occurrence of aspiration pneumonia during hospital stay were assessed at baseline and after intervention.
Results: Of the 55 patients who underwent randomization, 28 patients were assigned to receive standard dysphagia rehabilitation (44±14 min/day) and 27 patients to intensive dysphagia rehabilitation (60±12 min/day). The number of patients whose FILS score improved significantly increased in the intensive group (81%, 22/27 patients) compared with the standard group (57%, 16/28 patients). Regarding food form, the number of patients who were capable of eating standard cooked rice or whole porridge did not significantly increase after intervention in the standard group (4 patients to 10 patients), but significantly increased (2 patients to 11 patients) in the intensive group. The number of patients who suffered from aspiration pneumonia was significantly smaller in the intensive group than that in the standard group. There were no significant differences in other endpoints.
Conclusions: We conclude that intensive dysphagia rehabilitation may provide further improvements for post-stroke dysphagia.
