2003 Volume 7 Issue 2 Pages 117-125
Purpose： This study examined the severity of dysphagic inpatients following stroke， before and a fter swallowing training．
Methods： Out of 122 inpatients that received swallowing training for one year from April 1，2001，66 with etiologies of stroke or cerebral hemorrhage were investigated， focusing on the Dysphasia Severity Scale (“DSS”) and their diet status．To measure the DSS improvement，the variance between the start and end of training was calculated as follows：⊿DSS (“⊿DSS”) ＝ DSS at the end of training―DSS at the start of training．
Results： When the training started，those classified as “chance aspirator” on the DSS accounted for 73％．Concerning their diet status， 45％ were NPO (nothing per OS)．Comparison of 46 subjects between the start and end of the training presented a ⊿DSS average of 1.5 (minimum 0，maximum 5)．29(63％)，17(37％)，and 0(0％) patients respectively presented improvement，invariance and deterioration in DSS scores．The 29 presented improvement with a⊿DSS average of 2.4．Saliva，food，and water aspirators at the start of training presented ⊿DSS average scores of 1.3，2.0 and 2.3 respectively，with water aspirators presenting the greatest improvement．Concerning variance in ⊿DSS of different groups in terms of age，sex，and the first recurrence，no significant variance in ⊿DSS was found．
Discussion： When training started，risky cases held a majority； approximately 70％ of patients had aspiration，and about 50％ were in NPO condition．This requires effective risk management and the optimum timing of rehabilitation Saliva aspirators leveled in DSS scores while water aspirators improved，suggesting that saliva aspirators at the start of rehabilitation require a long-term follow-up．Rehabilitation programs undertaken by a team should be implemented on a continuing basis in a future．
