الفهرس | Only 14 pages are availabe for public view |
Abstract Oropharyngeal dysphagia is common in patients with stroke. It is known to be associated with general health intercurrences of the individual, which may cause pneumonia, dehydration, malnutrition and extend length of hospitalization, in addition to increasing the costs of health care. Thus, early identification and management of oropharyngeal dysphagia is extremely important to minimize the adverse consequences to the health of the patient with stroke. The aim of this work was to assess the incidence of oropharyngeal dysphagia and associated complications in stroke patients admitted to stroke units through a period of one year. And to investigate the effect of the onset time of swallowing therapy on recovery from oropharyngeal dysphagia following stroke. The swallowing functions were assessed in the 39 acute cortical and subcortical stroke patients at the time of presentation at the swallowing clinic and after two months of swallowing rehabilitation. The patients were allocated into one of three groups according to the time of presentation to the swallowing clinic post-stroke and subsequent initiation of swallowing therapy. Accordingly, patients were divided into (1) early initiation group (3 days up to 13 days after stroke); (2) intermediate group (14 – 29 days after stroke); and (3) late group (30 days up to 45 days after stroke). Patients were assessed before starting swallowing rehabilitation by Acute stroke Dysphagia Screen, Mann Assessment of Swallowing Ability, functional oral intake scale, Bedside swallowing examination, fiberoptic endoscopic evaluation of swallowing, and/or videofluoroscopic swallowing study, and chest x-ray. A plan for treatment strategies is tailored for each patient to overcome his problem. The choice of specific swallowing exercises established by the findings of clinical examination and instrumental examination. Patients received swallowing rehabilitation sessions 3 times per week for 2 months. At the end of the study patients were assessed by fiberoptic endoscopic evaluation of swallowing, and/or videofluoroscopic swallowing study, functional oral intake scale, Mann Assessment of Swallowing Ability, chest x-ray and count the number of sessions needed for improvement. |