Effects of a sensorimotor short-term rehabilitation programme on dysphagia after cerebral infraction. a comparative study

Abstract

Background and Aims: The aim of the study was to compare the effects of a short rehabilitation training programme on dysphagia after stroke between a sensorimotor therapeutic tool and traditional dysphagia therapy (TDT). The therapeutic protocol consisted of alternating exercises aiming to muscle strengthening (Chin Tuck Against Resistance, CTAR) and sensory stimulation of swallowing (Thermal Tactile Stimulation, TTS). Methods: In this prospective study 30 eligible stroke patients with dysphagia were included. Two (2) groups were matched in terms of demographic characteristics (p>0,05). The experimental group (N=15, 10 men, 11 with subcortical lesions, mean (±SD) age 63,9±5.6, days post-stroke 10±3.7) received the intense therapeutic protocol while the control group (N=15) received TDT. Fiberoptic endoscopic evaluation of swallowing (FEES) was conducted at baseline and 2 weeks post, measuring standing pharyngeal secretions, spillage, penetration-aspiration, pharyngeal swallow onset time and residue. Dysphagia severity (Dysphagia Severity Rating Scale) and Functional Oral intake scale (FOIS) were also scored. Parametric statistical test Anova was used to compare the variables between the 2 groups (SPSS-v. 23). Results: Significant changes were observed in the experimental group: vallecula residue (measured with Yale residue scale) (p=0.002), penetration/ aspiration scores (p<0.001), dysphagia severity (Dysphagia Severity Rating Scale) (p=0.007 κα p<0.001). Delayed pharyngeal swallow was observed in 46.7% of patients from experimental group vs. 80% in control group. Conclusions: This study demonstrated that sensorimotor treatment approach in the form of combined CTAR and TTS is effective in improving the pharyngeal swallow, reducing pharyngeal residue, and improving the swallowing function efficacy in post-stroke dysphagic patients.