Document Type : Special Articles

Authors

• Jalal Bakhtiyari ¹
• Payam Sarraf ²
• Noureddin Nakhostin-Ansari ³
• Abbas Tafakhori ²
• Jeri Logemann ⁴
• Soghrat Faghihzadeh ⁵

¹ Department of Speech Therapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran

² Iranian Center of Neurological Researches AND Department of Neurology, School of Medicine, Tehran University of Medical Sciences. Tehran, Iran

³ Department of Physiotherapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran

⁴ Departments of Neurology and Otolaryngology-Head and Neck Surgery Feinberg, School of Medicine, Northwestern University, Evanston, IL

⁵ Department of Biological Statistics and Epidemiology, School of Medicine, Zanjan University Medical Sciences, Zanjan, Iran

Abstract

Background: Dysphagia is common after stroke. The onset time of swallowing rehabilitation following stroke has an important role in the recovery of dysphagia and preventing of its complications, but it was either highly variable or was not stated in previous trials. The aim of this study was investigation effects of onset time of swallowing therapy on recovery from dysphagia following stroke.Methods: Sixty dysphagia patients due to stroke range of age 60-74 (67.1 ± 3.8), participated in this randomized clinical trial study. The patients allocated in Early, Medium and Late groups, on the base of initiation of swallowing therapy after the stroke. After basic clinical and video fluoroscopic swallowing study assessments, traditional swallowing therapy was initiated 3 times per week for 3 months. The outcome measures were North-Western dysphagia patient check sheet, functional oral intake scale, video fluoroscopy, and frequency of pneumonia. Statistical analysis was done by repeated measure ANOVA, Bonferroni and χ2 tests.Results: Three groups of patients in terms of demographic and clinical characteristics were similar in the pre-treatment P > 0.050. Onset time of swallowing therapy after stroke was effective on swallowing recovery on the main outcome variables. So that in first group patients, recovery was rather than other groups P < 0.050. Furthermore, the frequency of pneumonia in the early group was less than other groups and in the early group no patients experienced pneumonia P = 0.002.Conclusion: Our data suggested that early interventions for dysphagia in stroke have an important role in recovery from dysphagia and prevention of complications like aspiration pneumonia.