Abstract T MP47: Intentional Oral Food Intake Challenge Improves the Functional Outcome of Severe Stroke Patients

Abstract

Background and Purpose: Dysphagia is a common complication after stroke that ends up with severe physical disability in many cases. In our convalescent rehabilitation ward, we had observed that tube-fed stroke patients showed remarkable recovery of activities of daily living (ADL) after regaining oral food intake. This led to our hypothesis that intentional oral food intake challenge (IOFIC) might improve overall ADL recovery of severe stroke patients with dysphagia. To address this question, we started IOFIC in early stage of convalescent rehabilitation for tube-fed severe stroke patients since April 2011. Methods: We picked up 119 consecutive severe stroke patients who were on tube-feeding on admission and discharged from our convalescent rehabilitation ward between Apr. 2009 and Mar. 2013. Their functional independence measure (FIM) scores on admission were lower than 55 to select severe stroke patients. We divided the patients into the Pre-IOFIC (Apr.2009-Mar.2011) and the After-IOFIC (Apr.2011-Mar.2013) groups, and compared the recovery rate of oral food intake, FIM scores on admission and discharge, FIM gain during the admission period, and final destination of the patients. Statistical analyses were performed using t-test, Mann-Whitney U-test, and χ 2 -test. Results: Patients’ age ranged between 39 and 97 (72±14), and 71 were male and 48 were female. Comparing the Pre-IOFIC (n=59) and Post-IOFIC (n=60) groups, there was no significant difference in age, sex, stroke type, and FIM on admission. There were significant differences in the Pre-IOFIC and the Post-IOFIC groups in terms of the percentage of patients who regained full oral food intake (10.2% vs. 70.0%, p<0.001), the percentage of patients who were able to return to their home (25.9% vs. 50.9%, p<0.01), and FIM gain during the admission period (6.0±10.8 vs. 17.8±19.9, p<0.001). Conclusions: Our data indicates that IOFIC during post-stroke rehabilitation greatly improves the ADL outcome of severe stroke patients with dysphagia. Oral food intake may be the “gate step” to the functional recovery in stroke rehabilitation.