An overview of dysphagia rehabilitation for stroke patients.

Klayne Cunha Matos,Pedro Braga Neto,Paula Luanna Carvalho De Oliveira,Vanessa Fernandes De Oliveira

doi:10.1590/0004-282x-anp-2021-0073

Abstract

Dysphagia is characterized by difficulty in the swallowing pattern at any stage of this neuromuscular process. It is a frequent symptom after stroke. This study aimed to investigate the most commonly used phonoaudiological interventions as therapy for the treatment of swallowing disorders in patients with dysphagia after stroke. We performed a review of studies indexed in MEDLINE-PubMed, LILACS, Cochrane, and Clinical trials.gov focusing on speech-language interventions for adult dysphagic patients after stroke between January 2008 and January 2021. Thirty-six articles of clinical trials were selected. Eleven different types of therapies have been studied. Studies on the efficacy of therapeutic interventions for the rehabilitation of adult patients with dysphagia after stroke are still scarce. Most techniques are combined with conventional therapy, so the effectiveness of the other techniques alone cannot be assessed. Therapeutic interventions should be selected in accordance with the possibilities and limitations of the patients, and especially with the findings of the clinical evaluation and with its objective.

Highlights

Dysphagia is characterized by difficulty or discomfort in swallowing
60 studies were selected for inclusion according to their titles and abstracts, of which 38 clinical trials that met the inclusion criteria were included in this review
A total of 12 different therapies have been studied with a variety of study designs: [1] electrical stimulation (n = 14; 36.8% of the total)7-20, [2] transcranial magnetic stimulation techniques (n = 3; 7.9%)21–23, [3] active pharyngeal electrostimulation (n = 3; 7.9%)24–26, [4] exercises with Mendelsohn maneuver (n = 2; 5.3%)27,28, [5] transcranial direct current stimulation (n = 3; 7.9%)29–31, [6] CTAR exercise (n = 5; 13.6%)32–36, [7] Shaker exercise (n = 2; 5.3%)33,37, [8] acupuncture (n = 3; 7.9%)38–40, [9] resistance to tongue pressure (n = 2; 5.3%)41,42, [10] modified jaw opening exercise (n = 1; 2.6%)[43] and [11] cervical isometric exercises (n = 1; 2.6%)[44]

Summary

Introduction

Dysphagia is characterized by difficulty or discomfort in swallowing. Recent studies indicate an average frequency of dysphagia of 50% after stroke. It causes a large increase in hospital costs per patient. Dysphagia is characterized by difficulty in the swallowing pattern at any stage of this neuromuscular process. It is a frequent symptom after stroke. Objective: This study aimed to investigate the most commonly used phonoaudiological interventions as therapy for the treatment of swallowing disorders in patients with dysphagia after stroke. Studies on the efficacy of therapeutic interventions for the rehabilitation of adult patients with dysphagia after stroke are still scarce. Conclusions: Therapeutic interventions should be selected in accordance with the possibilities and limitations of the patients, and especially with the findings of the clinical evaluation and with its objective

Objectives

Methods

Results