Is an Oral Health Status a Predictor of Functional Improvement in Ischemic Stroke Patients Undergoing Comprehensive Rehabilitation Treatment?

Piotr Gerreth,Karolina Gerreth,Mateusz Maciejczyk,Anna Zalewska,Katarzyna Hojan

doi:10.3390/brainsci11030338

Abstract

The study’s aim was a clinical observation concerning the influence of oral health on functional status in stroke patients undergoing neurorehabilitation. This pilot cross-sectional clinical study was performed in 60 subacute phase stroke patients during 12 weeks of treatment. The program was patient-specific and consisted of neurodevelopmental treatment by a comprehensive rehabilitation team. The functional assessment was performed using the Barthel index (BI), Berg balance scale (BBS), functional independence measure (FIM), and Addenbrooke’s cognitive examination III (ACE III) scales. Oral health was assessed according to World Health Organization (WHO) criteria, and it was presented using DMFT, DMFS, gingival index (GI), and plaque index (PlI). Significant improvement in many functional scales was noticed. However, important differences in most dental parameters without relevant changes in GI and PlI after the study were not observed. Reverse interdependence (p < 0.05) was shown between physical functioning (BI, FIM, or BBS) with GI and PlI results, and most dental parameters correlated with ACE III. Using multivariate regression analysis, we showed that ACE III and BI are predictive variables for DMFT, just as FIM is for DS (p < 0.05). The present research revealed that poor oral health status in patients after stroke might be associated with inpatient rehabilitation results.

Highlights

Stroke has become the second leading cause of long-term disability and cognitive impairment
92 ischemic stroke sufferers were enrolled in the study, and 60 participants who completed all assessments were qualified for the analysis (Figure 1)
We showed that decayed teeth (DT), filled due to caries (FT), DMFT, decayed surfaces of tooth (DS), MS, and DMFS depend on age, but we noticed that MT, gingival index (GI), and plaque index (PlI) depend on the number of strokes Brain Sci. 2021, 11, x FOR PEER REVIEWin our study group

Summary

Introduction

Stroke has become the second leading cause of long-term disability and cognitive impairment. It is generally accepted that poor oral health may affect the general condition, whereas, on the other hand, systemic diseases might have oral manifestation and disturb the health of the oral cavity [5,6] Such disorders as periodontal disease or untreated caries that often result in severe complications might intensify general diseases or even cause life-threatening situations [4,7]. The quality of rehabilitation in stroke patients can be measured according to the level of independence achieved in daily activities. This goal seems to be of paramount importance in the rehabilitation of this group of patients. An adequate and rigorous assessment is vital for the rehabilitation physician (physiatrist) to establish proper physiotherapy and physical recovery outcomes, monitor progress in patients’ rehabilitation, and prescribe an adequate medicine treatment [16] with particular attention to polypharmacy and its possible consequences [17]

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Discussion

Conclusion