Video Fluoroscopic Swallowing Study Scores Research Articles

A meta-analysis of the effect of nape acupuncture combined with rehabilitation training in the treatment of dysphagia after stroke.

To systematically evaluate the general efficacy of nape acupuncture combined with rehabilitation training for the treatment of post-stroke dysphagia and in the recovery of swallowing function. Three English databases (PubMed, Excerpta Medica Database, Cochrane Library) and three Chinese databases (China National Knowledge Infrastructure, Wanfang Data, CQVIP) were searched using the date range January 1, 2001-January 1, 2022. Study Selection: Randomized controlled trials (RCT) of nape acupuncture combined with rehabilitation for the treatment of dysphagia after stroke with appropriate evaluation methods were included in the study. The results indicated that nape acupuncture combined with rehabilitation training led to higher clinical effectiveness (odds ratio (OR) =4.25 and 95% confidence interval (CI)=[2.94, 6.15]), higher videofluoroscopic swallowing study scores(VFSS) (weighted mean difference (WMD)=1.33; 95% CI=[1.09, 1.58]), and lower Standardized Swallowing Assessment (SSA) scores (WMD = -2.57, 95% CI=[-3.51, -1.62]) in patients with post-stroke dysphagia compared with rehabilitation training alone. This Meta-analysis suggested that nape acupuncture combined with rehabilitation training is more effective in the treatment of dysphagia after stroke than rehabilitation alone.

Effect of Cold Fluid Compensatory Swallowing Combined with Balloon Dilation on the Treatment of Poststroke Cricopharyngeal Achalasia: A Pilot Randomized Controlled Trial.

Objective This study is aimed at comparing the treatment efficacy between catheter balloon dilation combined with cold fluid compensatory swallowing training and catheter balloon dilation alone on poststroke cricopharyngeal achalasia (CPA). Methods We conducted a single-blind, randomized controlled trial (RCT). Poststroke patients with CPA were divided into two groups: the control group (treated with catheter balloon dilation) and the trial group (catheter balloon dilation combined with cold fluid compensatory swallowing). Videofluoroscopic swallowing study (VFSS) was performed, and functional oral intake scale (FOIS) was used to evaluate and compare the swallowing function of patients in the 2 groups before and after intervention. Posttreatment VAS pain scores and recovery time were also measured. Results VFSS and FOIS scores in the two groups were improved after treatment (P < 0.05). In the trial group, VFSS scores in the pharyngeal phase and aspiration degree were significantly higher compared with the control group (P < 0.05) but not in the oral phase (P > 0.05). The difference in FOIS scores and patients' recovery time from intervention to eating mushy food between the trial and control groups was significant (P < 0.05), but not the VAS scores (P > 0.05). Conclusion The catheter balloon dilation combined with cold fluid compensatory swallowing was superior to catheter balloon dilation alone in terms of relieving dysphagia and reducing aspiration in patients with CPA following stroke. Long-term efficacy should be followed up with more objective and quantitative indicators in future studies.

Altered Brain Function Activity in Patients With Dysphagia After Cerebral Infarction: A Resting-State Functional Magnetic Resonance Imaging Study.

ObjectiveDysphagia after cerebral infarction (DYS) has been detected in several brain regions through resting-state functional magnetic resonance imaging (rs-fMRI). In this study, we used two rs-fMRI measures to investigate the changes in brain function activity in DYS and their correlations with dysphagia severity.MethodIn this study, a total of 22 patients with DYS were compared with 30 patients without dysphagia (non-DYS) and matched for baseline characteristics. Then, rs-fMRI scans were performed in both groups, and regional homogeneity (ReHo) and fractional amplitude of low-frequency fluctuation (fALFF) values were calculated in both groups. The two-sample t-test was used to compare ReHo and fALFF between the groups. Pearson's correlation analysis was used to determine the correlations between the ReHo and fALFF of the abnormal brain regions and the scores of the Functional Oral Intake Scale (FOIS), the Standardized Bedside Swallowing Assessment (SSA), the Videofluoroscopic Swallowing Study (VFSS), and the Penetration-Aspiration Scale (PAS).ResultsCompared with the non-DYS group, the DYS group showed decreased ReHo values in the left thalamus, the left parietal lobe, and the right temporal lobe and significantly decreased fALFF values in the right middle temporal gyrus and the inferior parietal lobule. In the DYS group, the ReHo of the right temporal lobe was positively correlated with the SSA score and the PAS score (r = 0.704, p < 0.001 and r = 0.707, p < 0.001, respectively) but negatively correlated with the VFSS score (r = −0.741, p < 0.001). The ReHo of the left parietal lobe was positively correlated with SSA and PAS (r = 0.621, p = 0.002 and r = 0.682, p < 0.001, respectively) but negatively correlated with VFSS (r = −0.679, p = 0.001).ConclusionThe changes in the brain function activity of these regions are related to dysphagia severity. The DYS group with high ReHo values in the right temporal and left parietal lobes had severe dysphagia.

Effects of vitamin C stimulation on rehabilitation of dysphagia after stroke: a randomized trial.

Stroke is a clinical syndrome of localized or global brain dysfunction caused by cerebrovascular disease. The aim of this study was to explore the effect of vitamin C acid stimulation on the rehabilitation process, Nourishment State Index and immune function indicators of stroke patients with dysphagia. This is a prospective cohort study. This study was conducted at our hospital. We analyzed stroke patients with dysphagia. A total of 120 stroke patients with dysphagia were randomly divided into a routine group and a test group, with 60 cases in each group. Routine swallowing training was performed in the routine group, and the test group was stimulated with vitamin C acid. The water swallow test (WST) and video fluoroscopic swallowing study (VFSS) were used to compare the rehabilitation of dysphagia in the two groups. Nourishment State Index was evaluated by BMI, serum albumin, total serum protein and hemoglobin. Immune Function Index was evaluated by IgA, IgM and IgG. Compared with the control group, the WST level of patients treated with vitamin C acid stimulation intervention were significantly reduced, and the VFSS score were significantly increased. Serum levels of hemoglobin, albumin, total protein, IgA, IgM and IgG in the vitamin C acid stimulation group were remarkably increased than those in the control group. Vitamin C acid stimulation exhibits a good application effect in patients with dysphagia after stroke. Moreover, vitamin C acid stimulation can further improve the nutritional status and immune function after stroke and promote postoperative recovery of patients. Therefore, we believe that vitamin C stimulation therapy can be widely used in stroke rehabilitation management. Vitamin C acid stimulation significantly improves rehabilitation of stroke patients with dysphagia and ameliorates the nutritional status and immune function of patients.

Acupoint injection combined with Vitalstim electrical stimulation for post-stroke dysphagia:a randomized controlled trial

To observe the clinical efficacy of acupoint injection combined with Vitalstim electrical stimulation for post-stroke dysphagia. A total of 98 patients with dysphagia after first stroke were randomized into an acupoint injection group (35 cases, 2 cases dropped off), an electrical stimulation group (31 cases, 3 cases dropped off) and a combination group (32 cases, 3 cases dropped off). Injection of mecobalamin into Tunyan point, Vitalstim electrical stimulation and the combination of injection of mecobalamin into Tunyan point and Vitalstim electrical stimulation were applied respectively in the 3 groups, once a day, 10 times as one course, 2 courses were required. Before and after treatment, the tongue muscle thickness and video fluoroscopic swallowing study (VFSS) score were observed in the 3 groups. After treatment, the tongue muscle thickness was decreased (P<0.05), the VFSS scores were increased (P<0.05) compared with before treatment in the 3 groups, and the variation of tongue muscle thickness and VFSS score in the combination group was greater than the acupoint injection group and the electrical stimulation group (P<0.05). Both acupoint injection of mecobalamin and Vitalstim electrical stimulation have therapeutic effect on dysphagia after stroke, and the two have synergistic effect.

Combination of acupuncture with rehabilitation training for pseudobulbar paralysis after stroke:A randomized controlled trial吞咽五穴联合康复训练 治疗脑卒中后假性延髓麻痹：随机对照试验

ObjectiveTo compare the clinical effects of needling at “five acupoints for swallow function” combined with rehabilitation training and only rehabilitation training in the treatment of dysphagia due to pseudobulbar paralysis after stroke. MethodsSeventy-six patients were randomized into rehabilitation group and combination group, with 38 cases in each. Both groups were treated with basic treatment of western medicine. The rehabilitation group was treated with routine rehabilitation training, and the combination group was treated with acupuncture at “five acupoints for swallow function” based on treatment in the rehabilitation group. Patients in the two groups were treated once a day, 6 days a week, 1 day for rest, for 3 weeks in succession. The changes in the grades and scores of water swallow test (WST), video fluoroscopic swallowing study (VFSS), and swallowing quality of life questionnaire (SWAL-QOL) in the two groups were observed before and after treatment, and the clinical effects of the two groups were compared. ResultsAfter treatment, the WST grades of the two groups were statistically different from that of before treatment (both P< 0.05), and the WST grade of the combination group was statistically different from that of the rehabilitation group (P< 0.05). After treatment, the VFSS and SWAL-QOL scores of the two groups were increased in comparing with those of before treatment (all P < 0.05), and the VFSS and SWAL-QOL scores of the combination group were higher than those of the rehabilitation group (both P < 0.05). The total effective rate of the combination group was 92.1% (35/38), higher than 60.1% (23/38) of the rehabilitation group. ConclusionThe acupuncture combined with rehabilitation training for pseudobulbar paralysis after stroke is more effective than rehabilitation training only. The combination of the two can significantly relieve the dysphagia and improve the patients’ quality of life.

Clinical effect of Liyan Tongqiao acupuncture in treatment of post-stroke dysphagia: an analysis based on diffusion tensor imaging

To investigate the clinical change of post-stroke dysphagia after the intervention of Liyan Tongqiao （relieving sore-throat and dredging orifices）acupuncture using cranial diffusion tensor imaging (DTI). A total of 60 patients with post-stroke dysphagia were enrolled and randomly divided into Liyan Tongqiao acupuncture group and neurology treatment group, with 30 patients in each group. The patients in the neurology treatment group were given routine neurology treatment and swallowing rehabilitation training, and those in the Liyan Tongqiao acupuncture group received acupuncture at Sishencong (EX-HN1), Baihui (GV20), bilateral Tai-yang (EX-HN5), and bilateral Fengchi (GB20) and tongue triple acupuncture, with an electroacupuncture apparatus for EX-HN1, bilateral GB20, and tongue triple acupuncture, for a needle retaining time of 30 minutes each time, once a day and 5 times a week, in addition to the treatment in the neurology treatment group. Each course of treatment was 3 weeks, and both groups were treated for 2 courses. Swallowing function assessment and cranial DTI were performed after treatment. After 6 weeks of treatment, both groups had a marked improvement in swallowing function, a significantly greater change in video fluoroscopic swallowing study (VFSS) score and a higher mean FA value (P<0.05). Compared with the neurology treatment group, the Liyan Tongqiao acupuncture group had a marked improvement in swallowing function, a significantly greater change in VFSS score in the pharyngeal phase and a higher mean FA value (P<0.05). Liyan Tongqiao acupuncture can improve dysphagia and swallowing function in the pharyngeal phase in VFSS, possibly by promoting the remodeling of cerebral cortex and increasing the FA value of infarct zone through the stimulation of related acupoint signals.

Treatment of dysphagia after stroke with acupuncture and related therapies: A protocol for systematic review and network meta-analysis.

Background:Dysphagia is a common complication after stroke, with high disability rate and high fatality rate. Although several clinical studies and evidence-based medicine have demonstrated the efficacy of acupuncture in the treatment of dysphagia after stroke, there are significant differences in study design and intervention methods. The objective of this study is to compare the efficacy and safety of different acupuncture and related therapies in the treatment of dysphagia after stroke, so as to provide a superior clinical program.Methods:We will search 7 databases for randomized controlled trials of acupuncture-related therapies for dysphagia after stroke, including PubMed, the Cochrane Library, EMbase, China National Knowledge Infrastructure, China Biological Medicine, Chinese Scientific Journals Database, and wan-fang databases, from the date of the establishment of each database to March 31, 2020. The network meta-analysis will be implemented through Aggregate Data Drug Information System 1.16.8 and Stata 13.0 software. Clinical Efficiency, videofluoroscopic swallowing study score and Kubota Drinking Water Test grade will be the primary outcomes, Swallowing disorder specific quality of life score, Standardized Assessment and Adverse effects will be evaluated as secondary outcomes. Mean differences or odds ratios will be used for statistical analysis. We will ensure the reliability of the results through node-split model and heterogeneity analysis. In addition, methodological quality will be evaluated based on the Cochrane Collaboration's tool, and the quality of evidence will be evaluated according to the Grading of Recommendations Assessment, Development and Evaluation system.Results:This study will provide a reliable evidence for the selection of acupuncture and related therapies for dysphagia after stroke.Conclusion:The results of this study will provide references for evaluating the influence of acupuncture and related therapies for dysphagia after stroke, and provide decision-making references for clinical research.Ethics and dissemination:This study did not require ethical approval. We will disseminate our findings by publishing results in a peer-reviewed journal.OSF registration number:DOI 10.17605/OSF.IO/TAHND.

Therapeutic effect of nape cluster acupuncture combined with swallowing function training on post-stroke dysphagia

To observe the effect on swallowing function in patients with post-stroke dysphagia treated with nape cluster acupuncture and the immediate effect of acupuncture at Fengchi (GB 20). A total of 60 patients with post-stroke dysphagia were randomized into an observation group and a control group, 30 cases in each one.On the basis of conventional western medication treatment, swallowing function training was applied in the control group, once a day.On the base of the treatment as the control group, nape cluster acupuncture was applied at Fengchi (GB 20), Tianzhu (BL 10), Wangu (GB 12), Lianquan (CV 23), Panglianquan (Extra), Jinjin (EX-HN 12) and Yuye (EX-HN 13) in the observation group, once a day. Additionally, pricking blood was applied at Jinjin (EX-HN 12) and Yuye (EX-HN 13), 2 times a week. The treatment was given 30 min each time, a week as one course and 4 courses were required. Before and after treatment, the standardized swallowing assessment (SSA) score and video fluoroscopic swallowing study (VFSS) score were compared in the two groups. The ultrasonic diagnostic device of swallowing and surface electromyography were used to observe the immediate effect on swallowing related muscles of acupuncture at Fengchi (GB 20). Compared before treatment, the SSA scores were reduced after treatment in the two groups (P<0.05), and the change of the observation group was larger than the control group (P<0.05). Compared before treatment, the VFSS scores were increased after treatment in the two groups (P<0.05), and the change of the observation group was larger than the control group (P<0.05). Acupuncture at Fengchi (GB 20) immediately increased the amplitude of submental muscles and infrahyoid muscles in the observation group (P<0.05), the geniohyoid muscle movement time was reduced and geniohyoid muscle displacement was increased (P<0.05). On the base of the routine treatment, nape cluster acupuncture could improve swallowing function in patients with post-stroke dysphagia. Acupuncture at Fengchi (GB 20) could immediately affect swallowing related muscles, improve muscle amplitude and reduce swallowing time.

Effect of "Tongdu Tiaoshen" needling combined with swallowing training on dysphagia, cerebral blood flow and serum BDNF and NGF levels in ischemic stroke patients

To observe the efficacy of Tongdu Tiaoshen (dredging Governor Vessel and regulating mind) needling combined with swallowing training in the treatment of ischemic stroke (IS) with dysphagia, and to investigate its effect on cerebral blood flow and serum levels of brain-derived neurotrophic factor (BDNF) and nerve growth factor (NGF). A total of 100 IS inpatients with dysphagia were enrolled in the present study, and randomly and equally divided into control group and treatment group by using a random number table. The patients of the control group received routine swallowing training including tongue extending and retracting, cheek-muscle training, breathing exercise, and laryngopharyngeal exercise, beginning from the 2nd day after hospitalization. The patients of the treatment group received manual acupuncture stimulation of Dazhui (GV14), Fengfu (GV16), Shenting (GV24), Shendao (GV11), Baihui (GV20), Shuigou (GV26), etc., on the basic treatment as those mentioned in the control group. The treatment was conducted once daily, 5 times per week and for 4 successive weeks. The swallowing ability was tested by using video fluoroscopic swallowing study (VFSS), Kubota water swallowing test, and the standard swallowing function assessment (SSA) scale, separately, and patients' daily life quality was assessed by using swallowing related quality of life questionnaire (SWAL-QOL). The cerebral hemodynamics including mean blood flow velocity (Vm), maximum peak flow speed (Vs), and vascular resistance index (RI) of the bilateral cerebral arteries was detected by transcranial color Doppler ultrasound tests, and serum BDNF and NGF contents were assayed by enzyme linked immunosorbent assay. The therapeutic effect of swallowing ability was evaluated after the treatment. After 4 weeks' treatment, the scores of Kubata water swallowing test, SSA, and SWAL-QOL and RI were considerably decreased (P<0.01), and the VFSS scores, Vs and Vm levels as well as serum BDNF and NGF contents were significantly increased (P<0.01) in both groups compared with their own pre-treatment. Of the 48 and 49 cases in the control and treatment groups, 4 (8.33%) and 8(16.33%) were cured, 26 (54.17%) and 33 (67.35%) effective, 18 (37.50%) and 8 (16.33%) failed, with the effective rate being 62.50% and 83.67%, respectively. The therapeutic effect of the treatment group was significantly superior to that of the control group in the effective rate (P<0.05), and in lowering the scores of Kubota water swallowing test, SWAL-QOL, SSA, RI, and in up-regulating the scores of VFSS, Vs and Vm, and serum BDNF and NGF levels (P<0.01). Tongdu Tiaoshen needling combined with swallowing training is effective in improving swallowing ability, promoting cerebral blood flow and in up-regulating serum neurotrophic factor levels in patients with dysphagia after ischemic stroke.

Transcranial magnetic stimulation can relieve dysphagia after stroke

Objective To explore the effect of high-frequency repetitive transcranial magnetic stimulation (rTMS) on activity in the intact motor cortex controlling the suprahyoid muscles and thus on dysphagia after an unilateral stroke. Methods Forty patients suffering dysphagia more than two weeks after a unilateral cerebral stroke were randomly divided into an experimental group and a control group, each of 20. Both groups were given traditional swallowing rehabilitation training, while the experimental group was additionally provided with 5 Hz rTMS for two weeks. Before and after the treatment, all of the patients were characterized using X-ray fluoroscopy, video fluoroscopic swallowing study (VFSS) and surface electromyography, and their swallowing was evaluated using a standardized swallowing assessment (SSA) and a penetration-aspiration scale (PAS). Results After the treatment, significant improvement was observed in both groups in the average swallowing time and in the maximum amplitude of sEMG, as well as the average SSA, PAS and VFSS scores (P<0.05). The average values in the experimental group were in all cases significantly better than the control group′s averages (P<0.05). Conclusion Applying rTMS at 5 Hz to the motor cortex of the contralateral hemisphere controlling the suprahyoid muscles can effectively improve unilateral-hemisphere dysphagia after stroke. Key words: Repetitive transcranial magnetic; Dysphagia; Stroke; Surface electromyography

The Value of Adding Transcutaneous Neuromuscular Electrical Stimulation (VitalStim) to Traditional Therapy for Poststroke Dysphagia

Background: Dysphagia may delay the functional recovery and substantially affects the quality of life after stroke, mainly if left untreated. Electrical stimulation has been reported as a treatment for pharyngeal dysphagia in recent studies, but the therapeutic effect of neuromuscular electrical stimulation (VitalStim) therapy lacks convincing supporting evidence and needs further clinical investigation. Methods: A total of 135 subjects were randomly divided into 3 groups: traditional swallowing therapy (n = 45), VitalStim therapy (n = 45), and VitalStim therapy plus traditional swallowing therapy (n = 45). The traditional swallowing therapy included basic training and direct food intake training. Electrical stimulation was applied by an occupational therapist, using a modified handheld battery-powered electrical stimulator (VitalStim Dual Channel Unit and electrodes, Chattanooga Group, Hixson, Tennessee). The surface electromyography (sEMG), standardized swallowing assessment (SSA), videofluoroscopic swallowing study (VFSS), and visual analog scale (VAS) were used to assess swallowing function before and 4 weeks after the treatment. Results: A total of 118 subjects with dysphagia completed the study, 40 in the traditional swallowing group and VitalStim therapy group and 38 in the VitalStim and traditional swallowing therapy group. There were significant differences in sEMG values and SSA and VFSS scores in each group after the treatment (P &lt; .001). After 4-week treatment, sEMG value (917.1; standard deviation [SD], 91.2), SSA value (21.8; SD, 3.5), oral transit time (0.4; SD, 0.1), and pharyngeal transit time (0.8; SD, 0.1) were significantly improved in the VitalStim and traditional swallowing therapy group than in the other 2 groups (P &lt; .001). Conclusions: Data suggest that VitalStim therapy coupled with traditional swallowing therapy may be beneficial for poststroke dysphagia.

Therapeutic effect of oral rehabilitation method combined with Shaker exercise on dysphagia in patients with cerebral infarction

Objective To evaluate the effect of oral rehabilitation method combined with Shaker exercise on the swallowing function and the quality of life in the patients with dysphagia caused by cerebral infarction. Methods A total of 120 patients with swallowing disorder caused by cerebral infarction were randomly divided into conventional treatment group (n=30), oral rehabilitation method group (n=30), Shaker exercise group (n=30) and comprehensive therapy group (n=30). The patients in the conventional treatment group were treated with conventional treatment, while the patients in oral rehabilitation method group received oral rehabilitation method treatment in addition. The Shaker exercise group accepted Shaker exercise and conventional treatment, while the comprehensive therapy group accepted oral rehabilitation method in addition. All patients were assessed with video fluoroscopic swallowing study (VFSS) and swallowing-related quality of life (SWAL-QOL), before treatment and 4-week after treatment. Results Before treatment there was no significant difference among the four groups in VFSS and SWAL-QOL scores (P>0.05). After 4-week treatment the swallowing function showed different degrees of improvement. The difference of VFSS score in the conventional treatment group was not statistically significant before treatment and 4-week after treatment (P=0.38), but it was statistically significant among the other three groups(P<0.01). After 4-week treatment there was significant difference among the four groups in VFSS score (P<0.01), and the comprehensive therapy group curative effect was significantly better than that of the other groups. The total effective rate was 96.67% in the comprehensive therapy group, 26.67% in the conventional treatment group, 66.67% in the oral rehabilitation method group, and 70.00% in the Shaker exercise group. the SWAL-QOL score in the comprehensive therapy group was higher than that of the other three groups. The average SWAL-QOL score was 187.30±10.68 in the comprehensive therapy group, (140.10±16.62) in the conventional treatment group, (161.47±24.53) in the oral rehabilitation method group, and(163.97±23.91) in the Shaker exercise group. Conclusion Application of oral rehabilitation method combined with Shaker exercise in the patients with swallowing disorder caused by cerebral infarction could effectively improve the degree of swallowing disorder and the quality of life. Key words: Dysphagia; Oral rehabilitation method; Shake exercise; Quality of life; Elder

Treatment of post-stroke dysphagia by vitalstim therapy coupled with conventional swallowing training

To investigate the effects of VitalStim therapy coupled with conventional swallowing training on recovery of post-stroke dysphagia, a total of 120 patients with post-stroke dysphagia were randomly and evenly divided into three groups: conventional swallowing therapy group, VitalStim therapy group, and VitalStim therapy plus conventional swallowing therapy group. Prior to and after the treatment, signals of surface electromyography (sEMG) of swallowing muscles were detected, swallowing function was evaluated by using the Standardized Swallowing Assessment (SSA) and Videofluoroscopic Swallowing Study (VFSS) tests, and swallowing-related quality of life (SWAL-QOL) was evaluated using the SWAL-QOL questionnaire. There were significant differences in sEMG value, SSA, VFSS, and SWAL-QOL scores in each group between prior to and after treatment. After 4-week treatment, sEMG value, SSA, VFSS and SWAL-QOL scores were significantly greater in the VitalStim therapy plus conventional swallowing training group than in the conventional swallowing training group and VitalStim therapy group, but no significant difference existed between conventional swallowing therapy group and VitalStim therapy group. It was concluded that VitalStim therapy coupled with conventional swallowing training was conducive to recovery of post-stroke dysphagia.

Therapeutic effects of early rehabilitation training combined with acupuncture for dysphagia after cerebral infarction

Objective To study the clinical therapeutic effects of early rehabilitation training combined with acupuncture on dysphagia after acute cerebral infarction.Methods One hundred patients with dysphagia caused by acute cerebral infarction were randomly divided into 4 groups:a comprehensive treatment group(25 cases,received rehabilitation training,acupuncture and routine medication),a routine drug group(25 cases,routine medication),a rehabilitation group(25 cases,received comprehensive rehabilitation training and routine mediciation)and an acu-puncture group(25 cases,received acupuncture therapy and routine medication).Dysphagia was evaluated with videofluoroscopic swallowing study(VFSS),and the incidence of pneumonia was observed before treatment and at the 14th day after daily treatment. Results After treatment,the VFSS scores of the 4 groups were significantly higher than before treatment,and VFSS scores in the comprehensive treatment group were significantly higher than those in the other groups.The effectiveness rate in the comprehensive treatment group was significantly higher than that in the other three groups.and the incidence of pneumonia was significantly lower.Conclusions Early rehabilitation com-bined with acupuncture can improve swallowing and reduce the incidence of aspiration pneumonia in acute stroke pa-tients. Key words: Cerebral infarction; Dysphagia; Rehabilitation; Acupuncture