Reassessment of Poststroke Dysphagia in Rehabilitation Facility Results in Reduction in Diet Restrictions.

diet dysphagia poststroke care reassessment stroke

Journal

Journal of clinical medicine
ISSN: 2077-0383
Titre abrégé: J Clin Med
Pays: Switzerland
ID NLM: 101606588

Informations de publication

Date de publication:
15 Apr 2021
Historique:
received: 30 01 2021
revised: 28 03 2021
accepted: 12 04 2021
entrez: 30 4 2021
pubmed: 1 5 2021
medline: 1 5 2021
Statut: epublish

Résumé

Dysphagia assessment in postacute stroke patients can decrease the incidence of complications like malnutrition, dehydration, and aspiration pneumonia. It also helps to avoid unnecessary diet restrictions. The aim of this study is to verify if regular reassessment of dysphagia would change the diet management of postacute stroke patients in rehabilitation settings. This single-center retrospective study included 63 patients referred to an inpatient neurological rehabilitation center between 2018-2019. A standardized clinical swallowing evaluation and Fiberoptic Endoscopic Evaluation of Swallowing (FEES) were performed. Diet level according to Functional Oral Intake Scale (FOIS) was evaluated. As the primary endpoint, the FOIS values based on diagnostic procedures were assessed at hospital discharge, rehabilitation admission, and after FEES. 19 women (30%) and 44 men (70%), with a mean age of 75 y (SD ± 10.08), were enrolled. The intergroup ANOVA revealed significant differences ( Instrumental diagnostic by FEES during the early convalescence period of stroke patients leads to clinically relevant changes to diet restrictions and lower rates of pneumonia. Our findings underline the need for regular and qualitative dysphagia diagnostics in stroke patients participating in neurological rehabilitation.

Sections du résumé

BACKGROUND BACKGROUND
Dysphagia assessment in postacute stroke patients can decrease the incidence of complications like malnutrition, dehydration, and aspiration pneumonia. It also helps to avoid unnecessary diet restrictions. The aim of this study is to verify if regular reassessment of dysphagia would change the diet management of postacute stroke patients in rehabilitation settings.
METHODS METHODS
This single-center retrospective study included 63 patients referred to an inpatient neurological rehabilitation center between 2018-2019. A standardized clinical swallowing evaluation and Fiberoptic Endoscopic Evaluation of Swallowing (FEES) were performed. Diet level according to Functional Oral Intake Scale (FOIS) was evaluated. As the primary endpoint, the FOIS values based on diagnostic procedures were assessed at hospital discharge, rehabilitation admission, and after FEES.
RESULTS RESULTS
19 women (30%) and 44 men (70%), with a mean age of 75 y (SD ± 10.08), were enrolled. The intergroup ANOVA revealed significant differences (
CONCLUSION CONCLUSIONS
Instrumental diagnostic by FEES during the early convalescence period of stroke patients leads to clinically relevant changes to diet restrictions and lower rates of pneumonia. Our findings underline the need for regular and qualitative dysphagia diagnostics in stroke patients participating in neurological rehabilitation.

Identifiants

pubmed: 33921185
pii: jcm10081714
doi: 10.3390/jcm10081714
pmc: PMC8071486
pii:
doi:

Types de publication

Journal Article

Langues

eng

Références

J Phys Ther Sci. 2017 Sep;29(9):1552-1554
pubmed: 28931986
Stroke. 2009 Apr;40(4):1381-5
pubmed: 19228843
PLoS One. 2019 Jan 10;14(1):e0210313
pubmed: 30629665
J Neurosci Nurs. 2013 Jun;45(3):139-46
pubmed: 23636069
Phys Med Rehabil Clin N Am. 2008 Nov;19(4):747-68, viii
pubmed: 18940639
BMC Neurol. 2019 Nov 12;19(1):282
pubmed: 31718562
Dysphagia. 1999 Winter;14(1):44-51
pubmed: 9828274
Adv Med Educ Pract. 2018 Jun 12;9:433-441
pubmed: 29928150
J Hosp Med. 2019 May;14(5):315-317
pubmed: 30794132
J Am Coll Cardiol. 2020 Dec 22;76(25):2982-3021
pubmed: 33309175
Arch Phys Med Rehabil. 2005 Aug;86(8):1516-20
pubmed: 16084801
Cerebrovasc Dis. 2018;46(3-4):99-107
pubmed: 30199856
Int J Stroke. 2016 Jun;11(4):399-411
pubmed: 27006423
J Stroke Cerebrovasc Dis. 2014 Mar;23(3):e195-200
pubmed: 24361193
Arch Phys Med Rehabil. 1998 Jan;79(1):14-9
pubmed: 9440410
Dysphagia. 1996 Spring;11(2):93-8
pubmed: 8721066
Clin Nutr. 2018 Feb;37(1):354-396
pubmed: 29274834
J Speech Lang Hear Res. 2005 Dec;48(6):1280-93
pubmed: 16478371
J Stroke Cerebrovasc Dis. 2016 Apr;25(4):799-806
pubmed: 26796058
PLoS One. 2018 Feb 1;13(2):e0192142
pubmed: 29389984
Stroke. 2005 Sep;36(9):1972-6
pubmed: 16109909
J Eval Clin Pract. 2020 Dec;26(6):1744-1760
pubmed: 32083782
Arch Phys Med Rehabil. 1994 Feb;75(2):127-32
pubmed: 8311667
BMJ Open. 2018 Mar 6;8(3):e019016
pubmed: 29511010
Dysphagia. 2001 Winter;16(1):7-18
pubmed: 11213249
Stroke. 2005 Dec;36(12):2756-63
pubmed: 16269630
Arch Phys Med Rehabil. 2000 Aug;81(8):1030-3
pubmed: 10943750
Dysphagia. 2014 Jun;29(3):340-5
pubmed: 24445382
J Hum Nutr Diet. 2011 Oct;24(5):460-9
pubmed: 21605199
Stroke. 2009 Feb;40(2):482-6
pubmed: 19074481

Auteurs

Anna Maria Pekacka-Egli (AM)

Department for Pulmonary Medicine and Sleep Medicine, Zürcher RehaZentren, Klinik Wald, 8636 Wald, Switzerland.
Department for Neurology and Neurorehabilitation, Zürcher RehaZentren, Klinik Wald, 8636 Wald, Switzerland.

Radoslaw Kazmierski (R)

Department for Neurology and Cerebrovascular Disorders, Poznan University of Medical Sciences, 61701 Poznan, Poland.

Dietmar Lutz (D)

Department for Neurology and Neurorehabilitation, Zürcher RehaZentren, Klinik Wald, 8636 Wald, Switzerland.

Katarzyna Pekacka-Falkowska (K)

Department for History and Philosophy of Medicine, Poznan University of Medical Sciences, 61701 Poznan, Poland.

Adam Maszczyk (A)

Department for Methodology, Statistics, and Informatics Systems, Institute of Sport Science, Academy of Physical Education in Katowice, 40065 Katowice, Poland.

Wolfram Windisch (W)

Department for Pulmonary Medicine, Faculty of Health, University Witten-Herdecke, 58455 Witten, Germany.
Department of Pneumology, Cologne Merheim Hospital Kliniken der Stadt Koeln GmbH, 51109 Koeln, Germany.

Marc Spielmanns (M)

Department for Pulmonary Medicine and Sleep Medicine, Zürcher RehaZentren, Klinik Wald, 8636 Wald, Switzerland.
Department for Pulmonary Medicine, Faculty of Health, University Witten-Herdecke, 58455 Witten, Germany.

Classifications MeSH