The influence of physical therapy on oropharyngeal dysphagia in acute stroke patients

• Published in: The Egyptian journal of neurology, psychiatry and neurosurgery Vol. 52; no. 3; pp. 201 - 205
• Main Authors: El-Tamawy, Mohamed, Darwish, Moshera, El-Azizi, Hatem, Abdelalim, Ahmed, Taha, Shereen
• Format: Journal Article
• Language: English
• Published: Mumbai Medknow Publications Pvt Ltd 01-07-2015; Springer Nature B.V
• Subjects: Airway management; Barium; Conflicts of interest; Dysphagia; Larynx; Mouth; Neck; Patients; Physical therapy; Stroke; Therapists; physical rehabilitation; dysphagia; electrical stimulation; digital fluoroscopy; ischemic stroke
• ISSN: 1110-1083; 1687-8329
• DOI: 10.4103/1110-1083.162046

Background
Dysphagia occurs in 65% of acute stroke patients, resulting in airway obstruction, malnutrition, and chest infection.
Objective
The aim of this study was to evaluate the effect of a designed physical therapy program that consists of therapeutic physical exercises in addition to neuromuscular electrical stimulation on severe swallowing disorders (oropharyngeal dysphagia) in acute ischemic cerebrovascular stroke patients.
Methods
Thirty stroke patients suffering from severe dysphagia were assigned randomly to two equal groups: the study group (G1) and the control group (G2). The patients in the study group (G1) received medical treatment in addition to a designed physical therapy program mainly directed at strengthening and stimulating the elevator muscles of the larynx above and below the hyoid bone, whereas the patients in the control group (G2) were under medical treatment only. Digital fluoroscopy was used to assess the following variables: oral transit time, laryngeal elevation, hyoid elevation, esophageal sphincter opening, and aspiration or penetration. Assessment was carried out before and at the end of treatment after 6 weeks.
Results
Before treatment, there were no significant differences in different variables between G1 and G2. After treatment there was significant improvement in all variables in G1 compared with G2, as measured by digital fluoroscopy.
Conclusion
The suggested physical therapy program could be an effective and safe method for improving and restoring the normal swallowing mechanism in ischemic stroke patients suffering from severe dysphagia.