Evaluation of treatment outcome among stroke patients with dysphagia

Abstract

Introduction: Dysphagia occurs 37-78% of stroke patients and is an independent predictor of outcome. Following the rapidly changing lifestyles, socioeconomic status, stress, increasing cardiovascular diseases are a leading cause of stroke in the world and its diagnosis and treatment is one of the challenges in the health sector. Therefore, we aimed to study treatment outcome among stroke patients with dysphagia. Objective: To evaluate and compare the effects of nerve stimulation combined with rehabilitation, muscular stimulation combined with rehabilitation and neuromuscular stimulation combined with rehabilitation treatment in treating dysphagic patients with stroke. Materials and methods: The study was conducted on a hospital-based, cross-sectional method. Study participants were obtained from Affiliated Hospital of Inner Mongolian University for the Nationalities between July 2018 and March 2019. 149 dysphagic patients were evaluated by standardized swallowing assessment (SSA) score before the treatment. All patients were divided into the three treatment groups. A group of patients have treated by nerve stimulation combined with rehabilitation treatment, B group of patients have treated by muscular stimulation combined with rehabilitation treatment and C group of patients have treated by neuromuscular stimulation combined with rehabilitation treatment. Patients were re-evaluated by SSA score, 4 weeks after the treatment. SSA score was compared among 3 groups of patients, pre and post-treatment. Results: In total, 149 participants (mean age=59.70±9.55 years) aged between 34-77 were obtained in this study. There were no statistically significant differences between the three groups in age (p=0.609). The data showed statistically significant positive treatment effect for all three groups (p=0.0001). The first and second section score of SSA was 12.35±1.45 and 9.50±1.25 in A group, 12.40±1.03 and 9.96±1.53 in B group, 12.64±1.91 and 9.18±1.38 in C group before the treatment, respectively. The first (p=0.781) and second (p=0.658) section score of SSA shows no statistically significant difference, before the treatment. The first and second section score of SSA was 9.05±1.33 and 6.94±0.64 in A group, 9.48±1.55 and 7.22±0.97 in B group, 7.90±1.12 and 6.56±0.76 in C group after the treatment, respectively. The first (p=0.0001) and second (p=0.0001) section score of SSA shows statistically significant difference, after the treatment. Conclusion: Rehabilitation treatment combined with neuromuscular electrical simulation appears better outcome than nerve or muscular stimulation combined with rehabilitation among stroke patients with dysphagia.