Efficacy of swallowing training for residents following stroke

• Published in: Journal of advanced nursing Vol. 44; no. 5; pp. 469 - 478
• Main Authors: Lin, Li-Chan, Wang, Shu-Chen, Chen, Seng Hwa, Wang, Tyng-Guey, Chen, Miao-Yen, Wu, Shiao-Chi
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Science Ltd 01.12.2003; Wiley Subscription Services, Inc
• Subjects: Adult; Aged; Aged, 80 and over; Cerebrovascular Disorders - complications; Cerebrovascular Disorders - rehabilitation; Cluster Analysis; Deglutition - physiology; Deglutition Disorders - etiology; Deglutition Disorders - rehabilitation; Dysphagia; Female; Hospitalization; Humans; Long-Term Care; long-term care residents; Male; Middle Aged; nutrition; Nutritional Status; Rehabilitation; Strokes; swallowing function; swallowing training; Taiwan; timed-test of swallowing; Training; Treatment; Taiwan
• ISSN: 0309-2402; 1365-2648
• DOI: 10.1046/j.0309-2402.2003.02830.x

Background.  The presence of dysphagia is associated with an increased risk of mortality, malnutrition, dehydration, compromised pulmonary function, and disability. Appropriate swallowing training can establish optimal nutritional status and eliminate or reduce the risk of developing medical complications associated with swallowing impairment. Aim(s) of the study.  The aim of this study was to examine the functional swallowing and nutritional outcomes of swallowing training in institutionalized stroke residents with dysphagia. Design and methods.  A quasi‐experimental parallel cluster design was used. Seven institutions with similar bed sizes were selected. All subjects in the experimental group received a structured swallowing training programme. The subjects in the experimental group (n = 40) received 30 minutes of swallowing training each day for 6 days per week for 8 weeks. The control group (n = 21) did not receive any training. Results.  After swallowing training, mean differences in volume per second, volume per swallow, mid‐arm circumference and body weight between pre‐ and post‐training of the experimental group were significantly higher than for the control group, while mean differences in neurological examination and choking frequency during meals for the experimental group were significantly lower than in the control group. Conclusion.  This study used objective timed swallowing tests, a swallowing questionnaire, and a neurological examination to evaluate the effects of swallowing training. However, videofluroscopy is generally considered the best method for evaluating the pharyngeal and esophageal stages of swallowing, and introducing this technique is recommended for future studies. Furthermore, it is recommended that nursing professionals should conduct swallowing training protocols in stroke patients to help prevent aspiration from dysphagia.