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      Effortful swallow with resistive electrical stimulation training improves pharyngeal constriction in patients post-stroke with dysphagia

      1 , 1 , 1
      Journal of Oral Rehabilitation
      Wiley

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          Dysphagia in acute stroke.

          A prospective study was undertaken to define the incidence, duration, and consequences of dysphagia in an unselected group of 91 consecutive patients who had suffered acute stroke. The site of the present lesion and of any previous stroke was determined clinically and was confirmed by computed tomography of the brain or necropsy in 40 cases. Of 41 patients who had dysphagia on admission, 37 had had a stroke in one cerebral hemisphere. Only seven patients showed evidence of lesions in both hemispheres. Nineteen of 22 patients who survived a stroke in a hemisphere regained their ability to swallow within 14 days. Dysphagia in patients who had had a stroke in a cerebral hemisphere was associated in this study with a higher incidence of chest infections, dehydration, and death.
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            The Natural History of Dysphagia following a Stroke

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              Neuromuscular electrical stimulation (NMES) in stroke patients with oral and pharyngeal dysfunction.

              Neuromuscular electrical stimulation (NMES) technique is a dual-channel electrotherapy system designed specifically for the treatment of pharyngeal dysfunction. The purpose of this study was to evaluate and compare the outcome of NMES versus traditional swallowing therapy (TT) in stroke patients. Three European swallowing centers participated in this randomized trial. Twenty-five patients (16 men and 9 women) were included. Twelve patients were randomized for NMES and 13 for TT. Mean age was 70 years for the NMES group and 71 years for the TT group. Inclusion criteria were (1) patients 50-80 years old with cerebrovascular disease (stroke) for more than 3 months before the study, (2) only patients with hemispheric stroke, (3) no brainstem involvement, (4) ability to swallow, and (5) ability to communicate. Pre- and post-trial measurements were videoradiographic swallowing evaluation, nutritional status, oral motor function test, and a visual analog scale (VAS) for self-evaluation of complaints. All subjects received 15 therapy sessions. Statistically significant positive therapy effects for both NMES and TT combined were found, but there was no statistically significant difference in therapy effect between the groups. The correlations between measurements were low. The patient's subjective experience of improvement had low correlation with the outcome from the objective evaluation.
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                Author and article information

                Journal
                Journal of Oral Rehabilitation
                J Oral Rehabil
                Wiley
                0305182X
                October 2017
                October 2017
                July 10 2017
                : 44
                : 10
                : 763-769
                Affiliations
                [1 ]Department of Physical Medicine and Rehabilitation; Dongguk University Ilsan Hospital; Gyeonggi-do Korea
                Article
                10.1111/joor.12538
                7875f480-e0cc-4bd0-b8d2-11b8dc5a63d3
                © 2017

                http://doi.wiley.com/10.1002/tdm_license_1.1

                http://onlinelibrary.wiley.com/termsAndConditions#vor

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