How much swallowing rehabilitation is possible post stroke: a report of dosage and outcomes in a metropolitan stroke unit
Vickers, K, Togher, L, Mathisen, B & Power, E 2013, 'How much swallowing rehabilitation is possible post stroke: a report of dosage and outcomes in a metropolitan stroke unit', presented at Smart Strokes Conference, Session 1, 22 August 2013, International Journal of Stoke, vol. 8, no. 2 Supplement.
Purpose: In swallowing rehabilitation post stroke, no study has described the dosage of practice of direct exercise that can be completed in clinical rehabilitation sessions. This study aims to: (i) describe the dosage of swallowing rehabilitation practice participants were able to complete and (ii) document swallowing outcomes.
Methods: A descriptive feasibility study was conducted in a metropolitan comprehensive stroke unit. 20 participants with persisting dysphagia underwent an instrumental assessment before being prescribed individualized evidence based swallowing rehabilitation programs of direct interventional exercises. Throughout the program each participant's total dosage (i.e. number of repetitions) of exercises was recorded. Participants' pre and post-treatment outcome measures included the Mann Assessment of Swallowing Ability (MASA) and the Functional Oral Intake Scale (FOIS).
Results: Following a comprehensive swallowing rehabilitation program, there was a significant improvement (p < .01) in the MASA scores from moderate to nil dysphagia (148 vs. 179). Participants also showed a significant progression (p < .01) in their recommended diets on the FOIS (3.5 vs. 5.3). Dosage of swallowing rehabilitation practice achieved (μ = 3091 range 363 – 10,704) and number of therapy days (μ = 17 range 4–52) was variable.
Conclusion: Dosage of swallowing rehabilitation practice will vary across stroke survivors, however rehabilitation of persisting dysphagia in the sub-acute phase of stroke may facilitate recovery.