Behavioural Intervention for Dysphagia in Acute Stroke

A Randomised Controlled Trial of Dysphagia Therapies for Swallowing Disorders Following Stroke.

Swallowing dysfunction after stroke is common, but there is no reliable evidence for how it should be managed other than perhaps by nasogastric tube. This study compared the effectiveness of standardised, low and high intensity behavioral intervention for dysphagia with that of "usual care".

Stroke compromises swallowing function, causing dysphagia, in one quarter to one half of all patients. Dysphagia is associated with an increased risk of aspiration pneumonia, dehydration and malnutrition. Despite the development and implementation of several strategies of managing dysphagia after stroke, Few have been evaluated by means of randomised controlled trials.

Comparisons: This study aims to compare stroke patients with dysphagia assigned to receive usual swallowing care, prescribed by the attending physician; standardised low intensity intervention comprising swallowing compensation strategies and diet prescription; or standardised high intensity intervention and dietary prescription .

Inclusion Criteria:

• clinical diagnosis of stroke within the previous 7 days
• clinical diagnosis of swallowing difficulty

Exclusion Criteria:

• no previous history of swallowing treatment
• no previous history of surgery of the head or neck