Internationale Zeitschrift für Physikalische Medizin und Rehabilitation
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Abstrakt

New Orofacial Physiotherapy of Dysphagia after Stroke

Petr Konecny, Milan Elfmark, Petra Bastlova and Petra Gaul-Alacova

Background and Aim: Dysphagia commonly occurs after bulbar or pseudobulbar stroke. In our study, we used an X-ray videofluorography examination of swallowing to diagnose and measure the dysphagia post stroke. The therapy recommended for treating swallowing disorders is referred to as orofacial physiotherapy. During the new orofacial physiotherapy, an emphasis is placed on the optimization of movements of the tongue and hyoid muscles.

Methods: The effect was evaluated in a prospective pre-post-test study of chronic post stroke patients with a swallowing disorder. After eight weeks of physiotherapy, changes in swallowing were evaluated using a physiotherapy examination (functional oral intake scale – FOIS) and videofluorography (VFSS). The experimental group of 29 cases treated with our new orofacial physiotherapy was compared with 30 control cases with standard dysphagia therapy.

Results: The experimental group was composed of twenty-nine patients, while the control group was made up of thirty patients. Comparing swallowing function (FOIS) and the time differences of each swallowing phase before and after therapy between the experimental group and the control group, there were statistically significant differences (p˂0.05) in parameters of performance for FOIS (median value change from 4 to 6 in the experimental group, median value change from 4 to 5 in the control group), and two of the swallowing phases: OTT (transport time of the oral phase of swallowing) and PTT (transport time of the pharyngeal phase). The mean of differences before and after therapy of OTT in the experimental group was 0.49 ± 0.15, in the control group 0.12 ± 0.09. The mean difference before and after therapy of PTT in the experimental group was 0.19 ± 0.09, in the control group 0.06 ± 0.05.

Conclusion: After new orofacial physiotherapy, there was significant improvement in swallowing and of food intake in patients post stroke with dysphagia.