Randomized controlled feasibility trial of swallow strength and skill training with surface electromyographic biofeedback in acute stroke patients with dysphagia.

Background & Objectives: Swallow strength and skill training with surface electromyography (sEMG) biofeedback may improve dysphagia but little is known about the feasibility and efficacy of this intervention in acute stroke.

Methods: We conducted a randomized controlled feasibility study in acute stroke patients with dysphagia. Participants were randomized to either usual care or usual care plus swallow strength and skill training with sEMG biofeedback.

Reliability of the Penetration-Aspiration Scale and Temporal and Clearance Measures in Poststroke Dysphagia: Videofluoroscopic Analysis From the Swallowing Treatment using Electrical Pharyngeal Stimulation Trial.

Purpose: Information on reliability of outcome measures used to assess the effectiveness of interventions in dysphagia rehabilitation is lacking, particularly when used by different research groups. Here, we report on reliability of the penetration-aspiration scale (PAS) and temporal and clearance measures, determined using videofluoroscopy.

Method: Secondary analysis used videofluoroscopies from the Swallowing Treatment using Electrical Pharyngeal Stimulation trial in subacute stroke.

Effect of continuing versus stopping pre-stroke antihypertensive agents within 12 h on outcome after stroke: A subgroup analysis of the efficacy of nitric oxide in stroke (ENOS) trial.

Background: It is not known whether to continue or temporarily stop existing antihypertensive drugs in patients with acute stroke.

Methods: We performed a prospective subgroup analysis of patients enrolled into the Efficacy of Nitric Oxide in Stroke (ENOS) trial who were randomised to continue vs stop prior antihypertensive therapy within 12 h of stroke onset. The primary outcome was functional outcome, assessed with the modified Rankin Scale at 90 days by observers blinded to treatment assignment, and analysed with ordinal logistic regression.

Effects of Pharyngeal Electrical Stimulation on Swallow Timings, Clearance and Safety in Post-Stroke Dysphagia: Analysis from the Swallowing Treatment Using Electrical Pharyngeal Stimulation (STEPS) Trial.

Swallowing impairment (dysphagia) post-stroke results in poorer outcomes. Pharyngeal electrical stimulation (PES) is a potential treatment for post-stroke dysphagia. In a post hoc analysis, we investigated PES using videofluoroscopy swallow studies (VFSS) from the STEPS trial incorporating multiple measures of safety (penetration aspiration scale-PAS), speed and duration (timing), and efficiency (clearance), as opposed to the original trial which only measured PAS scores.

Diagnostic accuracy of the Dysphagia Trained Nurse Assessment tool in acute stroke.

Background And Purpose: Comprehensive swallow screening assessments to identify dysphagia and make early eating and drinking recommendations can be used by trained nurses. This study aimed to validate the Dysphagia Trained Nurse Assessment (DTNAx) tool in acute stroke patients.

Methods: Participants with diagnosed stroke were prospectively and consecutively recruited from an acute stroke unit.

Pharyngeal electrical stimulation for neurogenic dysphagia following stroke, traumatic brain injury or other causes: Main results from the PHADER cohort study.

Background: Neurogenic dysphagia is common and has no definitive treatment. We assessed whether pharyngeal electrical stimulation (PES) is associated with reduced dysphagia.

Methods: The PHAryngeal electrical stimulation for treatment of neurogenic Dysphagia European Registry (PHADER) was a prospective single-arm observational cohort study.

Psychometric assessment and validation of the dysphagia severity rating scale in stroke patients.

Post stroke dysphagia (PSD) is common and associated with poor outcome. The Dysphagia Severity Rating Scale (DSRS), which grades how severe dysphagia is based on fluid and diet modification and supervision requirements for feeding, is used for clinical research but has limited published validation information. Multiple approaches were taken to validate the DSRS, including concurrent- and predictive criterion validity, internal consistency, inter- and intra-rater reliability and sensitivity to change.

Accuracy and clinical utility of comprehensive dysphagia screening assessments in acute stroke: A systematic review and meta-analysis.

Introduction: Nurses and other nonspecialists in dysphagia are often trained to screen swallowing poststroke. There are many basic tools that test water only, they are usually conservative, and patients that fail the test remain nil by mouth until a speech and language therapy assessment. More comprehensive tests also allow nonspecialists to recommend modified oral intake.

Swallowing therapy for dysphagia in acute and subacute stroke.

Background: Dysphagia (swallowing problems), which is common after stroke, is associated with increased risk of death or dependency, occurrence of pneumonia, poor quality of life, and longer hospital stay. Treatments provided to improve dysphagia are aimed at accelerating recovery of swallowing function and reducing these risks. This is an update of the review first published in 1999 and updated in 2012.

Does Therapy With Biofeedback Improve Swallowing in Adults With Dysphagia? A Systematic Review and Meta-Analysis.

Objective: To describe and systematically review the current evidence on the effects of swallow therapy augmented by biofeedback in adults with dysphagia (PROSPERO 2016:CRD42016052942).

Data Sources: Two independent reviewers conducted searches that included MEDLINE, EMBASE, trial registries, and gray literature up to December 2016.

Study Selection: Randomized controlled trials (RCTs) and non-RCTs were assessed, including for risk of bias and quality.