The effect of bedside exercise program on stroke patients with Dysphagia

Abstract

Objective: To examine the effects of a bedside exercise program on the recovery of swallowing after a stroke.

Method: Fifty stroke patients with dysphagia (<6 months post-stroke) were enrolled and classified into two groups, the experimental (25 subjects) and control groups (25 subjects). The control group was treated with conventional swallowing therapy. The experimental group received additional bedside exercise training, which consisted of oral, pharyngeal, laryngeal, and respiratory exercises, 1 hour per day for 2 months, and they were instructed regarding this program through the nursing intervention. All patients were assessed for their swallowing function by Videofluoroscopic Swallowing Study (VFSS), using the New VFSS scale, the level of functional oral intake, the frequency of dysphagia complications, the presence (or not) of tube feeding, the mood state and quality of life before the treatment and at 2 months after the treatment.

Results: After 2 months of treatment, the experimental group showed a significant improvement in the swallowing function at the oral phase in the New VFSS Scale than that of the control group (p<0.05). Further, they also showed less depressive mood and better quality of life than the control group. However, there was no significant change in the incidence of dysphagia complication and the presence (or not) of tube feeding between the two groups.

Conclusion: Bedside exercise program showed an improvement of swallowing function and exhibited a positive secondary effect, such as mood state and quality of life, on subacute stroke patients with dysphagia. For improvement of rehabilitation results on subacute stroke patients with dysphagia, this study suggests that additional intensive bedside exercise would be necessary.

Keywords: Bedside exercise; Dysphagia; Videofluoroscopic swallowing study.

Fig. 1

Depressive mood state and quality of life according to feeding method (oral or tube feeding). (A) Beck Depressive Inventory (BDI) (B) Stroke Specific-Quality of Life (SS-QOL). In the oral feeding group, BDI score was significantly lower and SS-QOL score was higher than those of tube feeding group. ^*p<0.05 by Mann-Whitney U test: compared to Control.