Functional outcomes of standard dysphagia treatment in first time documented stroke patients

Abstract

Purpose. This retrospective study investigated whether there were statistically and/or clinically significant changes in functional status for patients between admission and discharge as measured by (1) the assistive/independence levels on the swallowing portion of the functional assessment measure (SFAM), and (2) the food and liquid dietary ratings. Also investigated was the relationship between the assistive/independence levels of the SFAM and the specific dietary ratings.

Method. Treatment was given at Rancho Los Amigos National Rehabilitation Centre in Downey, California. Subjects for this study consisted of 100 first-time documented acute stroke patients with swallowing disorders. Descriptive statistics, the Wilcoxon signed ranks test and Spearman rho were used to investigate the proposed questions in this study.

Results. There were statistically significant differences in both the dietary ratings and SFAM levels between admission and discharge and a high percentage of these differences were also determined to be clinically significant. In addition, it was found that there was a high level of variability in the dietary ratings at the majority of SFAM levels.

Conclusion. These results demonstrate that separate and specific dietary ratings in addition to the SFAM assistive/independence levels are necessary to obtain a comprehensive assessment of the stroke patient with dysphagia.

Keywords:

• Dysphagia
• deglutition
• deglutition disorders
• functional assessment measure
• acute stroke
• outcome