Factors affecting return to oral intake in inpatient rehabilitation after acquired brain injury

Abstract

Primary objective: To extend previous observations by investigating if differences exist in time to initiation or to recovery of total oral intake in patients with acquired brain injury assessed by either Facial-Oral Tract Therapy (F.O.T.T.®) or Fibreoptic Endoscopic Evaluation of Swallowing (FEES) and to investigate whether other factors influence these outcomes.

Research design: Randomized controlled trial.

Methods: One hundred and nineteen patients with dysphagia in inpatient neurorehabilitation were randomized. The main outcome was time to maximum on the Functional Oral Intake Scale.

Results: There was no difference in time to initiation or recovery of total oral intake using F.O.T.T.® or FEES. Oral intake was initiated for 42% on admission and 92% at discharge; 2.5% of the patients were on total oral intake within 24 hours of admission and 37% at discharge. The likelihood of recovery to total oral intake before discharge was found to depend on age, Functional Independence Measure score, length of stay and number of dysphagia interventions.

Conclusion: There was no significant difference in time to initiation and recovery of total oral intake before discharge, whether assessed by F.O.T.T.® or FEES, indicating that an instrumental assessment is unnecessary for standard evaluation. Age, functional independence and length of stay had a significant influence.

• Acquired brain injury
• dysphagia
• facial-oral tract therapy
• fiberoptic endoscopic evaluation of swallowing
• functional oral intake scale
• outcome

Acknowledgements

The authors acknowledge the occupational therapists at Hammel Neurocentre for their contribution to data collection and the Research Unit at Hammel Neurocentre for support with statistical analysis.

Declaration of interest

The study was funded by financial support from the Hammel Neurorehabilitation Centre and University Research Clinic, Aarhus University, University of Southern Denmark and the Danish Association of Occupational Therapists (FF 1/10-9 and FF1/11-2). The first author is a certified F.O.T.T. instructor. We certify that no party having a direct interest in the results of the research supporting this paper has or will confer a benefit on us or on any organization with which we are associated and we certify that all financial and material support for this research and work are clearly identified in this paper.