Article

OBJECTIVE: To investigate the relation between voluntary cough and swallowing
functions according to the type of lesion in patients with acute stroke. DESIGN: Cross-sectional study. SETTING: University rehabilitation hospital. PARTICIPANTS:
Acute stroke patients with dysphagia symptoms (N=397). INTERVENTIONS: Not
applicable. MAIN OUTCOME MEASURES: A peak cough flow meter was used to measure
voluntary coughing ability. Swallowing function was evaluated using the
functional dysphagia scale and the penetration-aspiration scale based on the
results of a videofluoroscopic swallowing study. Stroke lesions were divided into
one of the following 3 categories: cortical, subcortical, and brainstem. These
evaluations were performed within 2 weeks after stroke onset. RESULTS: Of the
enrolled 397 patients, 207 patients were classified as cortical stroke, 106
patients were classified as subcortical stroke, and 84 patients were classified
as brainstem stroke. Among the subscores of the functional dysphagia scale, the
amount of pharyngeal residue negatively correlated with peak cough flow meter
results across all stroke lesion types. In the brainstem lesion, peak cough flow
and penetration-aspiration scale scores were high compared with other lesions,
but these 2 functions did not show a correlation. CONCLUSIONS: This study
revealed that large amounts of pharyngeal residue correlated with weak voluntary
cough ability in all stroke lesion groups. We also showed a discrepancy between 2
functions in the brainstem lesion group. Our results suggest that voluntary
coughing exercises could be a helpful therapeutic option for dysphagia to prevent
pulmonary complications in some types of patients with stroke.
CI - Copyright (c) 2015 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS