Category: Stroke; Complementary Integrative Rehabilitation Medicine; Clinical Practice (assessment, diagnosis, treatment, knowledge translation/EBP, implementation science, program development)
To evaluate the therapeutic effect and complications of oro-esophageal (OE) tube in stroke patients with dysphagia
Design : Retrospective medical chart review
Participants (or Animals, Specimens, Cadavers) :
17 stroke patients who received OE tube feeding training
OE tube feeding was indicated for patients who had severe dysphagia and a decreased gag reflex but had possible cognitive and hand function to achieve OE tube insertion according to the physiatrist's instruction. Patients were recommended to use OE tube feeding based on their videofluorosopic swallowing study (VFSS) findings. After confirming OE tube insertion during the VFSS, the patient attempted OE tube feeding in the ward every meal time. If a patient could swallow therapeutic foods with certain viscosities during the VFSS, oral feeding was considered initiated.
Main Outcome Measure(s) :
Swallowing function was evaluated using the functional dysphagia scale and penetration-aspiration scale based on the results of the VFSS.
Results : Seventeen patients attempted OE tube feeding. Among them, 64.7% patients could change full oral feeding at their follow-up VFSS evaluation. 70.6% patients showed gastroesophageal reflux disease regardless of changing to oral feeding. On individual items of the functional dysphagia scale, both groups showed significant improvements in the triggering of pharyngeal swallow, the amounts of residue, and the pharyngeal transit time. These functions were more improved in the patients who could change to oral feeding than in those who could not. Both groups showed significant aggravation of nasal penetration.
Our study quantitatively shows the therapeutic effect and complication of OE tube training. OE tube feeding itself could facilitate swallowing and assist stroke patients in transitioning to oral feeding. This easy-to-apply technique may significantly impact future treatment strategies in stroke patients with severe dysphagia.
Sook Joung Lee– Dr. assistant professor, The Catholic University of Korea, Daejeon St. Mary's hospital, Daejeon, Taejon-jikhalsi
Min Kyu Park– Assistant Professor, Chungbuk National University Hospital, Cheongju-si, Ch'ungch'ong-bukto
Sang Beom Kim– Professor, Dong-A University Hospital, Busan, Pusan-jikhalsi