Clinical and cognitive predictors of swallowing recovery in stroke

This retrospective study determined whether specific neurological features were associated with initial and final swallowing outcomes in acute stroke patients. A chart review of 65 acute stroke patients suggested that certain clinical and neurocognitive behaviors were associated with swallowing outcomes. Hemispatial neglect was significantly associated with initial nonoral dietary intake, whereas aphasia was not associated with swallowing outcome. Results from the initial clinical swallowing evaluations suggested that the presence of at least four of six clinical features (cough after swallow, voice change after swallow, abnormal volitional cough, abnormal gag reflex, dysphonia, and dysarthria) were associated with poor initial and final swallowing outcomes. Whether specific lesion location, size, or a combination of clinical neurological deficits are associated with poor initial and final swallowing outcomes is unclear. Prospective studies are warranted for further investigation of these relationships.