Indian Journal of Physical Medicine and Rehabilitation

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VOLUME 31 , ISSUE 2 ( April-June, 2020 ) > List of Articles

Original Article

Improvement Pattern of VFSS due to Swallowing Maneuvers in Patients of Dysphagia with Posterior Circulation Stroke

Ayan Ghosal, Saumen Kumar De, Siddhartha Sinharay, Biman K Ray, Rajesh Pramanik

Keywords : Mendelsohn maneuver, Post-stroke dysphagia, Swallowing maneuvers, Videofluoroscopic swallowing study

Citation Information : Ghosal A, Kumar De S, Sinharay S, Ray BK, Pramanik R. Improvement Pattern of VFSS due to Swallowing Maneuvers in Patients of Dysphagia with Posterior Circulation Stroke. Indian J Phy Med Rehab 2020; 31 (2):24-30.

DOI: 10.5005/jp-journals-10066-0081

License: CC BY-NC 4.0

Published Online: 25-06-2021

Copyright Statement:  Copyright © 2020; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Background: Post-stroke dysphagia is a leading cause of morbidity and prolonged hospitalization in stroke patients. The videofluoroscopic swallowing study (VFSS) is one of the gold standard techniques, designed to define the anatomy and physiology of a patient\'s oropharyngeal swallow and examine the effectiveness of selected rehabilitation strategies designed to eliminate aspiration or excess oral or pharyngeal residue (the symptoms of patient\'s dysphagia). Objective: To quantify the improvement of patients’ subjective and objective symptoms. Materials and methods: Institutional ethics committee clearance was taken. Fifteen patients were selected who satisfy our inclusion criteria. A prospective interventional study was done in the Department of PMR, IPGME&R, Kolkata over 12 months. Videofluoroscopic swallowing study was done on all these patients at baseline and at 3 months interval and swallowing technique of head rotation to the paretic side applied at baseline and Mendelsohn maneuvers were applied for 3 months duration. Changes in VAS of swallowing (VASs) and videofluoroscopic dysphagia scale (VDS) were noted. Inclusion criteria: Clinical dysphagia in a patient with confirmed posterior circulation stroke, after 2 weeks of stroke. Exclusion criteria: Anterior circulation stroke, Other pertinent neurological diseases, any structural abnormalities in head-neck region, medically unstable patient. Results: Statistically significant improvements of both VASs and VDS were seen in all the patients in follow-up visits with the application of selected swallowing techniques and maneuvers. Conclusion: This study concludes that: • Simple swallowing techniques and maneuvers can improve the symptoms of dysphagia in patients with posterior circulation stroke. • Videofluoroscopy is helpful to diagnose and objectively quantify the improvement of dysphagia symptoms with different swallowing techniques and maneuvers.


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