Swallowing evaluation in patients without restriction of oral food three months after ischemic stroke

BACKGROUND: Our hypothesis was that even patients without complaints and without evident clinical signs of dysphagia three months after ischemic stroke, may have swallowing alterations. OBJECTIVE: To evaluate, by videofluoroscopy, swallowing pattern of ischemic stroke patients without symptomatic dysphagia or restriction of food intake. METHOD: Videofluoroscopic examinations were performed in 33 ischemic stroke patients three to five months after the accident, and 19 healthy volunteers. Oral and pharyngeal phases of swallowing were evaluated after swallowing of 5 mL and 10 mL of liquid and paste boluses, and after swallowing of a solid bolus, in duplicate and in a random sequence. RESULTS: Stroke patients had higher frequency of head movement, multiple swallows, premature spilage and vallecular residue than volunteers, after swallowing of 5 mL liquid bolus. There was no difference between patients and volunteers in oral and pharyngeal transit, except for a longer oral preparation for a 5 mL liquid bolus in patients. Changes in swallowing caused by increases in bolus volume and consistency were not different between patients and volunteers. CONCLUSION: No significant changes in swallowing dynamics were found in patients with no dysphagia symptoms and no restriction of food intake three months after isquemic stroke.