Dysphagia and Enteral Feeding After Stroke in the Rehabilitation Setting

Robynne G Braun; Jodi Arata; Marlis Gonzalez-Fernandez

doi:10.1016/j.pmr.2023.07.001

Dysphagia and Enteral Feeding After Stroke in the Rehabilitation Setting

Phys Med Rehabil Clin N Am. 2024 May;35(2):433-443. doi: 10.1016/j.pmr.2023.07.001. Epub 2023 Aug 17.

Authors

Robynne G Braun¹, Jodi Arata², Marlis Gonzalez-Fernandez³

Affiliations

¹ Department of Neurology, University of Maryland School of Medicine, Baltimore, MD, USA; University of Maryland Rehabilitation and Orthopedic Institute, Baltimore, MD, USA; Brain Rehab and Recovery Lab, University of Maryland School of Medicine, Bressler Research Building, Suite 12-019, 655 West Baltimore Street, Baltimore, MD 21201, USA. Electronic address: Robynne.Braun@umm.edu.
² Rehabilitation Research Lab, University of Maryland Rehabilitation and Orthopedic Institute, 2200 Kernan Drive, Baltimore, MD 21207, USA.
³ Department of PM&R, Johns Hopkins University School of Medicine, 600 North Wolf Street, Phipps 184, Baltimore, MD 21287, USA; Outpatient PM&R Clinics, Johns Hopkins Hospital, 600 North Wolfe Street Phipps 174, Baltimore, MD 21287, USA.

PMID: 38514228
DOI: 10.1016/j.pmr.2023.07.001

Abstract

Physiatrists play a vital role in post-stroke dysphagia management not only by providing guidance on the risks, benefits, and efficacy of various treatment options but also as advocates for patients' independence and quality of life. While swallow study results are often discussed broadly by acute stroke clinicians as "pass/fail" findings, physiatrists need a more nuanced working knowledge of dysphagia diagnosis and treatment that encompasses swallow pathophysiology, targeted treatment strategies, and prognosis for recovery. To that end, this review summarizes current clinical practice guidelines on dysphagia, nutrition and oral care, risks and benefits of differing enteral access routes, prognostic factors, and approaches to rehabilitation.

Keywords: Dysphagia; Enteral feeding; Neurorehabilitation; Physiatry; Prognosis; Stroke.

Publication types

Review

MeSH terms

Deglutition Disorders* / diagnosis
Deglutition Disorders* / etiology
Deglutition Disorders* / therapy
Enteral Nutrition / methods
Humans
Quality of Life
Stroke Rehabilitation* / methods
Stroke* / complications
Stroke* / therapy