The effects of ADL on recovery of swallowing function in stroke patients after acute phase

This study aimed to examine the association between the degree of recovery from dysphagia and changes in functional independence measure (FIM) items in stroke patients after acute phase by conducting a historical cohort study, because none explains the effects of activities of daily living (ADL) on recovery of swallowing function. Study patients included hospitalised stroke patients after acute phase in whom dysphagia was confirmed (n=72). Change in nutritional intake method score was examined for association with age, days from stroke onset to admission, length of hospital stay and change in FIM score. Moreover, to examine characteristics of patients who were removed from tube feeding, all patients who required tube feeding at the time of admission were divided into two groups comprising those who required tube feeding at discharge and those who did not. A significant and positive association was observed between change in nutritional intake method and FIM for all items other than self-care of bathing, locomotion of stairs and problem solving. Patients who were removed from tube feeding were significantly younger than those who required tube feeding at the time of discharge (P<0041) and also showed significantly higher FIM scores for transfer and all cognitive FIM items at the time of admission (P<005). This study demonstrated that nutritional intake methods improve in conjunction with FIM improvements in patients with dysphagia following the acute phase of stroke. Our results suggest that the age and cognitive function may influence the recovery of patient ability of oral intake.