Assessment and management of dysphagia in acute stroke: an initial service review of international practice

Fairfield, C. A. and Smithard, D. G. (2020) Assessment and management of dysphagia in acute stroke: an initial service review of international practice. Geriatrics, 5 (1). e4. ISSN 2308-3417 doi: 10.3390/geriatrics5010004

Abstract/Summary

The international approach to the assessment and management of dysphagia in the acute phase post stroke is little studied. A questionnaire was sent to clinicians in stroke services that explored the current practice in dysphagia screening, assessment, and management within the acute phase post stroke. The findings from four (the UK, the US, Canada, and Australia) of the 22 countries returning data are analysed. Consistent approaches to dysphagia screening and the modification of food and liquid were identified across all four countries. The timing of videofluoroscopy (VFS) assessment was significantly different, with the US utilising this assessment earlier post stroke. Compensatory and Postural techniques were employed significantly more by Canada and the US than the UK and Australia. Only food and fluid modification, tongue exercises, effortful swallow and chin down/tuck were employed by more than fifty percent of all respondents. The techniques used for assessment and management tended to be similar within, but not between, countries. Relationships were found between the use of instrumental assessment and the compensatory management techniques that were employed. The variation in practice that was found, may reflect the lack of an available robust evidence base to develop care pathways and identify the best practice. Further investigation and identification of the impact on dysphagia outcome is needed.

Item Type	Article
URI	https://reading-clone.eprints-hosting.org/id/eprint/88648
Identification Number/DOI	10.3390/geriatrics5010004
Refereed	Yes
Divisions	Life Sciences > School of Psychology and Clinical Language Sciences > Ageing
Uncontrolled Keywords	dysphagia, assessment, management, international, questionnaire, stroke
Publisher	MDPI
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