Stroke Clinical Trial
Official title:
The RETORNUS-2 Study: Impact of Respiratory Muscle Training on Swallowing Disorders in Stroke Patients
Clinical randomized clinical trial to assess the effectiveness of incorporating inspiratory
and expiratory muscle training (IEMT) in the rehabilitation of stroke patients with dysphagia
in terms of functional outcomes, comorbidities, survival and quality of life.
This project also incorporates a longitudinal study to assess the clinical impact of
dysphagia on body composition and nutritional status in stroke patients.
Stroke is a major cause of morbidity and mortality worldwide. Stroke can lead to varying
degrees of oropharyngeal dysphagia (25-85% of patients) and respiratory muscle dysfunction
associated with an increase in medical complications such as bronchoaspiration, malnutrition
and death. Dysphagia is present in a significant proportion of patients admitted to
Rehabilitation (up to 85% depending on series) in stroke. Standard swallow therapy consists
of educational intervention aimed to improve self-management of dysphagia and protect the
airway, oral exercises to improve lingual praxis, and compensatory techniques based on
videofluoroscopic findings. Recent studies suggest that IEMT can improve swallowing efficacy
and reduce eventual bronchoaspiration events.
Nutritional status appears in 9-67% of patients with acute and subacute stroke and has an
impact on functional outcomes and provides information about the risk of hospitalization and
death. Stroke patients are at risk of developing malnutrition because of neurologic
impairments related to feeding (chewing, deglutition and self-feeding) that can result in a
poor food intake. To date, there is only few studies on prevalence and influence of
malnutrition in stroke.
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