Rehabilitation of swallowing after stroke.

Seven consecutive patients who had lost the ability to swallow saliva or ingest food following cerebrovascular accidents were subsequently taught to eat again. Five patients were restored to eating a regular diet and two showed improvement limited by their underlying conditions. Prior to swallowing rehabilitation, their nutrition had been maintained by tube feedings for periods of 5 months to 3.9 years. Patients were instructed in sucking, elevation of the larynx, and coordination of those functions. This method has not been reported previously for use in stroke patients. Oral feeding was initiated with ice chips and progressed to a normal diet. Speech also improved after regaining deglutition. The clinical evidence suggests that paralysis initiated the swallowing disability which persisted due to disuse of retrainable pharyngeal muscles. The reflex sequence of deglutition can be retaught if lost due to stroke.