Community-based group rehabilitation program for stroke patients with dysphagia on quality of life, depression symptoms, and swallowing function: a randomized controlled trial.

Abstract

Abstract Background: Community-based exercise programs have demonstrated potential for use in older adults, however, it is still necessary to determine whether this strategy will lead to an equivalent benefit in stroke patients with dysphagia. This study evaluated the impact of community-based group rehabilitation on quality of life, depressive symptoms, and swallowing function in patients with dysphagia after stroke. To evaluate the clinical and cost-effectiveness of the protocol, the feasibility and acceptability of the study were also tested. Methods: Participants were recruited from inpatient rehabilitation hospital and community rehabilitation center. We randomized 64 stroke patients with dysphagia who were randomly assigned into an intervention group (n=32) and a control group (n=32). The intervention group performed health education followed by swallowing function training in communities’ public spaces, 5 days per week for 8 weeks (60minutes each). The control group received swallowing rehabilitation training, and booster educational information about dysphagia and how to improve quality of life. swallowing function (Functional Oral Intake Scale (FOIS) and Standardized Swallowing Assessment (SSA)), Depressive symptoms (Geriatric Depression Scale-15), and Quality of life (Swallowing-Quality of Life, SWAL-QOL) were assessed before and after the intervention. Results: Before the intervention, the two groups did not differ statistically. After, the intervention group showed significant improvement (P<0.001) in swallowing function (SSA: before: 34.73±3.062; after: 21.97±3.306; FOIS: before: 2.57±0.504; after: 4.83±1.262), but there was no significant difference in Functional Oral Intake Scale (P=0.479) change between groups. The intervention group showed improved substantially in depressive symptoms (P=0.002), and the number of depressed patients decreased significantly (13 to 6). There were significant differences between groups (P=0.003). Swallowing-Quality of Life scores showed the intervention group improved substantially more than the control group (P<0.001). In the Swallowing-Quality of Life sub-domain, the intervention group showed greater changes in symptoms and frequency (P<0.001), communication (P=0.012), and sleep (P=0.006) when compared to the control group. Conclusion: Community-based group rehabilitation program improved swallowing function, depression symptoms, and quality of life stroke patients with dysphagia.