title: Effects on facial dysfunction and swallowing capacity of intraoral stimulation early and late after stroke.
abstract: BACKGROUND
  Most patients with post-stroke dysphagia are also affected by facial dysfunction in all four facial quadrants. Intraoral stimulation can successfully treat post-stroke dysphagia, but its effect on post-stroke facial dysfunction remains unknown.
  
  
  OBJECTIVE
  This study aimed to investigate whether intraoral stimulation after stroke has simultaneous effects on facial dysfunction in the contralateral lower facial quadrant and in the other three facial quadrants, on lip force, and on dysphagia.
  
  
  METHODS
  Thirty-one stroke patients were treated with intraoral stimulation and assessed with a facial activity test, lip force test, and swallowing capacity test at three time-points: before treatment, at the end of treatment, and at late follow-up (over one year after the end of treatment).
  
  
  RESULTS
  Facial activity, lip force, and swallowing capacity scores were all improved between baseline and the end of treatment (P < 0.001 for each), with these improvements remaining at late follow-up. Baseline and treatment data did not significantly differ between patients treated short and late after stroke.
  
  
  CONCLUSIONS
  Treatment with intraoral stimulation significantly improved post-stroke dysfunction in all four facial quadrants, swallowing capacity, and lip force even in cases of long-standing post-stroke dysfunction. Furthermore, such improvement remained for over one year after the end of treatment.
authors.affiliation: Speech & Swallowing Centre, Department of Otorhinolaryngology, Hudiksvall Hospital, Sweden Centre for Research & Development, Uppsala University/County Council of Gävleborg, Gävle, Sweden.
authors.forename: Mary K D
authors.initials: MK
authors.lastname: Hägg
authors.affiliation: Department of Otorhinolaryngology, Linköping University, Linköping, Sweden.
authors.forename: Lita I E
authors.initials: LI
authors.lastname: Tibbling
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003680:Deglutition Disorders / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D005081:Exercise Therapy / Q000379:methods*; D005145:Face / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020127:Recovery of Function / Q000502:physiology*; D020521:Stroke / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D013997:Time Factors; D016896:Treatment Outcome
keywords: Facial dysfunction; dysphagia; lip force; oral screen; palatal plate; stroke