[Treatment and rehabilitation of dysphagia following cerebrovascular disease].

INTRODUCTION. Bronchopneumonia is a frequent complication in the first days after a cerebrovascular disease and is linked with a higher rate of mortality. It occurs in patients with an altered level of consciousness or tussigenic reflex, and could be prevented with an early dysphagia rehabilitation programme. AIMS. To review the scientific literature on the treatment and rehabilitation of patients with dysphagia after suffering a stroke, published between 2002 and 2012. DEVELOPMENT. A search conducted in the PubMed, Cochrane, PEDro, CINAHL and ENFISPO databases yielded 15 papers that fulfilled eligibility criteria and the initial aims of the study, providing information about 3,212 patients. The different protocols and techniques for re-education in dysphagia are described and include compensatory strategies, orofacial regulation therapy, music therapy, sensory stimulation, lip muscle, tongue, pharynx, larynx and respiratory tract training, Mendelsohn manoeuvre, neuromuscular electrical stimulation, repetitive transcranial magnetic stimulation and acupuncture. CONCLUSIONS. The studies examined in this research claim that the treatment of dysphagia following a stroke can improve the function of deglutition (coordination, speed, volume), quality of life and people's social relationships. Further work needs to be carried out to establish or define what kind of therapies, techniques, exercises or manoeuvres are the most effective in dysphagia. Generally agreed treatment or rehabilitation protocols also need to be drawn up within units that address stroke in an integrated manner.