102
K. W. Jang et al.
study was observed only after a short-term exercise
period of 2 weeks, and the effect was only measured
immediately after the treatment period ended. We could
not distinguish this effect from spontaneous recovery
of dysphagia after stroke. The current study could not
reveal the effect of additional MIE exercise on all the
phases of the swallowing process. As swallowing and
coughing functions have different characteristics ac-
cording to the stroke lesion types (26), well-designed
studies are needed to evaluate the effect of MIE ex-
ercise according to the stroke lesion type. Finally, the
comparisons in this study were performed on a rela-
tively smaller number of patients, with no long-term
follow-up records. Thus, further research on a larger
sample size and long-term follow-up are required to
confirm the results of this study.
Conclusion
The MIE exercise using cough assist has a therapeutic
effect on VPI in subacute stroke patients with dyspha-
gia. Furthermore, this MIE exercise affects both swal-
lowing and coughing functions in patients after stroke.
A combination rehabilitation therapy including addi-
tional MIE exercise was more effective for alleviating
the symptoms of VPI than conventional rehabilitation
therapy alone. This therapy is easy to apply in the clini-
cal setting, and can be a useful therapeutic strategy for
VPI with dysphagia in patients with stroke.
The authors have no conflicts of interest to declare.
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