<Effect of Chronic Obstructive Pulmonary Disease on Swallowing Function in Stroke Patients>

<Ann Rehabil Med 2015;39(2):-225>

Gun Woong Park, MD, Suk Kyoung Kim, MD, Chang Hwa Lee, MD, Chung Reen Kim, MD, Ho Joong Jeong, MD, Dong Kyu Kim, MD

Department of Rehabilitation Medicine, Dong-Eui Medical Center, Busan;
Department of Physical Medicine and Rehabilitation, Kosin University College of Medicine, Busan, Korea

Objective 
To investigate the prevalence of chronic obstructive pulmonary disease (COPD) in stroke patients, and to assess the difference in swallowing function between stroke patients with COPD (COPD group) and stroke patients without COPD (control group).

Methods
The subjects included 103 stroke patients. They underwent the pulmonary function test and were assigned to either the COPD group or the control group. Their penetration-aspiration scale (PAS) scores and functional dysphagia scale scores were compared by performing a videofluoroscopic swallowing study. The intergroup differences in lip closure, bolus formation, mastication, and the oral transit time, laryngeal elevation, cricopharyngeal dysfunction, oronasal regurgitation, residue in pyriform sinus and vallecula, pharyngeal transit time, aspiration, and esophageal relaxation were also compared.

Results
Thirty patients were diagnosed with COPD. The COPD group showed statistically higher PAS scores (4.67±2.15) compared to the control group (2.89±1.71). Moreover, aspiration occurred more frequently in the COPD group with statistical significance (p<0.05). The COPD group also showed higher occurrence of cricopharyngeal dysfunction, albeit without statistical significance.

Conclusion
This study shows that a considerable number of stroke patients had COPD, and stroke patients with COPD had higher risk of aspiration than stroke patients without COPD.

​Keywords
Stroke, Chronic obstructive pulmonary disease (COPD), Deglutition disorders, Respiratory aspiration