Improvement in Oral Health Enhances the Recovery of Activities of Daily Living and Dysphagia after Stroke

Objective: Oral problems affect rehabilitation outcomes. This study aimed to examine the association between improvement in oral health and functional outcomes in patients after stroke. Materials and Methods: This retrospective cohort study included post-acute rehabilitation patients who presented with oral problems at admission. Oral problems were assessed using the Revised Oral Assessment Guide (ROAG). The ROAG score change during hospitalization was calculated by subtracting the score at admission from the score at discharge; oral problems were defined as "improved", when the score change value was lower than the median value. Study outcomes were the activities of daily living assessed by the motor domain of the Functional Independence Measure (FIM-motor) scores and dysphagia as assessed by the Food Intake Level Scale (FILS). Multivariate regression analyses were used to determine whether improved oral problems were associated with study outcomes. P-values of <0.05 were considered statistically significant. Results: This study included 300 patients (mean age, 72.0 years; 51.7% men). The median [IQR] baseline ROAG score and its change value during hospitalization were 11 [10,14] and-1[-3, 0] points, respectively. Multivariate analyses showed that improved oral problems was independently associated with FIM-motor score (13 = 0.144, p = 0.001) and FILS score (13 = 0.227, p < 0.001) at discharge, after adjusting for potential confounders. Conclusions: Improvement in oral health was positively associated with recovery of the ADL and dysphagia after stroke. Early detection of oral problems and oral treatment should be implemented in these patients to maximize functional recovery.