The purpose of this study was to evaluate longitudinal changes of the swallowing process in stroke patients with aspiration using kinematic analysis. Twenty-eight subacute stroke patients with aspiration on fluid at initial videofluoroscopic swallowing studies (VFSS) were included. Follow-up VFSS was performed at 2-4 weeks after initial studies that were conducted at an average of 26 days after stroke. Temporal and spatial variables were calculated by two-dimensional motion analysis of hyoid bone and epiglottic movements. Swallowing process delays associated with hyoid bone and epiglottic movements were improved at follow-up studies, whereas spatial variables were not. Fourteen patients had recovered from aspiration at follow-up. Time to the start of the hyoid movement was longer in the nonrecovered patient group at initial studies (1.76 ± 1.07 s) than in the recovered group (0.90 ± 0.82 s, P=0.024). Although time-associated differences between the nonrecovered and recovered groups disappeared at follow-up studies, aspiration persisted in the nonrecovered group. This study shows that recovery from delays in the swallowing process is a conspicuous change during the subacute stage in stroke patients with aspiration. Our findings suggest that delayed swallowing triggering at initial VFSS is a useful predictor of poor recovery from aspiration in stroke patients.
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