Is swallowing therapy effective in the treatment of dysphagia in acute and subacute stroke?

Dysphagia is a swallowing problem that affects between a 27% to 64% of stroke survivors and can lead to complications such as choking, respiratory infections, longer hospital stay, and poorer quality of life.
Half of the stroke patients will recover from dysphagia spontaneously two weeks after the stroke, but a significant number of patients will remain with long-term feeding problems. If not treated, dysphagia not only affects quality of life but can also derive in severe complications such as pneumonia, aspiration and an increased risk of death.
Speech and language therapists use different interventions to treat dysphagia. These interventions include compensatory techniques such as modification of fluid and food consistencies, postural techniques such as chin-tuck position, rehabilitation methods that include swallowing exercises to improve muscle strength and in the last years, new stimulation methods such as peripheral pharyngeal electrical stimulation (PES) and neuromuscular surface electrical stimulation (NMES) and central stimulation (tDCS) have also emerged.
This Cochrane Review identified 41 trials looking for treatment of swallowing therapy after stroke. This is the largest up-to date review on dysphagia and combines all the current interventions for dysphagia in the acute and subacute phase of stroke. These studies investigated the efficacy of acupuncture, of behavioral interventions, drug therapy, NMES, PES, physical stimulation, tDCS in the treatment of dysphagia. However, it only examines the efficacy of these interventions at an individual level and does not include comparison among different interventions and which is more appropriate.
Swallowing therapy impacted in the patient´s quality of life decreasing length of stay, improving swallowing ability and reducing the incidence of chest infection and pneumonia but did not change the overall disability after stroke. 

Comment by Sara Laxe