Context/objective: Swallowing difficulties (dysphagia) are well recognized after spinal injury. There are no published rehabilitation efficacy studies to date. This study explored viability and outcomes of swallowing rehabilitation programs for four patients with persisting dysphagia.

Design: Prospective, quantitative experimental longitudinal case series.

Setting: Spinal rehabilitation unit or patients’ homes.

Interventions: Four patients engaged in a 6-week (3×weekly) individualized progressive rehabilitation program.

Outcome measures: Objective videofluoroscopic measures of timing and displacement and a validated self-reported questionnaire – the Eating Assessment Tool (EAT-10) were taken pre-therapy, immediately post-therapy and EAT-10 was repeated at 3 months. Feeling and fatigue scale scores were taken before and after each therapy session.

Results: Patients (63, 67 yr, 67 yr, 76 yr; 3 male) had varying spinal diagnoses (2 traumatic, all involving the C-spine) and length of dysphagia (6 weeks, 6 weeks, 12 weeks, 10 yr). Common physiological impairments across all patients were: reduced maximum hyoid displacement, reduced pharyngeal constriction and reduced pharyngoesophageal segment maximum opening. Therapy programs were well received with 100% compliance. Participants made quantitative improvements in their videofluoroscopic measures of timing and displacement. Three out of four participants were able to have their percutaneous endoscopic gastrostomies (PEG) removed. EAT-10 scores significantly improved for all patients (P < .001). Poor upper limb function and restricted neck flexion prohibited some exercises.

Conclusions: For many patients following spinal injury, dysphagia resolves during the acute phase of post-surgery recovery. For some, significant pharyngeal impairments persist. This case series demonstrates potential to regain functional swallowing following a 6-week tailored rehabilitation program. High-quality research exploring efficacy of rehabilitation programs are warranted.

背景/目标：吞咽困难（吞咽困难）在脊柱损伤后得到了很好的认识。迄今为止，还没有发表的康复疗效研究。本研究探讨了四名持续吞咽困难患者的吞咽康复计划的可行性和结果。

设计：前瞻性、定量实验纵向案例系列。

设置：脊柱康复单元或患者家。

干预：四名患者参与了为期 6 周（3 次每周）的个性化渐进式康复计划。

结果测量：时间和位移的客观视频透视测量和经过验证的自我报告问卷 - 饮食评估工具（EAT-10）在治疗前、治疗后立即进行，并在 3 个月时重复 EAT-10。在每次治疗之前和之后进行感觉和疲劳量表评分。

结果：患者（63 岁、67 岁、67 岁、76 岁；3 名男性）有不同的脊柱诊断（2 名创伤性，均涉及 C 脊柱）和吞咽困难的长度（6 周、6 周、12 周、10 年） . 所有患者的常见生理障碍是：最大舌骨位移减少、咽部收缩减少和咽食管段最大开口减少。治疗方案以 100% 的依从性受到好评。参与者对时间和位移的视频透视测量进行了定量改进。四分之三的参与者能够切除经皮内窥镜胃造口术（PEG）。所有患者的 EAT-10 评分均显着提高（P  < .001）。上肢功能不佳和颈部屈曲受限禁止进行一些锻炼。

结论：对于许多脊柱损伤后的患者，吞咽困难在术后恢复的急性期得到缓解。对于一些人来说，严重的咽部损伤持续存在。这个案例系列展示了在为期 6 周的定制康复计划后恢复功能性吞咽的潜力。探索康复计划功效的高质量研究是必要的。