Oral trials in stroke and neurological rehabilitation
Results highlight that individuals on oral trials were more likely to
have a neurological diagnosis and be on a neurological ward, supporting
findings that oral trials are used within stroke rehabilitation6. One explanation for this may be that in the case of
neurological damage, remaining nil by mouth in the early stages may
limit the opportunities for recruitment and reorganisation of
neurological pathways in contralateral brain regions17. Oral trials may therefore help to stimulate the
neuromuscular system in the early stages of recovery. Oral trials
support key principles of neuroplasticity in their approach, including
‘use it or lose it’, ‘use it and improve it’ and ‘specificity’12,18. Oral trials also utilise compensatory
strategies with active rehabilitation to enable access to neural
adaptation in the early stages of recovery 18.
Oral trials were also offered to patients on general medical, surgical,
respiratory and intensive care wards, suggesting that the approach is
not limited exclusively to neurological rehabilitation. One reason for
dysphagia in these situations could be that reduced oral intake in
critical care can cause muscle atrophy or deconditioning1,13,19,20. In these situations, oral trials may be
used in active rehabilitation or at a ‘maintenance dose’ to reduce risk
of deconditioning.