Rehabilitation of post-stroke dysphagia by controlled non-nutritive sucking: a hypothesis based on the principles of neonatology and neuroplasticity

Dysphagia is one of the most common complications of stroke and significantly impairs the quality of life of patients, increases the risk of aspiration pneumonia, dehydration, malnutrition, and long-term dependence on nasogastric tube or gastrostomy. Despite the existence of various rehabilitation methods, the rate of restoration of safe swallowing remains limited in a significant proportion of patients. This paper proposes a new hypothesis for the rehabilitation of post-stroke dysphagia based on the transfer of the principle of non-nutritive sucking, widely used in neonatology, to the rehabilitation of adult patients after stroke. It is hypothesized that a regular program of controlled non-nutritive sucking with a special device can stimulate the oropharyngeal muscles, activate sensorimotor neuroplasticity mechanisms, and accelerate the restoration of safe swallowing compared to standard therapy. A preliminary clinical trial design is proposed to test this hypothesis.