Ultrasound Parameters for Assessment and Rehabilitation Monitoring of Post-Stroke Dysphagia: A Narrative Review

Post-stroke dysphagia is a common complication of stroke. Quantitative ultrasonography has emerged as a noninvasive, radiation-free, and repeatable approach for evaluating swallowing-related structures and movements. This narrative review summarizes quantitative ultrasound parameters used for swallowing assessment and rehabilitation monitoring in patients with stroke. Ultrasound-derived measurements were categorized according to muscle quantity and morphology, muscle quality, spatial/kinematic function, and temporal/velocity function. Studies have demonstrated alterations in swallowing-related muscle morphology; reductions in the movement of the tongue, suprahyoid musculature, hyoid bone, and hyolaryngeal structures; and changes in movement duration and velocity. Several dynamic measures have been associated with the severity of dysphagia and conventional swallowing assessments. Ultrasonography has also been used longitudinally to monitor rehabilitation-related changes in muscle morphology and swallowing kinematics across different therapeutic interventions. However, improvements in swallowing function were not consistently accompanied by changes in individual ultrasound parameters. Dynamic ultrasound parameters have the potential to characterize swallowing impairment and monitor rehabilitation-related changes, whereas quantitative ultrasonography may provide a complementary approach to repeated bedside assessments. Further studies using standardized acquisition protocols, clearly defined parameters, and validation against established swallowing assessments are required to support broader clinical applications.