<p><b>Aims</b></p><p>The aims of the thesis were to validate investigation instruments for stroke patients with dysphagia, and to improve oropharyngeal dysphagia therapies.</p><p><b>Methods/Results</b></p><p>A Lip Force Meter, LF 100, affirmed excellent intra- and inter-reliability, sensitivity and specificity. Controls had significantly stronger lip force (LF) and swallowing capacity (SC) than stroke patients. A normal lower limit of LF was set to 15 Newton. Dysphagia symptoms improved in 7 stroke patients after a 5-week sensorimotor stimulation therapy comprising manual body and facial regulation in combination with palatal plate application. Impaired LF and impaired SC were parallel phenomena in 22 acute stroke patients and did not differ regardless of presence or absence of facial palsy. LF and SC improved and were parallel phenomena in 30 stroke patients and did not differ regardless of presence or absence of facial palsy, time lag between stroke attack and start of treatment, or age. SC was normalized in 19 of 30 dysphagia patients after a 5-8-week daily lip muscle self-training with an oral screen. </p><p><b>Conclusions</b></p><p>LF100 is an appropriate and reliable instrument for measuring lip force. Dysphagia improvement, by body and facial sensorimotor stimulation in combination with palatal plate application, or by training with an oral screen is excellent examples of brain plasticity and cortical reorganisation. . Swallowing capacity and lip force in stroke patients are parallel phenomena. A sub clinical facial paresis seems to be present in most stroke patients. Training with an oral screen can improve LF and SC in stroke patients with oropharyngeal dysphagia. </p>

<b>Aims</b> The aims of the thesis were to validate investigation instruments for stroke patients with dysphagia, and to improve oropharyngeal dysphagia therapies. <b>Methods/Results</b> A Lip Force Meter, LF 100, affirmed excellent intra- and inter-reliability, sensitivity and specificity. Controls had significantly stronger lip force (LF) and swallowing capacity (SC) than stroke patients. A normal lower limit of LF was set to 15 Newton. Dysphagia symptoms improved in 7 stroke patients after a 5-week sensorimotor stimulation therapy comprising manual body and facial regulation in combination with palatal plate application. Impaired LF and impaired SC were parallel phenomena in 22 acute stroke patients and did not differ regardless of presence or absence of facial palsy. LF and SC improved and were parallel phenomena in 30 stroke patients and did not differ regardless of presence or absence of facial palsy, time lag between stroke attack and start of treatment, or age. SC was normalized in 19 of 30 dysphagia patients after a 5-8-week daily lip muscle self-training with an oral screen. <b>Conclusions</b> LF100 is an appropriate and reliable instrument for measuring lip force. Dysphagia improvement, by body and facial sensorimotor stimulation in combination with palatal plate application, or by training with an oral screen is excellent examples of brain plasticity and cortical reorganisation. . Swallowing capacity and lip force in stroke patients are parallel phenomena. A sub clinical facial paresis seems to be present in most stroke patients. Training with an oral screen can improve LF and SC in stroke patients with oropharyngeal dysphagia.

Sväljkapacitet kan skilja sig åt mellan olika åldrar och kön. Detta kan inverka på prestationen på så kallade vattensväljtest. Ingen uttömmande studie har gjorts angående effekt av ålder, kön och vattenmängd på sväljförmåga hos friska vuxna i Sverige. Syftet med föreliggande studie var att presentera normdata för tre olika mått på sväljförmåga: sväljtid, sväljkapacitet och antal klunkar vid 1 respektive 2 dl vatten hos friska vuxna, samt att undersöka effekter av vattenmängd och ålder respektive kön på sväljförmågan. 239 vuxna deltagare stratifierades utifrån ålder och kön. Under testförfarandet noterades sväljtid, antal klunkar samt övriga observanda. Resultatet visade signifikant längre sväljtid, lägre sväljkapacitet och fler klunkar såväl hos individer över 70 år som hos kvinnor. Tydligare skillnader kunde ses med den större vattenmängden. Dessutom framkom att 1 dl vatten inte mäter sekventiell sväljning hos samtliga individer. / Swallowing may differ between different age groups and genders. This may affect performance on water swallow tests. So far there have been no comprehensive studies on the effect of age, gender and water volume on the swallowing performance of healthy adults in Sweden. The aim of this study was to present normative data for three different measures of swallowing: swallowing time, swallowing capacity and number of swallows at 100 ml and 200 ml of water in healthy adults, and to examine possible effects on swallowing of age and gender. The 239 adult participants were stratified according to age and gender. During testing, time, number of swallows and a number of deviations were noted. Results showed significantly longer swallowing times, lower swallowing capacity and more swallows both in individuals older than 70 and in women. These differences were greater when using the larger volume of water. Furthermore, results showed that 100 ml of water was insufficient for measuring sequential swallowing in some individuals.