Pelvic Floor Symptoms and Functional Status in Women With and Without Risk of Dysphagia After Stroke: A Cross-Sectional Comparative Study.

introduction and hypothesisDysphagia is associated with pelvic floor dysfunction and poor functional outcomes after stroke. We hypothesized that pelvic floor symptoms and functional status differ according to dysphagia risk in women with stroke.

methodsThis study included 71 women aged 18-65 years with a diagnosis of a stroke. Individuals scoring 3 or higher on the Turkish Eating Assessment Tool-10 were classified as being at risk of dysphagia (n = 31), whereas individuals scoring below 3 were classified as not at risk of dysphagia (n = 40). Assessments included the Pelvic Floor Distress Inventory-20 (PFDI-20), Short Physical Performance Battery (SPPB), Timed Up and Go Test (TUG), Jamar hand dynamometer, Fugl-Meyer Upper Extremity Assessment, and the Modified Barthel Index.

resultsThe PFDI-20 total was significantly higher in women with stroke who were at risk of dysphagia (p = 0.013 and p < 0.001 respectively). Participants at risk of dysphagia demonstrated lower, but not statistically significantly, SPPB subtests. Additionally, TUG test completion times were significantly longer in the dysphagia risk group (p = 0.002). In addition, dysphagia risk was independently associated with post-stroke urinary incontinence after adjustment for parity, post-stroke constipation, and physical performance.

conclusionsThis study addresses an important gap in the literature by examining the relationship between pelvic floor symptoms, functional status, and dysphagia in women after stroke. Pelvic floor symptoms were more common in individuals at risk of dysphagia, and physical performance, hand-grip strength, functional mobility, and independence in activities of daily living were lower. Given the risk of dysphagia after a stroke, holistic assessment including evaluation of pelvic symptoms and physical performance is important.