Objective
To identify the prevalence and factors associated with T-score discordance between the spine and hip, as well as between the paretic and non-paretic hips in hemiplegic stroke patients, this study investigated bone mineral density (BMD) patterns. Bone loss predominantly affects the paretic hip after a stroke, and typical clinical assessments using dual-energy X-ray absorptiometry (DXA) that scan the lumbar spine (LS) and a single hip may overlook an osteoporosis diagnosis. This oversight could potentially lead to suboptimal treatment for stroke patients.
Methods
This study was a multicenter retrospective analysis of 540 patients admitted for stroke rehabilitation between October 2014 and February 2022, who underwent DXA of LS and bilateral hips.
Results
The prevalence rates of concordance, low LS discordance, and low hip discordance between the LS and hips were 48.2%, 12.2%, and 39.6%, respectively. The discordance rate between bilateral hips was 17.0%. The paretic side had significantly lower total hip T-scores than the non-paretic side (p<0.001). Notably low paretic hip discordance was more prevalent during the chronic phase. DXA scans of the LS and both hips revealed a 0.7%–0.9% higher major discordance compared to LS and single hip DXA scans. The multivariate analysis revealed a significant correlation between a low paretic hip discordance and cognitive impairment (adjusted odds ratio 0.071, 95% confidence interval 0.931–1.003, p<0.05).
Conclusion
Since stroke survivors are at high risk for hip fractures, comprehensive BMD assessments, which include LS and bilateral hips, should be considered for post-stroke osteoporosis care to enhance diagnostic accuracy and timely treatment.

Citations

• Association between bone mineral density and stroke: a meta-analysis
  Peng Zhao, Huaxia Sun
  Frontiers in Neurology.2025;[Epub]     CrossRef

Objective
Dysphagia is a common clinical condition characterized by difficulty in swallowing. It is sub-classified into oropharyngeal dysphagia, which refers to problems in the mouth and pharynx, and esophageal dysphagia, which refers to problems in the esophageal body and esophagogastric junction. Dysphagia can have a significant negative impact one’s physical health and quality of life as its severity increases. Therefore, proper assessment and management of dysphagia are critical for improving swallowing function and preventing complications. Thus a guideline was developed to provide evidence-based recommendations for assessment and management in patients with dysphagia.
Methods
Nineteen key questions on dysphagia were developed. These questions dealt with various aspects of problems related to dysphagia, including assessment, management, and complications. A literature search for relevant articles was conducted using Pubmed, Embase, the Cochrane Library, and one domestic database of KoreaMed, until April 2021. The level of evidence and recommendation grade were established according to the Grading of Recommendation Assessment, Development and Evaluation methodology.
Results
Early screening and assessment of videofluoroscopic swallowing were recommended for assessing the presence of dysphagia. Therapeutic methods, such as tongue and pharyngeal muscle strengthening exercises and neuromuscular electrical stimulation with swallowing therapy, were effective in improving swallowing function and quality of life in patients with dysphagia. Nutritional intervention and an oral care program were also recommended.
Conclusion
This guideline presents recommendations for the assessment and management of patients with oropharyngeal dysphagia, including rehabilitative strategies.

Citations

• Using concept mapping to guide dysphagia service enhancements in Singapore: Recommendations from the speech-language pathology workforce
  Flora M.M Poon, Elizabeth C. Ward, Clare L. Burns
  International Journal of Speech-Language Pathology.2025; 27(1): 56.     CrossRef
• Cough Suppression Therapy in Patients With Chronic Refractory Cough and Oropharyngeal Dysphagia
  ShengYing A. Chen, Jessica F. Kim, Priya Krishna, Ethan Simmons, Brianna K. Crawley, Thomas Murry
  American Journal of Speech-Language Pathology.2025; 34(3): 1058.     CrossRef
• Characterization of Beverage Viscosity Based on the International Dysphagia Diet Standardisation Initiative and Its Correspondence to the Japanese Dysphagia Diet 2021
  Mari Nakao-Kato, Aya Takahashi, Jin Magara
  Nutrients.2025; 17(6): 1051.     CrossRef
• Factors influencing oropharyngeal dysphagia in individuals with chronic neurological disorders presenting to the outpatient swallowing disorder clinic
  Güleser Güney Yılmaz, Müberra Tanrıverdi, Remzi Doğan, Orhan Özturan
  Multiple Sclerosis and Related Disorders.2025; 97: 106387.     CrossRef
• The Efficacy of Outpatient Swallowing Therapy: A Retrospective Longitudinal Cohort Study
  Tyler W. Crosby, Sonja Molfenter, Matina Balou, Uche C. Ezeh, Milan R. Amin
  Dysphagia.2025;[Epub]     CrossRef
• The Role of Dysphagia on Head and Neck Cancer Patients’ Quality of Life, Functional Disabilities and Psychological Distress: Outcomes of Cancer Rehabilitation from an Observational Single-Center Study
  Špela Matko, Christina Knauseder, David Riedl, Vincent Grote, Michael J. Fischer, Samuel Moritz Vorbach, Karin Pfaller-Frank, Wilhelm Frank, Thomas Licht
  Current Oncology.2025; 32(4): 220.     CrossRef
• The impact of physical therapy on dysphagia in neurological diseases: a review
  Kun Li, Cuiyuan Fu, Zhen Xie, Jiajia Zhang, Chenchen Zhang, Rui Li, Caifeng Gao, Jiahui Wang, Chuang Xue, Yuebing Zhang, Wei Deng
  Frontiers in Human Neuroscience.2024;[Epub]     CrossRef
• Clinical Characteristics and Evaluation of Dysphagia in Patients with Parkinson’s Disease
  Seo Jung Yun, Han Gil Seo
  Journal of the Korean Dysphagia Society.2024; 14(1): 10.     CrossRef
• Updated Clinical Practice Guidelines for the Diagnosis and Management of Long COVID
  Jun-Won Seo, Seong Eun Kim, Yoonjung Kim, Eun Jung Kim, Tark Kim, Taehwa Kim, So Hee Lee, Eunjung Lee, Jacob Lee, Yu Bin Seo, Young-Hoon Jeong, Young Hee Jung, Yu Jung Choi, Joon Young Song
  Infection & Chemotherapy.2024; 56(1): 122.     CrossRef
• Association between the C-reactive protein/albumin ratio and mortality in older Japanese patients with dysphagia
  Chunhong Guo, Pingping Zheng, Shiyang Chen, Lin Wei, Xiuzhen Fu, Youyuan Fu, Tianhong Hu, Shaohua Chen
  Frontiers in Nutrition.2024;[Epub]     CrossRef
• Compensatory strategies of dysphagia after anterior cervical spinal surgery: A case report
  Sung Joon Chung, Jun Ho Lee, Yunsoo Soh
  Medicine.2024; 103(29): e39016.     CrossRef
• The Right ICD Code, Right Now: A Call to Action for Pragmatic Language Disorders After Right Hemisphere Stroke
  Jamila Minga, Shanika Phillips Fullwood, Deborah Rose, Danai Kasambira Fannin
  American Journal of Speech-Language Pathology.2024; 33(6): 3121.     CrossRef
• Dysphagia Screening in Residential Long-Term Care Settings in the Republic of Ireland: A Cross-Sectional Survey
  Constantino Estupiñán Artiles, Claire Donnellan, Julie Regan, Mary Mooney
  Dysphagia.2024;[Epub]     CrossRef
• Dysphagia and Dysphonia After Head and Neck Cancer
  Aaron Parsons, Karuna Dewan
  Oral Diseases.2024;[Epub]     CrossRef
• The pathophysiology of dysphagia post‐lung transplant: A systematic review
  Sana Smaoui, Elly Cummins, Maryah Mena, Summer Scott, Rodrigo Tobar‐Fredes
  Laryngoscope Investigative Otolaryngology.2024;[Epub]     CrossRef
• Effect of segmental tongue function training on tongue pressure attributes in individuals with dysphagia after receiving radiotherapy for nasopharyngeal carcinoma
  Fei Zhao, Chen Yang, Si-Ming Sun, Yao-Wen Zhang, Hong-Mei Wen, Zu-Lin Dou, Xiao-Mei Wei, Chun-Qing Xie
  BMC Oral Health.2024;[Epub]     CrossRef
• Diagnosis and treatment of dysphagia
  Kyoung Hyo Choi
  Journal of the Korean Medical Association.2023; 66(10): 604.     CrossRef