Post-Stroke Dysphagia: Moving Toward Evidence-Based, Recovery-Oriented Systems of Care.

PURPOSE OF REVIEW: This review examines challenges in post-stroke dysphagia management, including access to swallowing imaging, enteral feeding decisions, and barriers to reassessment and rehabilitation. It evaluates how healthcare systems and practice patterns influence swallowing outcomes and stroke recovery.

RECENT FINDINGS: Recent literature emphasizes that post-stroke dysphagia is a dynamic condition requiring longitudinal management rather than a temporary acute complication. Evidence supports validated dysphagia screening followed by clinical swallowing evaluation and swallowing imaging for accurate diagnosis and treatment planning. Studies highlight variability in gastrostomy tube practices, post-acute access to swallowing imaging, continuity of care, and the psychosocial burden of oral restriction and feeding decisions after stroke. Dysphagia management systems remain fragmented, contributing to inconsistent diagnosis, reassessment, access to intervention, and prolonged unnecessary oral intake restrictions. Future efforts should prioritize rehabilitation pathways that support recovery-oriented dysphagia management.