{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T11:06:16Z","timestamp":1777633576638,"version":"3.51.4"},"reference-count":31,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T00:00:00Z","timestamp":1777420800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Science and Technology Development Project of Chinese Rehabilitation Medical Association"},{"name":"Henan Provincial Department of Science and Technology Key R&D Special Project","award":["241111310600"],"award-info":[{"award-number":["241111310600"]}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Nutr."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Enteral nutrition is commonly practiced for ischemic stroke survivors with dysphagia. In Eastern Asia, nasogastric and oro-esophageal tubes are the mainstream options. However, there is a lack of rigorous clinical evidence on the effects of these two feeding methods on swallowing-related rehabilitation outcomes and clinical relevance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>This study is clinically oriented and aims to assess the effect of nasogastric versus oro-esophageal tube feeding on the degree and speed of dysphagia improvement, and aspiration symptoms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This multicenter randomized controlled trial will include 422 ischemic stroke patients with dysphagia who require tube feeding. Stratified randomization will be performed to assign participants 1:1 to the oro-esophageal or nasogastric groups. All participants will receive 15-days routine rehabilitation care and nasogastric or oro-esophageal feeding, according to their group assignment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Outcomes<\/jats:title>\n                    <jats:p>The primary outcome is the dysphagia severity assessed using the Dysphagia Outcome and Severity Scale (DOSS). The secondary outcomes include time to improvement of one level from the baseline DOSS, time to oral intake, accumulation of secretions assessed using the Murray Secretion Scale, pharyngeal residue after swallowing assessed using the Yale Pharyngeal Residual Severity Rating Scale, and airway protection assessed using the Penetration-Aspiration Scale. Aspiration symptoms will be monitored for 6\u202fweeks.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>This study aims to provide evidence-based support for the comprehensive effects of tube feeding on swallowing-related rehabilitation outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical trial registration<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link>ClinicalTrials.gov<\/jats:ext-link>\n                      , identifier NCT07386834.\n                    <\/jats:p>\n                  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China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yi","family":"Lu","sequence":"additional","affiliation":[{"name":"Suzhou Hospital of Traditional Chinese Medicine, Nanjing University of Chinese Medicine","place":["Suzhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hongji","family":"Zeng","sequence":"additional","affiliation":[{"name":"School of Health Policy and Management, Peking Union Medical College, Chinese Academy of Medical Sciences","place":["Beijing, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hongyan","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Respiratory and Critical Care Medicine, The Second Medical Center, National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital","place":["Beijing, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Weijia","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Medicinal Insurance, The Third Affiliated Hospital of Zhengzhou University","place":["Zhengzhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Liugen","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, The First Affiliated Hospital of Zhengzhou University","place":["Zhengzhou, China"]},{"name":"Dysphagia Research Institute, Zhengzhou University","place":["Zhengzhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xi","family":"Zeng","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, The First Affiliated Hospital of Zhengzhou University","place":["Zhengzhou, China"]},{"name":"Dysphagia Research Institute, Zhengzhou University","place":["Zhengzhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ying","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine and TCM, The People\u2019s Hospital of Suzhou New District","place":["Suzhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,4,29]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"15","DOI":"10.3389\/fneur.2024.1403610","article-title":"Prevalence, risk factors, and outcomes of dysphagia after stroke: a systematic review and meta-analysis","volume":"15","author":"Song","year":"2024","journal-title":"Front Neurol"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"LXXXIX","DOI":"10.1177\/23969873211039721","article-title":"European stroke organization and European Society for Swallowing Disorders guideline for the diagnosis and treatment of post-stroke 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