This prospective, observational study of acute stroke survivors was completed to report our clinical application of the Penetration-Aspiration Scale (PAS), an 8-point multidimensional assessment, used in conjunction with the Video Fluoroscopic Swallow Study (VFSS). In addition, we were interested in determining the association of PAS scores at admission, demographics and clinical characteristics with functional recovery (measured by the Functional Independence Measure [FIM]) at discharge from an inpatient rehabilitation hospital. There were thirty-five patients that met inclusion and consented. Out of the 35, 34 (97%) were successfully assessed with the PAS with VFSS. Multivariate regression model revealed that the PAS scores, sex, length of stay, and admission FIM scores were significantly associated with functional recovery at hospital discharge (all p values < .05). We conclude that the PAS was feasible to administer with VFSS and implement in our inpatient setting. The PAS provided information about the depth of the airway invasion, material remaining after the swallow, and the response to aspiration, which were not reported in a standardized way prior to this study. The association between the PAS and functional recovery at discharge suggests that stroke survivors with swallowing impairment have less functional improvement noted at discharge than those with better swallowing scores. Therefore, people with dysphagia may need additional services and care. Future research should determine if using the PAS can improve clinical practice and ensure consistency across care transitions (expansion), as those with dysphagia may need additional services and care.

Objectives: Free Water Protocols (FWPs) are implemented selectively because of mixed evidence on the benefits associated with their use. This retrospective study examines the implementation a long-standing clinical program and descriptively reports rehabilitation and quality care outcomes. Methods: Data were collected over 6 years (n = 575). Inpatient rehabilitation setting. Variables included in this study were age, medical diagnoses, rate of acute care hospital transfers, discharge destinations, length of time on FWP. Results: Cohort consisted of older adults (M = 68.43, SD = 15.11), with diagnosis of stroke (60.2%), brain injury (19.1%), spinal cord injury (7.3%), cardiac (1%), orthopedics (5%), other (13.1%). Acute care hospital transfers occurred in 6% as descriptively compared to national average (14%). Additionally, participants tolerated FWP for days (M = 14.1, SD = 14.4) and most went home following rehabilitation Discussion: This retrospective study concludes the feasibility of implementing a FWP in a rehabilitation facility and reports descriptive outcomes. Experimental research is required for conclusions to be made regarding effectiveness of the FWP for dysphagia.