Effects of Oro-Esophageal Versus Nasogastric Feeding on Mental Health in Ischemic Stroke: A Randomized Controlled Study

Objective: To explore the effects of oro-esophageal and nasogastric feeding on mental health in ischemic stroke survivors with dysphagia. Design: Open-label randomized controlled trial. Setting: Department of Rehabilitation Medicine of 2 hospitals. Participants: A total of 156 patients with ischemic stroke who needed enteral feeding were included and randomly divided, with 78 in the oro-esophageal group and 78 in the nasogastric group. Interventions: All participants received rehabilitation therapy. The intervention lasted for 14 days for each participant. Oro-esophageal or nasogastric feeding was conducted based on the group. Main Outcome Measures: The primary outcomes were the anxiety and depression symptoms assessed using the Hospital Anxiety and Depression Scale. Data were collected at baseline (day 0), after treatment (day 15), and during follow-up (day 60). Results: Finally, 66 of 70 participants (94.29%) in the oro-esophageal group and 61 of 67 participants (91.04%) in the nasogastric group completed the follow-up after treatment, significant (P<.001) interaction effects were observed in anxiety symptoms (η2=0.670), depression symptoms (η2=0.483), self-efficacy (η2=0.715), subjective social isolation (η2=0.773), and fatigue (odds ratio=0.617, 95% confidence interval: 0.548-0.694). On day 60, additional significance was observed in the time effect of perceived nausea (P<.001). Mental health was further affected by feeding methods during the follow-up period. Conclusions: Intermittent oro-esophageal feeding contributed more than nasogastric feeding to the improvement of mental health. This improvement showed long-term effects and was influenced by feeding methods after discharge. © 2026 American Congress of Rehabilitation Medicine