Inclusion Criteria- First-ever ischemic stroke
- Time since stroke onset: 1 to 3 weeks
- Tracheobronchial aspiration evaluated with the gold standard, videofluoroscopy,
- Cognitive impairment (Short Portable Mental Status Questionnaire less than 3)
Exclusion Criteria- Previous history of neurological diseases that might be associated with the presence of dysphagia
- Previous history of pulmonary diseases
- Significant alcohol abuse (>80 g/day) and 4) medical treatment with potential effect on muscle structure and function (steroids,thyroid hormones, immunosuppressors).