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Hino H, Suzuki T, Maekawa K, Ita R, Sasa A, Kulvanich S, Takei E, Magara J, Tsujimura T, Inoue M. Effect of bolus property on swallowing dynamics in patients with dysphagia. J Oral Rehabil 2024; 51:1422-1432. [PMID: 38685709 DOI: 10.1111/joor.13709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 02/20/2024] [Accepted: 04/12/2024] [Indexed: 05/02/2024]
Abstract
BACKGROUND Modification of foods or liquids is commonly administered as part of dysphagia treatment. However, no consensus exists on the parameters for defining texture-modified food for patients with dysphagia. OBJECTIVES The aim of this study was to evaluate the effect of food/liquid material on swallowing physiology in patients with dysphagia and to discuss the optimal food choice for direct swallowing therapy. MATERIALS AND METHODS A total of 140 patients underwent a videofluoroscopic swallowing study using three test foods/liquids: 3 mL of mildly thick liquid (Thick liquid), jelly made of agar and polysaccharide (Jelly) and jelly made of pectin (Reset gel). Outcome measures of videofluoroscopic images, bolus transit time and hyoid movements were compared. RESULTS The frequency of chewing movements was highest for Jelly, followed by Reset gel and Thick liquid. While the probability of oral residue was the highest for Reset gel, pharyngeal residue after swallowing was high for Thick liquid as compared to Jelly and Reset gel. Oral transit time and pharyngeal transit time for Thick liquid were significantly smaller than that for Jelly and Reset gel. Pharyngeal delay time was significantly smaller for Thick liquid than that for Jelly and Reset gel. There was no difference in hyoid elevation time and hyoid movement time among the conditions. CONCLUSION Mildly thick liquid material may be optimal for patients with primarily oral motor function impairment and jelly, such as Reset gel, may be more suitable for patients with primarily pharyngeal motor function impairment or oral and pharyngeal coordinative motor function decline.
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Affiliation(s)
- Haruka Hino
- Division of Dysphagia Rehabilitation, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Taku Suzuki
- Division of Dysphagia Rehabilitation, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Kazuya Maekawa
- Division of Dysphagia Rehabilitation, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Reiko Ita
- Division of Dysphagia Rehabilitation, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Anna Sasa
- Division of Dysphagia Rehabilitation, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Sirima Kulvanich
- Division of Dysphagia Rehabilitation, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
- Department of Community Dentistry & Gerodontology, Faculty of Dentistry, Thammasat University, Pathumthani, Thailand
| | - Eri Takei
- Division of Dysphagia Rehabilitation, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Jin Magara
- Division of Dysphagia Rehabilitation, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Takanori Tsujimura
- Division of Dysphagia Rehabilitation, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Makoto Inoue
- Division of Dysphagia Rehabilitation, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
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Choy J, Pourkazemi F, Bogaardt H, Anderson C, Chai SY, Pebdani RN. Factors influencing speech pathology practice in dysphagia after stroke: A qualitative focus group study. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2024; 59:1599-1611. [PMID: 38373146 DOI: 10.1111/1460-6984.13017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 01/08/2024] [Indexed: 02/21/2024]
Abstract
BACKGROUND Dysphagia affects over half of adults after stroke. Dysphagia rehabilitation aims to improve swallowing and reduce negative outcomes for these adults. However, significant variability exists in dysphagia rehabilitation. Research is needed to explore the underlying clinician-specific and workplace factors that contribute to variability in dysphagia rehabilitation after stroke. AIM To explore factors influencing speech pathology practice in dysphagia rehabilitation after stroke. METHODS & PROCEDURES We used a phenomenological approach with an interpretivist perspective. Twenty speech pathologists working in dysphagia rehabilitation participated from different workplace settings around Australia. Five semi-structured focus groups were conducted online. Data were inductively analysed using thematic analysis with a coding reliability method. OUTCOMES & RESULTS Four themes were discussed within focus groups: (1) relationship between experienced and less experienced clinicians: 'Following what other people have done', (2) need for collaborative learning: 'A safe space to share and train', (3) variation between settings impacts on continuity of care: 'There's a difference between community and acute', and (4) working effectively with multidisciplinary teams (MDT): 'An MDT which can listen to the voice of speech pathology'. CONCLUSIONS & IMPLICATIONS Relationships between senior and junior speech pathologists, within speech pathology and MDT, and across inpatient and community settings influenced speech pathology practice. Flattened hierarchies in speech pathology, collaborative learning in workplaces, mutual respect within teams and connection across inpatient and community settings could improve the quality and consistency of dysphagia rehabilitation after stroke. WHAT THIS PAPER ADDS What is already known on this subject Dysphagia rehabilitation can improve swallowing after a stroke. However, dysphagia rehabilitation is characterised by variability in clinical practice. Clinician-specific and workplace factors influence clinical practice and may contribute to variability in dysphagia rehabilitation. What this study adds Professional relationships influence speech pathologists' clinical practice, including relationships between senior and junior clinicians, between inpatient and community settings and with peers and multidisciplinary teams. Workplace norms and hierarchies, poor continuity of care between settings and competing priorities from other disciplines can hinder dysphagia rehabilitation. However, collaborative learning, positive workplace cultures and respectful transdisciplinary care can improve the quality and consistency of clinical practice. What are the clinical implications of this work? Flattening hierarchies in the workplace can foster a safe learning space. Further, questioning workplace norms and seeking out peer learning within and across settings can build clinical skills and confidence. Developing positive workplace cultures that support continuous development may be key for empowering speech pathologists to provide high-quality and consistent dysphagia rehabilitation.
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Affiliation(s)
- Jacinda Choy
- Faculty of Medicine and Health, Sydney School of Health Sciences, The University of Sydney, Sydney, New South Wales, Australia
- HammondCare Braeside Hospital, Prairiewood, New South Wales, Australia
- Speech Pathology Department, Royal Rehab, Putney, New South Wales, Australia
| | - Fereshteh Pourkazemi
- Faculty of Medicine and Health, Sydney School of Health Sciences, The University of Sydney, Sydney, New South Wales, Australia
| | - Hans Bogaardt
- Faculty of Medicine and Health, Sydney School of Health Sciences, The University of Sydney, Sydney, New South Wales, Australia
- School of Allied Health Science and Practice, University of Adelaide, Adelaide, South Australia, Australia
| | - Caitlin Anderson
- HammondCare Braeside Hospital, Prairiewood, New South Wales, Australia
- Nepean Hospital, Kingswood, New South Wales, Australia
| | - Shing Yee Chai
- HammondCare Braeside Hospital, Prairiewood, New South Wales, Australia
| | - Roxanna N Pebdani
- Faculty of Medicine and Health, Sydney School of Health Sciences, The University of Sydney, Sydney, New South Wales, Australia
- Centre for Disability Research and Policy, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
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Horyacheva A, Boyce K, Badesha M, Kerr C, Najeeb H, Namasivayam-MacDonald A. Identifying Non-Traditional Approaches to Swallowing Rehabilitation: A Scoping Review. Dysphagia 2024; 39:321-347. [PMID: 37853297 DOI: 10.1007/s00455-023-10622-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 09/20/2023] [Indexed: 10/20/2023]
Abstract
In recent years, dysphagia care has shifted toward a more patient-centered approach. This means that dysphagia clinicians are considering more factors in the treatment process including the goals of care, quality of life, and cultural values. The purpose of this scoping review was to examine relevant research and identify dysphagia interventions outside of those traditionally used by dysphagia clinicians that may improve swallowing function. A review of relevant studies was conducted using search terms related to swallowing and treatment. The search yielded 8439 unique studies. Of the 283 articles that underwent a full-text review, 37 articles were included in the final review. These articles highlighted three potential areas of non-traditional dysphagia intervention that may serve to provide holistic care, while also aiming to improve swallowing mechanisms: acupuncture and Eastern medicine interventions, vocal exercises, and physical function exercises. The results suggest that dysphagia clinicians should work collaboratively with other allied health professionals and consider non-traditional approaches to dysphagia care. Through the identification of potentially effective but non-traditional or non-Eurocentric interventions for dysphagia care, clinicians may promote a culturally relevant, patient-centered approach, in turn increasing patient acceptance of treatment plans and compliance. Future research should explore the efficacy and feasibility of these interventions in dysphagia rehabilitation, as well as their effectiveness compared to more traditional approaches.
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Affiliation(s)
- Angela Horyacheva
- School of Rehabilitation Science, McMaster University, 1280 Main Street West, IAHS 403, Hamilton, ON, L8S 4L8, Canada
| | - Keara Boyce
- School of Rehabilitation Science, McMaster University, 1280 Main Street West, IAHS 403, Hamilton, ON, L8S 4L8, Canada
- Hamilton Health Sciences, Hamilton, ON, Canada
| | - Maneetpal Badesha
- School of Rehabilitation Science, McMaster University, 1280 Main Street West, IAHS 403, Hamilton, ON, L8S 4L8, Canada
| | | | - Hiba Najeeb
- School of Rehabilitation Science, McMaster University, 1280 Main Street West, IAHS 403, Hamilton, ON, L8S 4L8, Canada
- St. Mary's General Hospital, Kitchener, ON, Canada
| | - Ashwini Namasivayam-MacDonald
- School of Rehabilitation Science, McMaster University, 1280 Main Street West, IAHS 403, Hamilton, ON, L8S 4L8, Canada.
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Zhang Y, Zhu Y, Wan H. Effectiveness of an evidence-based swallowing facilitation strategy for patients undergoing radiotherapy for head and neck cancer: a study protocol for a randomised controlled trial. BMJ Open 2024; 14:e072859. [PMID: 38199636 PMCID: PMC10806464 DOI: 10.1136/bmjopen-2023-072859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 12/14/2023] [Indexed: 01/12/2024] Open
Abstract
INTRODUCTION Dysphagia emerges as a frequent, persistent and enduring aftermath in individuals undergoing radiotherapy for head and neck cancer (HNC). Timely intervention becomes imperative to ameliorate prolonged dysphagia and curtail related complications. Among the evidence-grounded tactics, preventive swallowing training and proficient feeding management stand out as pivotal measures for precluding and mitigating dysphagia. However, past inquiries that amalgamated these dual interventions exhibited heterogeneous quality due to their restricted participant cohorts and a dearth of uniform, systematic and practicable procedural benchmarks. METHOD/DESIGN This randomised, parallel-controlled study enrols 94 patients diagnosed with HNC, who are undergoing radiotherapy either with or without concurrent chemotherapy. The patients will be randomly assigned to either the intervention group, which will receive a facilitation strategy to enhance swallowing function in conjunction with standard care, or the control group, which will receive typical radiotherapy care. Patient assessments will be conducted at three distinct time points: at the onset of radiotherapy (baseline), at the conclusion of radiotherapy and 3 months postradiotherapy. The primary outcome will revolve around measuring swallowing function, while secondary outcomes will encompass swallowing-related quality of life and nutritional status. ETHICS AND DISSEMINATION This research initiative received endorsement from the Shanghai Proton Heavy Ion Hospital Ethics Committee on 2 December 2 (Approval Number 2210-59-01). Throughout the recruitment process, patients will be acquainted with the primary aims and scope of the study. Their participation will be a voluntary choice, demonstrated by their informed consent form signatures. The outcomes of this study will be disseminated through publication in a peer-reviewed journal. TRIAL REGISTRATION NUMBER Clinical Trials.gov, ChiCTR2300067550, registered 11 January 2023.
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Affiliation(s)
- Yu Zhang
- Department of Nursing, Shanghai Proton and Heavy Ion Center, Fudan University Cancer Hospital, Shanghai, China
- Shanghai Key Laboratory of Radiation Oncology (20dz2261000), Shanghai, China
- Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai, China
| | - Yu Zhu
- Department of Nursing, Shanghai Proton and Heavy Ion Center, Fudan University Cancer Hospital, Shanghai, China
- Shanghai Key Laboratory of Radiation Oncology (20dz2261000), Shanghai, China
- Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai, China
| | - Hongwei Wan
- Department of Nursing, Shanghai Proton and Heavy Ion Center, Fudan University Cancer Hospital, Shanghai, China
- Shanghai Key Laboratory of Radiation Oncology (20dz2261000), Shanghai, China
- Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai, China
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Marques CHD, Lemme EMO, Abrahão-Júnior LJ. Swallow Impairment in Parkinson's Disease: Revelations from High-Resolution Videomanometry. Dysphagia 2023; 38:1371-1381. [PMID: 36884091 DOI: 10.1007/s00455-023-10566-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 02/17/2023] [Indexed: 03/09/2023]
Abstract
Parkinson's disease (PD) is a degenerative disorder that can cause dysphagia and dysphonia. We studied upper esophageal sphincter (UES) function and vocal tests using high-resolution videomanometry (HRVM) in PD. Ten healthy volunteers and 20 patients with PD performed swallowings (5 ml and 10 ml) and vocal tests using HRVM synchronized to the vocal acoustic recording. Mean age of the Parkinson group was 68.7 ± 9.7 years and mean disease stage of 2.7 ± 1.1 (Hoehn & Yahr scale). In videofluoroscopy swallow study (VFSS) for 5 ml, laryngeal elevation was significantly reduced (p = 0.01) in PD and for 10 ml, anteriorization (p = 0.03), elevation (p = 0.03) and total displacement (p = 0.05) were reduced in PD. In high-resolution manometry (HRM) for both volumes, intrabolus pressure was significantly higher in PD (p = 0.0004 and p = 0.001) and a higher NADIR UES relaxation pressure and NADIR UES relaxation at pharyngeal peak contraction in PD (p = 0.00007 and p = 0.0003, p = 0.01 and p = 0.04), respectively. Vocal tests results showed differences between the groups, especially for larynx anteriorization with high pitch /a/ emission (p = 0.06) in VFSS and for UES length with high pitch /i/ with tongue protrusion (p = 0.07) in HRM. Our results demonstrated a reduced compliance and subtle changes in UES function in early and moderate PD stage. We also demonstrated using HRVM that vocal tests can affect UES function. The use of HRVM proved to be an important tool in the description of events related to phonation and swallowing, which can affect the rehabilitation of patients with PD.
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Affiliation(s)
- Charles Henrique Dias Marques
- Medicine College, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
- Digestive Motility Laboratory - Gastroenterology Division of Clementino Fraga Filho University Hospital, Federal University of Rio de Janeiro, Rua Prof. Rodolpho Paulo Rocco, 255 - Cidade Universitária da Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, 21941-617, Brazil.
- Municipal Secretariat of Health - SMS, Rio de Janeiro City Hall, Rio de Janeiro, RJ, Brazil.
| | - Eponina Maria Oliveira Lemme
- Medicine College, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
- Digestive Motility Laboratory - Gastroenterology Division of Clementino Fraga Filho University Hospital, Federal University of Rio de Janeiro, Rua Prof. Rodolpho Paulo Rocco, 255 - Cidade Universitária da Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, 21941-617, Brazil
| | - Luiz João Abrahão-Júnior
- Medicine College, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
- Digestive Motility Laboratory - Gastroenterology Division of Clementino Fraga Filho University Hospital, Federal University of Rio de Janeiro, Rua Prof. Rodolpho Paulo Rocco, 255 - Cidade Universitária da Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, 21941-617, Brazil
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Martin M, Kendall S, Uveges MK. Traumatic Brain Injury, Dysphagia, and the Ethics of Oral Intake. AACN Adv Crit Care 2023; 34:255-262. [PMID: 37644626 DOI: 10.4037/aacnacc2023789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/31/2023]
Affiliation(s)
- Michael Martin
- Michael Martin is Professional Development Director, Tufts Medical Center, Boston Dispensary Building, 29 Bennet St, Boston, MA 02111
| | - Sarah Kendall
- Sarah Kendall is Professional Development Director, Tufts Medical Center, Boston, Massachusetts
| | - Melissa Kurtz Uveges
- Melissa Kurtz Uveges is Assistant Professor, Boston College, Connell School of Nursing, Chestnut Hill, Massachusetts
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Choy J, Pourkazemi F, Anderson C, Bogaardt H. Dosages of Swallowing Exercises Prescribed in Stroke Rehabilitation: A Medical Record Audit. Dysphagia 2023; 38:686-699. [PMID: 35951119 PMCID: PMC10006267 DOI: 10.1007/s00455-022-10500-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 07/13/2022] [Indexed: 01/19/2023]
Abstract
This study investigated how swallowing exercise dosage is recorded, and what swallowing exercise dosages are reported in a stroke rehabilitation setting. We additionally explored the relation between mean daily swallowing repetitions and likelihood of improvement in functional swallowing status and considered how swallowing exercise dosages in practice compared to evidence-based principles of neural plasticity and strength training. We audited medical records for 42 patients with post-stroke dysphagia admitted to an inpatient rehabilitation unit over 18 months. Data were collected on participant characteristics, swallowing exercises and dosages, and clinical outcomes. The relation between dosage and outcomes was investigated using logistic regression analysis. On average, patients were seen for a median of 2.4 swallowing intervention sessions per week (IQR: 1.7) over 21 days (IQR: 16) and received a median 44.5 swallowing exercise repetitions per session (IQR: 39.6). Results indicated variable reporting of swallowing exercise dosages. Frequency, intervention duration, exercise type, and number of repetitions were routinely recorded in medical records, while intensity, session length, content, and adherence to home exercise programs were not. Frequency of swallowing intervention was lower in practice compared to research studies, and swallowing exercises did not follow specificity or progressive resistance principles. Likelihood of improvement in swallowing status was partially explained by age (B = -.015, p = .007) but not by mean daily swallowing exercise repetitions. This study illustrates dosages of swallowing exercises used in clinical practice. Results highlight the need for improved consideration and reporting of dosage, and application of evidence-based principles to swallowing exercise dosages.
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Affiliation(s)
- Jacinda Choy
- Faculty of Medicine and Health, Sydney School of Health Sciences, The University of Sydney, Sydney, NSW, 2006, Australia.
- HammondCare Braeside Hospital, 340 Prairie Vale Road, Prairiewood, NSW, 2176, Australia.
| | - Fereshteh Pourkazemi
- Faculty of Medicine and Health, Sydney School of Health Sciences, The University of Sydney, Sydney, NSW, 2006, Australia
| | - Caitlin Anderson
- HammondCare Braeside Hospital, 340 Prairie Vale Road, Prairiewood, NSW, 2176, Australia
| | - Hans Bogaardt
- Faculty of Medicine and Health, Sydney School of Health Sciences, The University of Sydney, Sydney, NSW, 2006, Australia
- School of Allied Health Science and Practice, University of Adelaide, Adelaide, SA, 5005, Australia
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Choy J, Pourkazemi F, Anderson C, Bogaardt H. Dosages of swallowing exercises in stroke rehabilitation: a systematic review. Eur Arch Otorhinolaryngol 2023; 280:1017-1045. [PMID: 36471047 PMCID: PMC9899761 DOI: 10.1007/s00405-022-07735-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 10/29/2022] [Indexed: 12/12/2022]
Abstract
PURPOSE To investigate the dosages of swallowing exercises reported in intervention studies on post-stroke dysphagia through systematic review. METHODS Five electronic databases were searched from inception until February 2022 with reference tracing of included studies. Studies were included, where adults with post-stroke dysphagia received rehabilitative, behavioural swallowing exercises, pre/post outcomes were reported, and intervention dosage was described in detail, including frequency, intensity, time, and type of exercise. Two reviewers independently screened studies and rated quality using ASHA Levels of Evidence tool. Data was tabulated and narratively described. RESULTS 54 studies were included with a total 1501 participants. Studies included 28 randomised controlled trials, 8 non-randomised controlled trials, 12 pre/post studies, 3 retrospective case controls and 3 case studies. Results showed inconsistent reporting of intervention dosage, with intensity the least consistently reported dosage component. While swallowing intervention was most commonly provided five times per week for four weeks, there was a wide breadth of type, frequency, intensity and duration of swallowing exercises reported. Dosage under-reporting and variation was particularly observed in "standard care" co-interventions or control groups. Study strengths included following PRISMA guidelines, providing a comprehensive review of swallowing exercise methodology and dosages, and including non-English studies. The limitation was lack of meta-analysis due to the heterogeneity of included studies. CONCLUSIONS Dosages of swallowing exercises are inconsistently reported and vary significantly in post-stroke dysphagia studies. Results indicate the need for consistent and comprehensive dosage reporting in dysphagia studies, and for further research into evidence-based principles to optimise swallowing exercise dosages. SYSTEMATIC REVIEW REGISTRATION NUMBER 131294.
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Affiliation(s)
- Jacinda Choy
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.
- HammondCare Braeside Hospital, Sydney, NSW, Australia.
| | - Fereshteh Pourkazemi
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | | | - Hans Bogaardt
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
- School of Allied Health Science and Practice, The University of Adelaide, Adelaide, SA, Australia
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Molfenter SM. The relationship between sarcopenia, dysphagia, malnutrition, and frailty: making the case for proactive swallowing exercises to promote healthy aging. Curr Opin Otolaryngol Head Neck Surg 2022; 30:400-405. [PMID: 36004774 DOI: 10.1097/moo.0000000000000835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
PURPOSE OF REVIEW The purpose of this review is to summarize current evidence regarding the relationship between sarcopenia of the swallowing muscles, dysphagia, malnutrition, and frailty in the context of aging. Further, this review will provide preliminary support for proactive swallowing exercises to reverse and/or prevent sarcopenia of the swallowing muscles. RECENT FINDINGS Recent studies lend support to a cyclic relationship between sarcopenia of the swallowing muscles, dysphagia, malnutrition, and frailty. Unfortunately, all studies are limited by their study design and lack instrumental imaging of swallowing function. Research (in the limbs) supports the use of proactive exercises and protein supplementation to reverse sarcopenia, especially in prefrail individuals. This provides a foundation to design and test similar preventive exercises for the swallowing muscles. SUMMARY As the population is rapidly aging, it is vital to understand how the natural loss of muscle in aging impacts swallowing function and the downstream impact on nutritional and physical function. Prospective, longitudinal research with sophisticated outcome measures are required to fully understand this cycle and provide an opportunity to test methods for interrupting the cycle.
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Affiliation(s)
- Sonja M Molfenter
- Communicative Sciences and Disorders, NYU Steinhardt, Rusk Rehabilitation, NYU Langone Health, New York, USA
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Tan SW, Wu A, Cheng LJ, Wong SH, Lau Y, Lau ST. The Effectiveness of Transcranial Stimulation in Improving Swallowing Outcomes in Adults with Poststroke Dysphagia: A Systematic Review and Meta-analysis. Dysphagia 2022; 37:1796-1813. [PMID: 35430717 DOI: 10.1007/s00455-022-10424-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 02/14/2022] [Indexed: 12/16/2022]
Abstract
Transcranial stimulation has been proposed as an alternative rehabilitation therapy for adults with post-stroke dysphagia (PSD). This systematic review sought to determine the effectiveness of transcranial stimulation in patients with post-stroke dysphagia to improve swallowing function. From inception to January 3, 2021, an extensive search was conducted in PubMed, EMBASE, Cochrane, CINAHL, and Scopus, Web of Science. The randomized controlled trials (RCTs) included studies in adults aged 18 years and older who suffered from post-stroke dysphagia. Using Hedges' g as effect size, meta-analyses were conducted using random-effects models. To investigate potential sources of heterogeneity, subgroup analyses, and multivariable meta-regression analyses were conducted. Sixteen RCTs were included in this review, and 13 RCTs were used for meta-analysis. The meta-analysis showed that a large effect size in improving swallowing function after repetitive Transcranial Magnetic Stimulation (g = - 0.86, 95% CI - 1.57, - 0.16) and medium effect size in Transcranial Direct Current Stimulation (g = - 0.61, 95% CI - 1.04, - 0.17) at post-intervention, respectively. Subgroup and meta-regression analysis indicated that stimulation of the esophagus cortical area and middle-aged adults had a greater effect on swallowing function. The overall certainty of evidence assessed using the GRADE approach was low. Despite the positive results, transcranial stimulation requires additional research to reach definitive conclusions about the optimal stimulation protocol and to achieve the greatest benefit. Future trials should be more rigorous and include a larger sample size to demonstrate the efficacy of transcranial stimulation. Transcranial stimulation enables a more efficacious approach to dysphagia mitigation in PSD rehabilitation.
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Affiliation(s)
- Shu Wen Tan
- National Healthcare Group, Department of Nursing, Tan Tock Seng Hospital, Singapore, Singapore
| | - Anping Wu
- National Healthcare Group, Department of Nursing, Tan Tock Seng Hospital, Singapore, Singapore
| | - Ling Jie Cheng
- Health Systems and Behavioural Sciences Domain, Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Sai Ho Wong
- Alexandra Hospital, National University Health System, Singapore, Singapore
| | - Ying Lau
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Siew Tiang Lau
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore. .,Clinical Research Centre, Level 2, Block MD11, 10 Medical Drive, Singapore, 117597, Singapore.
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Namasivayam-MacDonald A, Rapley M, Stewart J, Webster E, Quon C, Rogus-Pulia N. Impact of Dysphagia Rehabilitation in Adults on Swallowing Physiology Measured With Videofluoroscopy: A Mapping Review. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2022; 31:2195-2228. [PMID: 35868298 PMCID: PMC9907451 DOI: 10.1044/2022_ajslp-21-00342] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 02/02/2022] [Accepted: 04/21/2022] [Indexed: 05/15/2023]
Abstract
PURPOSE The research aims of this review were to (a) map swallowing rehabilitation approaches to specific swallowing impairments using the Modified Barium Swallow Impairment Profile (MBSImP) to develop evidence maps, (b) match desired rehabilitation treatment targets to treatment approaches, and (c) identify gaps in the literature and highlight which rehabilitation approaches require further investigation to support accurate mapping of interventions to physiologic change. METHOD A mapping review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses-Scoping Review extension framework. The databases searched were CINAHL, Ovid Medline, and Ovid Embase. Data extracted included swallowing rehabilitation approach details via the Rehabilitation Treatment Specification System framework, study characteristics, and resulting change in swallowing physiology. The resulting change in swallowing physiology was mapped onto MBSImP components, where applicable, and effect sizes were reported where data were available. Extracted data were summarized in the form of evidence maps. RESULTS Forty-three unique articles met the inclusion criteria for this review and were divided into single-approach and multi-approach exercise studies. Within single-approach studies, 13 different exercise approaches were investigated, and 117 outcome measures could be mapped to MBSImP components. Within multi-approach studies, 13 different combinations of exercise approaches were investigated and 60 outcome measures could be mapped to MBSImP components. CONCLUSIONS This review supports speech-language pathologists in incorporating current best evidence into their practice, as it found there is potential for improvement in many MBSImP components by using rehabilitative exercises. In the future, more intervention studies are needed to ensure that recommended rehabilitation approaches are beneficial for improving the targeted swallowing physiology.
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Affiliation(s)
| | - Megan Rapley
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Josephine Stewart
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Eryn Webster
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Christina Quon
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Nicole Rogus-Pulia
- Division of Geriatrics and Gerontology, Department of Medicine, School of Medicine and Public Health, University of Wisconsin–Madison
- Geriatric Research Education and Clinical Center (GRECC), William S. Middleton Memorial Veterans Hospital, Madison, WI
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Heslin N, Regan J. Effect of effortful swallow on pharyngeal pressures during swallowing in adults with dysphagia: A pharyngeal high-resolution manometry study. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2022; 24:190-199. [PMID: 34607470 DOI: 10.1080/17549507.2021.1975817] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Purpose: Evidence base to support the use of the effortful swallow in clinical populations with dysphagia is currently lacking. This study aims to quantify the effects of effortful swallowing on pharyngeal swallowing biomechanics in adults with dysphagia using pharyngeal high-resolution manometry (PHRM).Method: ManoScan HRM equipment with a 4.2 mm pressure catheter was used. Participants completed duplicate 10ml baseline and 10ml effortful liquid (IDDSI Level 0) swallows in randomised order. PHRM data were analysed using a semi-automated online platform (www.swallowgateway.com).Result: Fifteen adults (8 males; range 45-86 years) with mixed aetiology dysphagia (Functional Oral Intake Scale Level 2-5) were included. Median pharyngeal contractile (156.81 mmHg cm s; IQR 80.62) increased significantly (213.50 mmHg cm s; IQR 117.2) during effortful swallowing. Significant increases were also observed in velopharyngeal pressure, mesopharyngeal pressure, hypopharyngeal pressure and upper oesophageal sphincter (UOS) relaxation duration. UOS integrated relaxation pressure (IRP) was not significantly altered with effortful swallowing.Conclusion: Effortful swallowing induced significant biomechanical changes to swallow in adults with dysphagia. Increases in global pharyngeal rigour, tongue base pressure and UOS opening duration were captured by PHRM during effortful swallowing. Further investigation in larger homogeneous clinical populations is needed to verify the physiological effects of this frequently employed intervention.
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Affiliation(s)
- Niall Heslin
- Department of Clinical Speech & Language Studies, Trinity College, Dublin, Ireland
| | - Julie Regan
- Department of Clinical Speech & Language Studies, Trinity College, Dublin, Ireland
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Julier R, Benfield JK. A qualitative exploration of how oral trials are used in dysphagia management in one inpatient hospital. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2022; 57:340-351. [PMID: 35092338 DOI: 10.1111/1460-6984.12698] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 12/15/2021] [Accepted: 12/17/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND The lack of high-quality evidence to support specific treatment approaches has been widely documented in the existing literature, with evidence suggesting speech and language therapists (SLTs) frequently rely on experience and expert opinion to inform treatment. One approach that is commonly used within dysphagia management, in spite of a lack of existing evidence to support its efficacy, is the use of oral trials, otherwise known as swallow trials or tasters. This approach involves offering specified, limited amounts of oral diet or fluids for those at risk of aspiration or choking if full amounts are taken orally and may be recommended for rehabilitation or quality of life. METHODS & PROCEDURES A total of nine SLTs working in one acute hospital volunteered to participate in focus groups in order to discuss their experience and clinical reasoning for using oral trials within one inpatient hospital setting in the UK. The objectives of this study were (1) to explore how oral trials are used within one inpatient hospital; (2) to consider the barriers and facilitators to the approach; and (3) to consider why this approach may be favoured over other evidenced dysphagia therapies. A grounded theory approach was used to guide data analysis, using two independent coders to identify themes within the focus groups. OUTCOMES & RESULTS Analysis of data revealed the following themes: (1) delivering oral trials requires 'a whole team approach'; (2) SLTs vary recommendations based on patient and environmental factors; and (3) oral trials as a holistic approach. CONCLUSIONS & IMPLICATIONS The use of oral trials was considered by SLTs to be a holistic and flexible approach which can be adapted to a range of patient and environmental factors. Although clinical experience guided rationale, an understanding of the principles of neuroplasticity and swallow physiology was also integral to the approach. Further research is warranted to investigate the use and efficacy of oral trials across the SLT community and within specific patient groups and different environments.
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Affiliation(s)
- Rebecca Julier
- Department of Speech and Language Therapy, Royal Derby Hospital, Derbyshire Community Health Services, Derby, UK
- School of Health and Social Care, University of Lincoln, Lincoln, UK
| | - Jacqueline K Benfield
- Department of Speech and Language Therapy, Royal Derby Hospital, Derbyshire Community Health Services, Derby, UK
- Stroke Trials Unit, Division of Mental Health and Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, UK
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Morita A, Horiuchi A, Horiuchi I, Takada H. Effectiveness of Water Jelly Ingestion for Both Rehabilitation and Prevention of Aspiration Pneumonia in Elderly Patients With Moderate to Severe Dysphagia. J Clin Gastroenterol 2022; 56:e109-e113. [PMID: 33471491 PMCID: PMC8754089 DOI: 10.1097/mcg.0000000000001493] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Accepted: 12/16/2020] [Indexed: 12/10/2022]
Abstract
BACKGROUND AND AIMS We evaluated the effectiveness of water jelly ingestion for both rehabilitation and the prevention of aspiration pneumonia in a retrospective analysis of elderly patients with moderate to severe dysphagia. PATIENTS AND METHODS Study 1: consecutive patients with borderline ingestion in an endoscopic swallowing evaluation were enrolled (n=36, 18 men and 18 women: mean age 82±9 y) and categorized into a group with water jelly (50 to 100 mL) ingestion training 3×/day or an untrained control group. Their food intake levels were then compared using a Food Intake Level Scale. Study 2: consecutive patients who were hospitalized because of aspiration pneumonia were enrolled (n=64, 35 men and 29 women: mean age 81±9 y) and categorized into a group with cyclic ingestion of water jelly immediately after each meal or a control group. The incidence of aspiration pneumonia that was newly developed during hospitalization was compared between the groups. RESULTS In study 1, 36 patients with a Hyodo-Komagane score of 8 were enrolled. Three of the 12 (25%) patients who underwent water jelly ingestion training were able to eat a pureed diet (level 5, 2 patients; level 6, 1 patient) while none of the 24 patients (0%) who did not undergo this training were able to eat any form of diet (levels 5 and 6, no patients) (P=0.011). In study 2, 64 patients were enrolled. No newly developed aspiration pneumonia was observed in the 34 patients (0%) who received cyclic water jelly ingestion, whereas 17% (5/30) of patients not receiving water jelly after meals newly developed aspiration pneumonia during hospitalization (P=0.031). CONCLUSIONS Water jelly ingestion was effective for both rehabilitation and the prevention of aspiration pneumonia in elderly patients with moderate to severe dysphagia.
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Affiliation(s)
- Atsushi Morita
- Digestive Disease Center, Showa Inan General Hospital, Komagane
- Department of Pediatrics, University of Tsukuba Hospital
- Department of Child Health, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Akira Horiuchi
- Digestive Disease Center, Showa Inan General Hospital, Komagane
| | | | - Hidetoshi Takada
- Department of Pediatrics, University of Tsukuba Hospital
- Department of Child Health, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
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15
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Suzuki K, Shimizu Y, Ohshimo S, Oue K, Saeki N, Sadamori T, Tsutsumi Y, Irifune M, Shime N. Real-time assessment of swallowing sound using an electronic stethoscope and an artificial intelligence system. Clin Exp Dent Res 2022; 8:225-230. [PMID: 35018714 PMCID: PMC8874105 DOI: 10.1002/cre2.531] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 11/02/2021] [Accepted: 12/14/2021] [Indexed: 12/01/2022] Open
Abstract
Objectives Daily assessments of swallowing function and interventions such as rehabilitation and dietary adjustments are necessary to improve dysphagia. Cervical auscultation is convenient for health care providers for assessing swallowing ability. Although this method allows for swallowing sound evaluations, sensory evaluations with this method are difficult. Thus, we aimed to assess swallowing sound by the combined use of an electronic stethoscope and an artificial intelligence (AI) system that incorporates sound recognition. Material and Methods Herein, 20 fifth‐year dentistry student volunteers were included; each participant was drank 10 ml and then 20 ml of water in different positions (sitting and supine). We developed an algorithm for indexing bolus inflow sounds using AI, which compared the swallowing sounds and created a new index. Results The new index value used for swallowing sound was significantly higher in men than in women and in the sitting position than in the supine position. A software for acoustic analysis confirmed that the swallowing index was significantly higher in men than in women as well as in the sitting position than in the supine position. These results were similar to those obtained using the new index. However, the new index substantially differed between sexes in terms of posture compared with effective sound pressure. Conclusions We developed a new algorithm for indexing swallowing sounds using a stethoscope and an AI system, which could identify swallowing sounds. For future research and development, evaluations of patients with dysphagia are necessary to determine the efficacy of the new index for bedside screening of swallowing conditions.
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Affiliation(s)
- Kazuma Suzuki
- Department of General Dentistry, Hiroshima University Hospital, Hiroshima, Japan
| | - Yoshitaka Shimizu
- Department of Dental Anesthesiology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Shinichiro Ohshimo
- Department of Emergency and Critical Care Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Kana Oue
- Section of Dental Anesthesiology, Department of Oral & Maxillofacial Surgery and Oral Medicine, Hiroshima University Hospital, Hiroshima, Japan
| | - Noboru Saeki
- Department of Anesthesiology and Critical Care, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Takuma Sadamori
- Department of Emergency and Critical Care Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Yasuo Tsutsumi
- Department of Anesthesiology and Critical Care, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Masahiro Irifune
- Department of Dental Anesthesiology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Nobuaki Shime
- Department of Emergency and Critical Care Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
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Maden T, Usgu G, Tuncer A. Myotonometric comparison of sternocleidomastoideus and masseter muscles in multiple sclerosis patients with swallowing problem and healthy individuals. Mult Scler Relat Disord 2021; 57:103387. [DOI: 10.1016/j.msard.2021.103387] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Revised: 10/16/2021] [Accepted: 11/05/2021] [Indexed: 11/25/2022]
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Treatment of Oropharyngeal Dysphagia in Persons with Traumatic Brain Injury: a Narrative Review of Current Challenges from Practicing Clinicians. CURRENT PHYSICAL MEDICINE AND REHABILITATION REPORTS 2021. [DOI: 10.1007/s40141-021-00320-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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18
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Baijens LWJ, Walshe M, Aaltonen LM, Arens C, Cordier R, Cras P, Crevier-Buchman L, Curtis C, Golusinski W, Govender R, Eriksen JG, Hansen K, Heathcote K, Hess MM, Hosal S, Klussmann JP, Leemans CR, MacCarthy D, Manduchi B, Marie JP, Nouraei R, Parkes C, Pflug C, Pilz W, Regan J, Rommel N, Schindler A, Schols AMWJ, Speyer R, Succo G, Wessel I, Willemsen ACH, Yilmaz T, Clavé P. European white paper: oropharyngeal dysphagia in head and neck cancer. Eur Arch Otorhinolaryngol 2021; 278:577-616. [PMID: 33341909 PMCID: PMC7826315 DOI: 10.1007/s00405-020-06507-5] [Citation(s) in RCA: 67] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Accepted: 11/17/2020] [Indexed: 12/14/2022]
Abstract
PURPOSE To develop a European White Paper document on oropharyngeal dysphagia (OD) in head and neck cancer (HNC). There are wide variations in the management of OD associated with HNC across Europe. METHODS Experts in the management of specific aspects of OD in HNC across Europe were delegated by their professional medical and multidisciplinary societies to contribute to this document. Evidence is based on systematic reviews, consensus-based position statements, and expert opinion. RESULTS Twenty-four sections on HNC-specific OD topics. CONCLUSION This European White Paper summarizes current best practice on management of OD in HNC, providing recommendations to support patients and health professionals. The body of literature and its level of evidence on diagnostics and treatment for OD in HNC remain poor. This is in the context of an expected increase in the prevalence of OD due to HNC in the near future. Contributing factors to increased prevalence include aging of our European population (including HNC patients) and an increase in human papillomavirus (HPV) related cancer, despite the introduction of HPV vaccination in various countries. We recommend timely implementation of OD screening in HNC patients while emphasizing the need for robust scientific research on the treatment of OD in HNC. Meanwhile, its management remains a challenge for European professional associations and policymakers.
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Affiliation(s)
- Laura W J Baijens
- Department of Otorhinolaryngology, Head and Neck Surgery, Maastricht University Medical Center, Maastricht, The Netherlands.
- GROW School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, The Netherlands.
| | - Margaret Walshe
- Department of Clinical Speech and Language Studies, Trinity College Dublin, Dublin, Ireland
| | - Leena-Maija Aaltonen
- Department of Otorhinolaryngology, Head and Neck Surgery, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Christoph Arens
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Magdeburg, Otto-von-Guericke University, Magdeburg, Germany
| | - Reinie Cordier
- Department of Special Needs Education, University of Oslo, Oslo, Norway
- School of Occupational Therapy, Social Work and Speech Pathology, Curtin University, Perth, Australia
| | - Patrick Cras
- Department of Neurology, Born Bunge Institute, Antwerp University Hospital, University of Antwerp, Antwerp, Belgium
| | - Lise Crevier-Buchman
- Voice, Speech, Swallowing Lab, Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital UVSQ and Research lab CNRS-UMR7018, Hôpital Foch, Suresnes, France
| | - Chris Curtis
- Swallows Head and Neck Cancer Charity, Blackpool, UK
| | - Wojciech Golusinski
- Department of Head and Neck Surgery, The Greater Poland Cancer Centre, Poznan University of Medical Sciences, Poznan, Poland
| | - Roganie Govender
- Head and Neck Cancer Centre, University College London Hospital, London, UK
| | - Jesper Grau Eriksen
- Department of Experimental Clinical Oncology, Aarhus University Hospital, Aarhus, Denmark
| | - Kevin Hansen
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty, University of Cologne, Cologne, Germany
| | - Kate Heathcote
- Robert White Centre for Airway, Voice and Swallow, Poole Hospital NHS Foundation Trust, Dorset, UK
| | - Markus M Hess
- Deutsche Stimmklinik, Hamburg, Germany
- Departement of Voice, Speech and Hearing Disorders, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Sefik Hosal
- Department of Otolaryngology, Head and Neck Surgery, Faculty of Medicine, Atılım University, Medicana International Ankara, Ankara, Turkey
| | - Jens Peter Klussmann
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty, University of Cologne, Cologne, Germany
| | - C René Leemans
- Department of Otolaryngology, Head and Neck Surgery, Amsterdam University Medical Centres, Vrije Universiteit, Amsterdam, The Netherlands
- Cancer Center Amsterdam, Amsterdam University Medical Centres, Vrije Universiteit, Amsterdam, The Netherlands
| | - Denise MacCarthy
- Division of Restorative Dentistry and Periodontology, Faculty of Health Sciences, Trinity College Dublin, Dublin Dental University Hospital, Dublin, Ireland
| | - Beatrice Manduchi
- Department of Clinical Speech and Language Studies, Trinity College Dublin, Dublin, Ireland
| | - Jean-Paul Marie
- Department of Otorhinolaryngology, Head and Neck Surgery, Rouen University Hospital, Rouen, France
| | - Reza Nouraei
- Department of Ear Nose and Throat Surgery, The Robert White Centre for Airway Voice and Swallowing, Poole Hospital NHS Foundation Trust, University of Southampton, Southampton, UK
| | - Claire Parkes
- Department of Speech and Language Therapy, St. James's Hospital, Dublin, Ireland
| | - Christina Pflug
- Departement of Voice, Speech and Hearing Disorders, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Walmari Pilz
- Department of Otorhinolaryngology, Head and Neck Surgery, Maastricht University Medical Center, Maastricht, The Netherlands
- MHeNs School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Julie Regan
- Department of Clinical Speech and Language Studies, Trinity College Dublin, Dublin, Ireland
| | - Nathalie Rommel
- Department Neurosciences, Experimental Otorhinolaryngology, Deglutology, University of Leuven, Leuven, Belgium
| | - Antonio Schindler
- Department of Biomedical and Clinical Sciences "L. Sacco", University of Milan, Milan, Italy
| | - Annemie M W J Schols
- Department of Respiratory Medicine, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Renee Speyer
- Department of Special Needs Education, University of Oslo, Oslo, Norway
- School of Occupational Therapy, Social Work and Speech Pathology, Curtin University, Perth, Australia
- Department of Otorhinolaryngology and Head and Neck Surgery, Leiden University Medical Centre, Leiden, The Netherlands
- Faculty of Health, School of Health and Social Development, Victoria, Australia
| | - Giovanni Succo
- Head and Neck Oncology Service, Candiolo Cancer Institute, FPO - IRCCS, Candiolo, TO, Italy
- Department of Oncology, University of Turin, Orbassano, TO, Italy
| | - Irene Wessel
- Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Anna C H Willemsen
- GROW School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, The Netherlands
- Department of Respiratory Medicine, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center, Maastricht, The Netherlands
- Division of Medical Oncology, Department of Internal Medicine, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Taner Yilmaz
- Department of Otorhinolaryngology, Head and Neck Surgery, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Pere Clavé
- Gastrointestinal Physiology Laboratory, Hospital de Mataró, Universitat Autònoma de Barcelona, Mataró, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Barcelona, Spain
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Prehabilitation in head and neck cancer patients: a literature review. J Otolaryngol Head Neck Surg 2021; 50:2. [PMID: 33407922 PMCID: PMC7789666 DOI: 10.1186/s40463-020-00486-7] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Accepted: 12/21/2020] [Indexed: 12/26/2022] Open
Abstract
Background Dysphagia is one consequence of head and neck cancer that has a significant impact on quality of life for head and neck cancer survivors. While survival rates continue to improve, focus has shifted to maximizing long-term function, with prevention or prehabilitation programs becoming more common. Prehabilitation programs typically include an exercise regime that specifies the exercise type, the number of repetitions to complete per set, the number of sets of each exercise to complete per day, as well as the length of the treatment block. Ideally, exercise programs are designed with principles of neuromuscular plasticity in mind. Methods Twenty-nine original research articles published between 2006 and 2020 were included in this state-of-the-art review and examined for program timing and details. Results Two definitions for prehabilitation were noted: one third of the studies defined prehabilitation as preventative exercises prior to the start of acute cancer treatment; the remaining two thirds defined prehabilitation as treatment concurrent prehabilitation. Exercises prescribed ranged from general stretching and range of motion exercises, to trismus and swallowing specific exercises. The most common swallowing specific exercise was the Mendelsohn’s maneuver, followed by the effortful swallow, Shaker, and Masako maneuver. The most common dose was 10 repetitions of an exercise, three times per day for the duration of radiation therapy. The most common measures were questionnaires, followed by g-tube dependence, mouth opening, and MBS reports. Conclusion This review of the literature has shed light on the variability of prehabilitation timing, exercise type, dose, duration of treatment, and outcomes associated with prehabilitation, making the selection of an optimal prehabilitation program difficult at this time.
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Best Practice Recommendations for Stroke Patients with Dysphagia: A Delphi-Based Consensus Study of Experts in Turkey-Part II: Rehabilitation. Dysphagia 2021; 36:800-820. [PMID: 33399995 DOI: 10.1007/s00455-020-10218-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Accepted: 11/17/2020] [Indexed: 01/01/2023]
Abstract
Dysphagia is one of the most common and important complications of stroke. It is an independent marker of poor outcome following acute stroke and it continues to be effective for many years. This consensus-based guideline is not only a good address to clinical questions in practice for the clinical management of dysphagia including management, diagnosis, follow-up, and rehabilitation methods, but also includes detailed algorithms for these topics. The recommendation paper has been written by a multidisciplinary team and offers 117 recommendations for stroke patients with dysphagia. While focusing on management principles, diagnosis, and follow-up in the 1st part (45 items), rehabilitation details were evaluated in the 2nd part (72 items).
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Kato K, Ikeda R, Suzuki J, Hirano-Kawamoto A, Kamakura Y, Fujiu-Kurachi M, Hyodo M, Izumi SI, Koyama S, Sasaki K, Nakajima J, Karaho T, Kimura Y, Kumai Y, Fujimoto Y, Nito T, Oku Y, Kurosawa H, Kuriyama S, Katori Y. Questionnaire survey on nurses and speech therapists regarding dysphagia rehabilitation in Japan. Auris Nasus Larynx 2020; 48:241-247. [PMID: 32859444 DOI: 10.1016/j.anl.2020.08.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 06/25/2020] [Accepted: 08/03/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVE Current interventions of dysphagia are not generalizable, and treatments are commonly used in combination. We conducted a questionnaire survey on nurses and speech therapists regarding dysphagia rehabilitation to understand the current situation in Japan. METHODS The questionnaire was sent to 616 certified nurses in dysphasia nursing and 254 certified speech-language-hearing therapists for dysphagia. Based on "Summaries of training methods in 2014" by JSDR, 24 local indirect exercises, 11 general indirect exercises, and 13 direct exercises were selected. The Likert scale "How do you feel about each method" was used as follows: A; Frequency, B; Ease, C; Adherence, D; Effectiveness (1-5))?". RESULTS Two hundred fifty (40%) nurses and 145 (57%) speech-language-hearing therapists (ST) responded to the questionnaire. The direct exercise was associated with a significantly high score in every question. In indirect exercises, "Cervical range of motion exercise," "Orofacial myofunctional exercise," "Lip closure exercise." "Ice massage of pharynx" and "Huffing" were used relatively frequently. "Balloon dilatation therapy" and "Tube exercise" was associated with a relatively high discrepancy for two questions. Frequency" and the sum of "Ease," "Adherence," and "Effectiveness." was significantly correlated for local indirect exercises (r2 = 0.928, P < 0.01), general indirect exercises (r2 = 0.987, P < 0.01), and direct exercises (r2 = 0.996, P < 0.01) (Fig. 5). CONCLUSION This study examined the current situation of dysphagia rehabilitation in Japan. Our results aid to increase understanding and selection of rehabilitative treatments for dysphagia patients in Japan.
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Affiliation(s)
- Kengo Kato
- Department of Otolaryngology and Head and Neck Surgery, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai 980-8574, Japan
| | - Ryoukichi Ikeda
- Department of Otolaryngology and Head and Neck Surgery, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai 980-8574, Japan.
| | - Jun Suzuki
- Department of Otolaryngology and Head and Neck Surgery, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai 980-8574, Japan
| | - Ai Hirano-Kawamoto
- Department of Otolaryngology and Head and Neck Surgery, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai 980-8574, Japan
| | - Yayoi Kamakura
- Faculty of Nursing, Japanese Red Cross Toyota College of Nursing, Aichi, Japan
| | - Masako Fujiu-Kurachi
- Department of Speech and Hearing Sciences, International University of Health and Welfare, Narita, Japan
| | - Masamitsu Hyodo
- Department of Otolaryngology, Kochi Medical School, Kochi, Japan
| | - Shin-Ichi Izumi
- Department of Physical Medicine and Rehabilitation, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Shigeto Koyama
- Maxillofacial Prosthetics Clinic, Tohoku University Hospital, Japan
| | - Keiichi Sasaki
- Division of Advanced Prosthetic Dentistry, Tohoku University Graduate School of Dentistry, Tohoku University, Japan
| | - Junko Nakajima
- Research on Social and Human Sciences, Tokyo Metropolitan Institute of Gerontology, Japan
| | - Takahiro Karaho
- Department of Otolaryngology Head and Neck Surgery, Kyorin University, School of Medicine, Japan
| | - Yurika Kimura
- Department of Otolaryngology, Ebara Hospital, Tokyo Metropolitan Health and Medical Treatment Corporation, Japan
| | - Yoshihiko Kumai
- Department of Otolaryngology-Head and Neck Surgery, Nagasaki University Graduate School of Biomedical Sciences, Japan
| | - Yasushi Fujimoto
- Department of Otolaryngology, Nagoya University Graduate School of Medicine, Japan
| | - Takaharu Nito
- Department of Otolaryngology, Saitama Medical University, Japan
| | - Yoshitaka Oku
- Department of Physiology, Hyogo College of Medicine, Japan
| | - Hajime Kurosawa
- Department of Occupational Health, Tohoku University Graduate School of Medicine, Japan
| | - Shinichi Kuriyama
- Department of Disaster-Related Public Health, International Research Institute of Disaster Science, Tohoku University, Japan
| | - Yukio Katori
- Department of Otolaryngology and Head and Neck Surgery, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai 980-8574, Japan
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Jing YH, Lin T, Li WQ, Wu C, Li X, Ding Q, Wu MF, Xu GQ, Lan Y. Comparison of Activation Patterns in Mirror Neurons and the Swallowing Network During Action Observation and Execution: A Task-Based fMRI Study. Front Neurosci 2020; 14:867. [PMID: 32973431 PMCID: PMC7472888 DOI: 10.3389/fnins.2020.00867] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Accepted: 07/27/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Observation of a goal-directed motor action can excite the respective mirror neurons, and this is the theoretical basis for action observation (AO) as a novel tool for functional recovery during stroke rehabilitation. To explore the therapeutic potential of AO for dysphagia, we conducted a task-based functional magnetic resonance imaging (fMRI) study to identify the brain areas activated during observation and execution of swallowing in healthy participants. METHODS Twenty-nine healthy volunteers viewed the following stimuli during fMRI scanning: an action-video of swallowing (condition 1, defined as AO), a neutral image with a Chinese word for "watching" (condition 2), and a neutral image with a Chinese word for "swallowing" (condition 3). Action execution (AE) was defined as condition 3 minus condition 2. One-sample t-tests were performed to define the brain regions activated during AO and AE. RESULTS Many brain regions were activated during AO, including the middle temporal gyrus, inferior frontal gyrus, pre- and postcentral gyrus, supplementary motor area, hippocampus, brainstem, and pons. AE resulted in activation of motor areas as well as other brain areas, including the inferior parietal lobule, vermis, middle frontal gyrus, and middle temporal gyrus. Two brain areas, BA6 and BA21, were activated with both AO and AE. CONCLUSION The left supplementary motor area (BA6) and left middle temporal gyrus (BA21), which contains mirror neurons, were activated in both AO and AE of swallowing. In this study, AO activated mirror neurons and the swallowing network in healthy participants, supporting its potential value in the treatment of dysphagia.
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Affiliation(s)
- Ying-hua Jing
- Department of Rehabilitation Medicine, Guangzhou First People’s Hospital, School of Medicine, South China University of Technology, Guangzhou, China
| | - Tuo Lin
- Department of Rehabilitation Medicine, Guangzhou First People’s Hospital, School of Medicine, South China University of Technology, Guangzhou, China
| | - Wan-qi Li
- Department of Rehabilitation Medicine, Guangzhou First People’s Hospital, Guangzhou Medical University, Guangzhou, China
| | - Cheng Wu
- Department of Rehabilitation Medicine, Guangzhou First People’s Hospital, School of Medicine, South China University of Technology, Guangzhou, China
| | - Xue Li
- Department of Rehabilitation Medicine, Guangzhou First People’s Hospital, Guangzhou Medical University, Guangzhou, China
| | - Qian Ding
- Department of Rehabilitation Medicine, Guangzhou First People’s Hospital, School of Medicine, South China University of Technology, Guangzhou, China
| | - Man-feng Wu
- Department of Rehabilitation Medicine, Guangzhou First People’s Hospital, School of Medicine, South China University of Technology, Guangzhou, China
| | - Guang-qing Xu
- Department of Rehabilitation Medicine, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Yue Lan
- Department of Rehabilitation Medicine, Guangzhou First People’s Hospital, School of Medicine, South China University of Technology, Guangzhou, China
- Department of Rehabilitation Medicine, Guangzhou First People’s Hospital, Guangzhou Medical University, Guangzhou, China
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23
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Sayaca C. Swallowing dıfficulty and swallowing anxiety in patients with type-II diabetes mellitus. Eur Arch Otorhinolaryngol 2020; 277:2005-2010. [PMID: 32189071 DOI: 10.1007/s00405-020-05902-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2020] [Accepted: 03/02/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND Type-II Diabetes Mellitus (TII-DM) is the most common endocrine disorder in people who are over 65 years of age. It leads to a decrease in muscle strength and impaired muscle coordination. Ageing and weakness cause swallowing difficulty (SD). OBJECTIVE The aim of this study was to evaluate the relationship between duration of disease, SD and swallowing anxiety (SA) in TII-DM patients. STUDY DESIGN Prospective case-control study. METHODS A total of 103 elderly individuals (74 females and 29 males) participated in this study. Fifty-two elderly patients (aged 70.27 ± 4.65 years) had a TII-DM and the duration of DM was 11.32 ± 10.03 years (minimum: 0-40 years). Fifty-one patients without diabetes mellitus (69.35 ± 3.58 years) were included in the control group. SD was determined using the EAT-10 Questionnaire. SA was evaluated with the Swallowing Anxiety Scale developed in the Turkish population. Handgrip strength was evaluated with a Jamar dynamometer on the dominant side. RESULTS There was a significant difference in SD (p : 0.042), SA (p : 0.001), and handgrip strength (p : 0.039) between groups. There was a relationship between SD and SA in the control and DM groups (r : 0.577; p : 0.000 and r : 0.663; p : 0.000, respectively). There was no relationship between the other parameters (age, SD, SA, and handgrip strength) in the control group (p < 0.05). There was a positive moderate relationship between SA and duration of disease in the TII-DM group (r : 0.472; p : 0.000). There was no relationship between other parameters (age, SD, SA, handgrip strength, and duration of disease) in the DM group (p < 0.05). CONCLUSION In elderly individuals with TII-DM and without DM, there were differences in SD, SA, and handgrip strength. Although there was a relationship between SD and SA in both groups, this relationship was found to be higher in elderly patients with TII-DM. In addition, there was a relationship between the duration of diagnosis and SA. In elderly individuals, evaluating SD with SA was thought to be helpful in the prevention or early rehabilitation of swallowing disorders.
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Affiliation(s)
- Cetin Sayaca
- Faculty of Healthy Science Physical Therapy and Rehabilitation, Uskudar University, Altunizade Mahallesi, Mahir Iz Cad. No:23, 34674, Uskudar, Istanbul, Turkey.
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Sayaca C, Serel-Arslan S, Sayaca N, Demir N, Somay G, Kaya D, Karaduman A. Is the proprioceptive neuromuscular facilitation technique superior to Shaker exercises in swallowing rehabilitation? Eur Arch Otorhinolaryngol 2019; 277:497-504. [PMID: 31873776 DOI: 10.1007/s00405-019-05772-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Accepted: 12/13/2019] [Indexed: 11/26/2022]
Abstract
PURPOSE This prospective study was planned to investigate whether the combined isotonic technique of proprioceptive neuromuscular facilitation (PNF) is superior to Shaker exercises in improving the function of swallowing muscles. METHODS Fifty individuals (30 females and 20 males; mean age 68 ± 3.89 years) with swallowing difficulties were separated into two groups randomly. The treatment groups were Shaker and PNF groups, which performed these exercises three times in a week for6 weeks. Swallowing difficulties were determined with the Turkish version of the eating assessment tool (T-EAT-10). The 100 ml-water swallow test was used to measure capacity, volume, and speed of swallowing. Contraction amplitude changes used as a universal measurement of motor unit activity during the muscle action were measured with superficial electromyography. RESULT After 6 weeks of exercise training, T-EAT-10 scores decreased in both groups (p < 0.001). Water swallowing capacity and volume improved in both groups (p < 0.001). There was no change in swallowing speed in both groups (p > 0.05). Maximal voluntary contraction values of suprahyoid muscles were higher in PNF than the Shaker group (p < 0.05). CONCLUSION Both the types of exercise can be used in the rehabilitation of swallowing difficulties. However, the PNF technique increased the contraction amplitude values that occur during maximum contraction more than the Shaker exercises. Different functional evaluations are needed to determine the effectiveness of PNF on swallowing difficulty.
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Affiliation(s)
- Cetin Sayaca
- Uskudar University Faculty of Healty Science Physical Therapy and Rehabilitation, Altunizade Mahallesi, Mahir İz Cd. No:23, 34674, Üsküdar/İstanbul, Turkey.
| | - Selen Serel-Arslan
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Nurhan Sayaca
- Ministry of Health Istanbul Provincial Health Directorate Istanbul Kartal Dr. Lutfi Kirdar Education and Research Hospital, Istanbul, Turkey
| | - Numan Demir
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Goksel Somay
- Okan University Vocational School of Health Services Electroneurophysiology Program, Istanbul, Turkey
| | - Defne Kaya
- Uskudar University Faculty of Healty Science Physical Therapy and Rehabilitation, Altunizade Mahallesi, Mahir İz Cd. No:23, 34674, Üsküdar/İstanbul, Turkey
| | - Ayse Karaduman
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
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25
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Araújo BCL, Simões SDM, Moreira MGS, Mendes ALF, Martins-Filho PRS. Evidence of orofacial myofunctional therapy patients with asthma and rhinitis: a systematic review. Codas 2019; 31:e20190009. [PMID: 31483044 DOI: 10.1590/2317-1782/20192019009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2019] [Accepted: 04/01/2019] [Indexed: 11/22/2022] Open
Abstract
PURPOSE to evaluate the efficacy of orofacial myofunctional therapy in improving orofacial function and nasal breathing in patients with asthma and rhinitis and, consequently, achieve clinical control of these conditions. RESEARCH STRATEGIES We used the elements of the PICOT method (study population, intervention, comparison, outcomes and type of studies) to define the eligibility criteria: (1) Population: patients with asthma and rhinitis; (2) Intervention: orofacial myofunctional therapy to improve chewing, swallowing, and breathing; (3) Comparison: control group without orofacial myofunctional therapy; (4) Predefined outcomes: clinical control of asthma and improvement of orofacial functions and nasal breathing; (5) Study type: clinical trials. The data were collected from PubMed, SCOPUS, Web of Science, Science Direct, LILACS, Google Scholar, Cochrane Central Register of Controlled Trials (CENTRAL), OATD, and Open Thesis, in November 2018. SELECTION CRITERIA Randomized controlled trials published in full-text versions without language restriction, no filter was used. DATA ANALYSIS Demographic characteristics of study participants, specific diagnosis of asthma and control medication, type, duration, intensity and follow-up of orofacial myofunctional therapy, and outcome data. The risk of bias was assessed according to the Cochrane guidelines for clinical trials. RESULTS One study met the eligibility criteria: although the study has shown an improvement of functional control and clinical scores of asthma, the evidence is very low. CONCLUSION There is no scientific evidence on the efficacy of orofacial myofunctional therapy in improving clinical control, orofacial function, and nasal breathing in patients with asthma and rhinitis.
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Affiliation(s)
- Brenda Carla Lima Araújo
- Departamento de Fonoaudiologia, Universidade Federal de Sergipe - UFS - Aracaju (SE), Brasil.,Programa de Pós-graduação em Ciências da Saúde, Universidade Federal de Sergipe - UFS - Aracaju (SE), Brasil
| | - Silvia de Magalhães Simões
- Programa de Pós-graduação em Ciências da Saúde, Universidade Federal de Sergipe - UFS - Aracaju (SE), Brasil.,Departamento de Medicina, Universidade Federal de Sergipe - UFS - Aracaju (SE), Brasil
| | | | | | - Paulo Ricardo Saquete Martins-Filho
- Programa de Pós-graduação em Ciências da Saúde, Universidade Federal de Sergipe - UFS - Aracaju (SE), Brasil.,Laboratório de Patologia Investigativa, Universidade Federal de Sergipe - UFS - Aracaju (SE), Brasil
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26
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Shune SE, Namasivayam-MacDonald AM. Swallowing Impairments Increase Emotional Burden in Spousal Caregivers of Older Adults. J Appl Gerontol 2019; 39:172-180. [DOI: 10.1177/0733464818821787] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Objective: The aim of this study was to determine the type and extent of caregiver burden uniquely experienced by spousal caregivers of older adults with dysphagia. Method: Using the Round 1 surveys from the National Health and Aging Trends Study and the National Study of Caregiving, we analyzed data on 422 community-dwelling older adults and their spousal caregivers. Results: Approximately 17% of care recipients reported swallowing difficulties. Logistic regression analysis revealed that caregivers of spouses with dysphagia were significantly more likely to experience emotional burden, p = .038; odds ratio (OR) = 2.06; 95% confidence interval (CI): [1.04, 4.09]. Of those spouses caring for partners with dysphagia who reported emotional burden, nearly 70% rated the burden moderate to severe. Discussion: Dysphagia in community-dwelling older adults is associated with increased emotional burden among spousal caregivers. Given the intricate relationship between the health and well-being of both members of the caregiving dyad, these findings support the need for interventions that prioritize dyadic health.
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27
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McGinnis CM, Homan K, Solomon M, Taylor J, Staebell K, Erger D, Raut N. Dysphagia: Interprofessional Management, Impact, and Patient-Centered Care. Nutr Clin Pract 2018; 34:80-95. [DOI: 10.1002/ncp.10239] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Affiliation(s)
| | - Kimberly Homan
- Sanford USD Medical Center; Sioux Falls South Dakota USA
| | - Meghan Solomon
- Sanford USD Medical Center; Sioux Falls South Dakota USA
| | - Julia Taylor
- Sanford USD Medical Center; Sioux Falls South Dakota USA
| | | | - Denise Erger
- Sanford USD Medical Center; Sioux Falls South Dakota USA
| | - Namrata Raut
- Sanford USD Medical Center; Sioux Falls South Dakota USA
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28
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Vahabzadeh-Hagh AM, Goel AN, Frederick JW, Berke GS, Long JL. Transplanted human multipotent stromal cells reduce acute tongue fibrosis in rats. Laryngoscope Investig Otolaryngol 2018; 3:450-456. [PMID: 30599029 PMCID: PMC6302725 DOI: 10.1002/lio2.202] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/01/2018] [Indexed: 12/25/2022] Open
Abstract
Background Tongue fibrosis resulting from head and neck cancer, surgery, radiation, chemotherapy, or a combination thereof devastates one's quality of life. Therapeutic options are limited. Here we investigate human bone marrow-derived multipotent stromal cells (MSC) as a novel injectable treatment for post-injury tongue fibrosis. Methods MSCs were grown in culture. Eighteen athymic rats underwent unilateral partial glossectomy. After two weeks for scar formation, a single injection was performed in the tongue scar. Three treatment groups were studied: low and high concentration MSC, and control media injection. Tongues were harvested for evaluation at three weeks post-treatment. Results Dense fibrosis was achieved in control animals at five weeks. High concentration MSC reduced cross sectional scar burden (P = .007) and pathologic score for inflammation and fibrosis. Conclusion This study establishes the feasibility of a novel rodent tongue fibrosis model, and begins to assess the utility of human MSCs to reduce scar burden. Level of Evidence N/a.
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Affiliation(s)
| | - Alexander N Goel
- From the Department of Head and Neck Surgery, UCLA David Geffen School of Medicine Los Angeles California U.S.A
| | - John W Frederick
- From the Department of Head and Neck Surgery, UCLA David Geffen School of Medicine Los Angeles California U.S.A
| | - Gerald S Berke
- From the Department of Head and Neck Surgery, UCLA David Geffen School of Medicine Los Angeles California U.S.A
| | - Jennifer L Long
- From the Department of Head and Neck Surgery, UCLA David Geffen School of Medicine Los Angeles California U.S.A.,Research Service Greater Los Angeles VA Healthcare System Los Angeles California U.S.A
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29
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Restivo DA, Hamdy S. Pharyngeal electrical stimulation device for the treatment of neurogenic dysphagia: technology update. MEDICAL DEVICES-EVIDENCE AND RESEARCH 2018; 11:21-26. [PMID: 29379319 PMCID: PMC5757971 DOI: 10.2147/mder.s122287] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Neurogenic dysphagia (ND) can occur in patients with nervous system diseases of varying etiologies. Moreover, recovery from ND is not guaranteed. The therapeutic approaches for oropharyngeal ND have drastically changed over the last decade, mainly due to a better knowledge of the neurophysiology of swallowing along with the progress of neuroimaging and neurophysiological studies. For this reason, it is a priority to develop a treatment that is repeatable, safe, and can be carried out at the bedside as well as for outpatients. Pharyngeal electrical stimulation (PES) is a novel rehabilitation treatment for ND. PES is carried out via location-specific intraluminal catheters that are introduced transnasally and enable clinicians to stimulate the pharynx directly. This technique has demonstrated increasingly promising evidence in improving swallowing performance in patients with ND associated with stroke and multiple sclerosis, probably by increasing the corticobulbar excitability and inducing cortical reorganization of swallowing motor cortex. In this article, we update the reader as to both the physiologic background and past and current studies of PES in an effort to highlight the clinical progress of this important technique.
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Affiliation(s)
| | - Shaheen Hamdy
- School of Translational Medicine-Inflammation Sciences, Faculty of Medical and Human Sciences, University of Manchester, Salford Royal Hospital, Salford, UK
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30
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Bearelly S, Wang SJ, Cheung SW. Oral sensory dysfunction following radiotherapy. Laryngoscope 2017; 127:2282-2286. [DOI: 10.1002/lary.26591] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Revised: 02/01/2017] [Accepted: 02/20/2017] [Indexed: 11/07/2022]
Affiliation(s)
- Shethal Bearelly
- Department of Otolaryngology-Head and Neck Surgery; Vanderbilt University; Nashville Tennessee U.S.A
| | - Steven J. Wang
- Department of Otolaryngology-Head and Neck Surgery; University of Arizona; Tucson Arizona U.S.A
| | - Steven W. Cheung
- Department of Otolaryngology-Head and Neck Surgery; University of California, San Francisco; San Francisco California U.S.A
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