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Sekimoto Y, Matsuo K, Sakai A, Shibata S, Minakuchi S. Improvement of oral function and its impact on oral food intake in subacute stroke patients: A prospective study with dental intervention. J Oral Rehabil 2024. [PMID: 38651211 DOI: 10.1111/joor.13711] [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: 11/24/2023] [Revised: 03/19/2024] [Accepted: 04/12/2024] [Indexed: 04/25/2024]
Abstract
BACKGROUND The association between oral food intake and oral function during the subacute stage of stroke is not well known. OBJECTIVE To investigate (1) oral function changes in subacute stroke patients and (2) association between oral function and oral intake status at several time points. METHODS In a prospective study involving 324 stroke patients at a convalescent rehabilitation unit, four oral function parameters (maximum tongue pressure, MTP; lip-tongue motor function, LTMF; maximum occlusal force, MOF and oral health assessment tool, OHAT) were quantitatively measured upon admission (T0), at 1 month (T1) and 2 months (T2). Oral feeding status was assessed using the Functional Oral Intake Scale (FOIS) and divided based on the FOIS score into the dysphagic and regular diet groups. The changes in oral functions at the three time points were tested using generalized estimating equation analysis. The association between FOIS groups and oral functions at T1 and T2 was analysed by means of logistic regression analysis. RESULTS All oral function parameters improved significantly over time during the hospital stay (mean differences: 4.9 for MTP, 0.6 for LTMF, 1.1 for MOF and -1.8 for OHAT). The FOIS groups were significantly associated with MTP (p < .05) and OHAT (p < .05) at both T1 and T2. CONCLUSION Our findings suggest that oral function significantly improves in patients during subacute stroke rehabilitation and better oral health can be associated with better oral intake. Improved oral function through dental intervention and oral rehabilitation may contribute to gains in oral food intake.
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Affiliation(s)
- Yu Sekimoto
- Department of Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
- Department of Dentistry, PL General Hospital, Medical Corporation Hosho, Tokyo, Japan
- Department of Dentistry and Oral-Maxillofacial Surgery, School of Medicine, Fujita Health University, Toyoake, Japan
| | - Koichiro Matsuo
- Department of Oral Health Sciences for Community Welfare, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Ayu Sakai
- Department of Dentistry and Oral-Maxillofacial Surgery, Fujita Health University Hospital, Toyoake, Japan
| | - Seiko Shibata
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Japan
| | - Shunsuke Minakuchi
- Department of Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
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Okada T, Yamaguchi H, Tanaka S, Koyama K, Hishida A, Konno S, Nakamura M, Sugiura H, Nishida Y. Hand Grip Strength Assessment Based on Sarcopenia Diagnostic Criteria Predicts Swallowing Function. Dysphagia 2024; 39:223-230. [PMID: 37507638 DOI: 10.1007/s00455-023-10604-y] [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: 01/30/2022] [Accepted: 07/06/2023] [Indexed: 07/30/2023]
Abstract
The purpose of this study is to clarify whether swallowing function can be inferred from grip strength. Based on the diagnostic criteria of sarcopenia, patients were divided into two groups according to grip strength, and it was analyzed whether there was a difference in the evaluation index for swallowing function between the two groups. Among the cases requesting evaluation of swallowing function from June 10, 2020 to October 28, 2020, 83 cases (mean age: 71.7 years, 59 males and 24 females) who received assessment tests and swallowing endoscopy were included. According to the diagnostic criteria for grip strength in the Asian working group in Sarcopenia, less than 28 kgf and 18 kgf were defined as the weak group for men and women, respectively. Hyodo scores, repeated salivary swallowing tests (RSST), maximum vocalization time (MPT), and dysphagia severity classification (DSS) were compared between the two groups. Of the 83 patients, 29 and 54 were in the normal group and weak group, respectively. In all indicators, the normal group showed significantly better results than the weak group: Hyodo score (2.4 vs. 4.0, p < 0.01), RSST (4.1 times vs. 2.4 times, p < 0.01), MPT (12.1 s vs. 5.9 s, p < 0.001), DSS (4.5 vs. 5.9, p < 0.001), respectively. In multiple regression analysis with DSS as the dependent variable, grip strength was a significant independent variable of DSS even after adjusting for age, gender, and body mass index. Grip strength assessment based on sarcopenia criteria can be a useful tool for estimating swallowing function.
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Affiliation(s)
- Takashi Okada
- Department of Rehabilitation, Nagoya University Hospital, 65 Tsurumai-Cho, Showa-Ku, Nagoya, 466-8560, Japan
| | - Hidetoshi Yamaguchi
- Department of Rehabilitation, Nagoya University Hospital, 65 Tsurumai-Cho, Showa-Ku, Nagoya, 466-8560, Japan
| | - Shinya Tanaka
- Department of Rehabilitation, Nagoya University Hospital, 65 Tsurumai-Cho, Showa-Ku, Nagoya, 466-8560, Japan
| | - Kyohei Koyama
- Department of Rehabilitation, Nagoya University Hospital, 65 Tsurumai-Cho, Showa-Ku, Nagoya, 466-8560, Japan
| | - Aika Hishida
- Department of Rehabilitation, Nagoya University Hospital, 65 Tsurumai-Cho, Showa-Ku, Nagoya, 466-8560, Japan
| | - Suzuna Konno
- Department of Rehabilitation, Nagoya University Hospital, 65 Tsurumai-Cho, Showa-Ku, Nagoya, 466-8560, Japan
| | - Masataka Nakamura
- Department of Rehabilitation, Nagoya University Hospital, 65 Tsurumai-Cho, Showa-Ku, Nagoya, 466-8560, Japan
| | - Hideshi Sugiura
- Department of Integrated Health Sciences, Graduate School of Medicine, Nagoya University, Nagoya, Japan
| | - Yoshihiro Nishida
- Department of Rehabilitation, Nagoya University Hospital, 65 Tsurumai-Cho, Showa-Ku, Nagoya, 466-8560, Japan.
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Ninomiya S, Fujii W, Matsumoto E, Yamaguchi K, Hiratsuka M. Association between tongue pressure and oral status and activities of daily living in stroke patients admitted to a convalescent rehabilitation unit. Clin Exp Dent Res 2024; 10:e825. [PMID: 38037529 PMCID: PMC10860403 DOI: 10.1002/cre2.825] [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: 01/30/2022] [Revised: 11/17/2023] [Accepted: 11/22/2023] [Indexed: 12/02/2023] Open
Abstract
BACKGROUND Clarifying how tongue pressure in convalescent stroke patients affects oral condition and activities of daily living (ADL) is important for developing oral rehabilitation programs and for rehabilitation care to reacquire ADL. OBJECTIVE To clarify how tongue pressure is associated with oral status, ADL, and nutritional status in stroke patients. METHODS Sixty-eight patients aged 77.9 ± 10.0 years participated. The Japanese version of the Oral Health Assessment Tool was used to evaluate oral status. Data such as the ADL index functional independence measure (FIM), nutritional intake method, serum albumin, and body mass index were extracted from medical records. To examine factors associated with tongue pressure, multiple regression analysis was performed adjusting for confounding factors. The level of statistical significance was set at p < .05. RESULTS In recovery phase stroke patients, tongue pressure was significantly lower in the total assistance group than in the partial assistance/independent group. In addition, tongue pressure was significantly lower in tube feeding patients than in oral feeding patients. FIM cognition score was an independent factor that had a significant effect on tongue pressure. CONCLUSION These findings suggest that ADL status also affects tongue pressure, thus patients' ADL including the FIM cognition subscale should also be evaluated while measuring tongue pressure.
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Affiliation(s)
- Shizuka Ninomiya
- Division of DentistryFukuoka Rehabilitation HospitalFukuokaJapan
- Graduate School of Dentistry, Department of Oral Health SciencesKyushu Dental UniversityKitakyushuJapan
| | - Wataru Fujii
- Unit of Interdisciplinary Promotion, School of Oral Health Sciences, Faculty of DentistryKyushu Dental UniversityKitakyushuJapan
| | - Erika Matsumoto
- Graduate School of Dentistry, Department of Oral Health SciencesKyushu Dental UniversityKitakyushuJapan
| | | | - Masao Hiratsuka
- Division of DentistryFukuoka Rehabilitation HospitalFukuokaJapan
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Nakamori M, Toko M, Yamada H, Hayashi Y, Haruta A, Hiraoka A, Yoshikawa M, Nagasaki T, Ushio K, Yoshikawa K, Shimizu Y, Mikami Y, Maruyama H. Detailed findings of videofluoroscopic examination among patients with Parkinson's disease on the effect of cervical percutaneous interferential current stimulation. Front Neurol 2023; 14:1279161. [PMID: 38020611 PMCID: PMC10664245 DOI: 10.3389/fneur.2023.1279161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 10/23/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction Parkinson's disease (PD) leads to various types of swallowing disorders. We investigated the effect of cervical percutaneous interferential current stimulation on dysphagia. By conducting detailed qualitative and quantitative analysis of videofluoroscopic examination, we aimed to understand dysphagia in patients with PD and investigate its effects on swallowing function. Methods Patients received cervical percutaneous interferential current stimulation for 20 min twice a week for 8 weeks. In this exploratory study, we evaluated aspiration/laryngeal penetration, oral cavity residue, vallecular residue, and pharyngeal residue. In addition, we performed temporal analysis. Results Twenty-five patients were completely evaluated. At baseline, the proportions of laryngeal penetration/aspiration, oral cavity residue, epiglottic vallecula residue, and pharyngeal residue were 40.0, 88.0, 72.0, 60.0, and 16.0%, respectively. Conversely, pharyngeal transit time, laryngeal elevation delay time, pharyngeal delay time, and swallowing reflex delay were nearly within the normal ranges. Cervical percutaneous interferential current sensory stimulation improved only oral cavity residue at the end of the intervention, from 88.0 to 56.0%. Discussion Patients with PD demonstrated remarkably high frequencies of residues in the oral and pharyngeal regions. The usefulness of cervical interferential current stimulation was partially demonstrated for oral cavity residue. Considering that PD exhibits diverse symptoms, further accumulation of cases and knowledge is warranted. Trial registration jRCTs062220013.
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Affiliation(s)
- Masahiro Nakamori
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Megumi Toko
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Hidetada Yamada
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Yuki Hayashi
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Azusa Haruta
- Department of Advanced Prosthodontics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Aya Hiraoka
- Department of Advanced Prosthodontics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Mineka Yoshikawa
- Department of Advanced Prosthodontics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Toshikazu Nagasaki
- Department of Oral and Maxillofacial Radiology, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Kai Ushio
- Department of Rehabilitation Medicine, Hiroshima University Hospital, Hiroshima, Japan
| | - Kohei Yoshikawa
- Department of Rehabilitation Medicine, Hiroshima University Hospital, Hiroshima, Japan
| | - Yoshitaka Shimizu
- Department of Dental Anesthesiology, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Yukio Mikami
- Department of Rehabilitation Medicine, Hiroshima University Hospital, Hiroshima, Japan
| | - Hirofumi Maruyama
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
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Lopes RFT, Palinkas M, Pádua da Silva G, Verri ED, Regalo IH, Gonçalves CR, Hallak JEC, Costa Gomes GG, Regalo SCH, Siéssere S. Stroke: An electromyographic approach to the masseter and temporal muscles, orofacial soft tissue pressure, and occlusal force. PLoS One 2023; 18:e0282362. [PMID: 36857404 PMCID: PMC9976995 DOI: 10.1371/journal.pone.0282362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 02/13/2023] [Indexed: 03/02/2023] Open
Abstract
Stroke is a cerebrovascular disease that triggers changes in the central and peripheral nervous systems, and can compromise human body function. This cross-sectional observational study aimed to analyze the electromyographic (EMG) activity of the masseter and temporal muscles, orofacial soft tissue pressure, and strength of occlusal contacts in patients who had suffered a stroke. Twenty-four patients were divided into two groups: stroke (n = 12) and control (n = 12). The EMG of the masseter and temporal muscles was evaluated during mandibular rest, protrusion, right laterality, left laterality, and maximal voluntary contraction. The Iowa Oral Pressure Instrument (IOPI) was used to measure pressure from the tongue, lips, and buccinator muscles. A computerized system for occlusal analysis (T-Scan III) was used to measure the occlusal contact points of the right and left hemiarches (upper and lower) and the upper and lower first molars. Data were subjected to Student's t-test (p < 0.05). The stroke group had lower normalized electromyographic activity, with a significant difference in the left temporal muscle during rest (p = 0.03) when compared to the control group. There was a significant difference between the groups in tongue pressure (p = 0.004) with a lower mean value in the stroke group. There was a significant difference between the groups in the evaluation of the occlusal contact points of the first permanent molars, with a lower mean percentage in the stroke group. The results indicate that stroke negatively affects functional performance of the stomatognathic system.
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Affiliation(s)
- Robson Felipe Tosta Lopes
- Department of Basic and Oral Biology, Ribeirão Preto School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Marcelo Palinkas
- Department of Basic and Oral Biology, Ribeirão Preto School of Dentistry, University of São Paulo, São Paulo, Brazil
- Faculty of Medicine of Ribeirão Preto, Department of Neuroscience and Behavioral Sciences, University of São Paulo and National Institute and Technology—Translational Medicine (INCT.TM), São Paulo, Brazil
- * E-mail:
| | - Gabriel Pádua da Silva
- Department of Basic and Oral Biology, Ribeirão Preto School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Edson Donizetti Verri
- Department of Basic and Oral Biology, Ribeirão Preto School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Isabela Hallak Regalo
- Department of Basic and Oral Biology, Ribeirão Preto School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Camila Rosa Gonçalves
- Department of Basic and Oral Biology, Ribeirão Preto School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Jaime Eduardo Cecilio Hallak
- Faculty of Medicine of Ribeirão Preto, Department of Neuroscience and Behavioral Sciences, University of São Paulo and National Institute and Technology—Translational Medicine (INCT.TM), São Paulo, Brazil
| | - Guilherme Gallo Costa Gomes
- Department of Basic and Oral Biology, Ribeirão Preto School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Simone Cecílio Hallak Regalo
- Department of Basic and Oral Biology, Ribeirão Preto School of Dentistry, University of São Paulo, São Paulo, Brazil
- Faculty of Medicine of Ribeirão Preto, Department of Neuroscience and Behavioral Sciences, University of São Paulo and National Institute and Technology—Translational Medicine (INCT.TM), São Paulo, Brazil
| | - Selma Siéssere
- Department of Basic and Oral Biology, Ribeirão Preto School of Dentistry, University of São Paulo, São Paulo, Brazil
- Faculty of Medicine of Ribeirão Preto, Department of Neuroscience and Behavioral Sciences, University of São Paulo and National Institute and Technology—Translational Medicine (INCT.TM), São Paulo, Brazil
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Yanagida R, Hara K, Namiki C, Okumura T, Saiki A, Nakagawa K, Yamaguchi K, Yoshimi K, Nakane A, Mauclaire JM, Tohara H. Effects of tongue right positioner use on tongue pressure: a pilot study. Sci Rep 2023; 13:3289. [PMID: 36841869 PMCID: PMC9968309 DOI: 10.1038/s41598-023-30450-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Accepted: 02/23/2023] [Indexed: 02/27/2023] Open
Abstract
The effectiveness of the tongue right positioner (TRP) use on oral and swallowing functions remains unclear. To investigate the effects of TRP use on tongue function in patients with dysphagia. This interventional study included eight participants with dysphagia who visited a university dental hospital. The measurement variables included tongue pressure (TP) as the primary outcome and lip and tongue movements, peak nasal inspiratory flow, and changes in the tongue and suprahyoid muscle regions on ultrasonography as the secondary outcomes. Each participant was asked to use a TRP for at least 8 h every night for 2 months. The measurement variables before and after the intervention were compared using the paired t test and Wilcoxon signed-rank test. TP after intervention (31.5 ± 13.1 kPa) was significantly higher than that before intervention (23.0 ± 13.4 kPa), while other measurement variables did not significantly improve. Numerous exercises have been suggested to improve TP; however, most require patients' adherence to instructions. In contrast, although participants did not perform active exercises, most participants in this study observed an improved TP. Our findings show that TRP can greatly improve TP after 2 months of usage.Trial registration number: University Hospital Medical Information Network Clinical Trials Registry (UMIN000040253, date of first registration: 27/04/2020).
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Affiliation(s)
- Ryosuke Yanagida
- Department of Dysphagia Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Koji Hara
- Department of Dentistry for the Special Patient, Kanagawa Dental University, 82 Inaokacho, Yokosuka, Kanagawa, 238-8580, Japan.
| | - Chizuru Namiki
- Department of Dysphagia Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan.,Department of Dentistry for the Special Patient, Kanagawa Dental University, 82 Inaokacho, Yokosuka, Kanagawa, 238-8580, Japan
| | - Takuma Okumura
- Department of Dysphagia Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Akino Saiki
- Department of Dysphagia Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Kazuharu Nakagawa
- Department of Dysphagia Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Kohei Yamaguchi
- Department of Dysphagia Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Kanako Yoshimi
- Department of Dysphagia Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Ayako Nakane
- Department of Dysphagia Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | | | - Haruka Tohara
- Department of Dysphagia Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
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Okuno K, Kobuchi R, Morita S, Masago A, Imaoka M, Takahashi K. Relationships between the Nutrition Status and Oral Measurements for Sarcopenia in Older Japanese Adults. J Clin Med 2022; 11:jcm11247382. [PMID: 36555998 PMCID: PMC9785267 DOI: 10.3390/jcm11247382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 12/09/2022] [Accepted: 12/09/2022] [Indexed: 12/15/2022] Open
Abstract
INTRODUCTION The purpose of the present study was to clarify the relationships between the risk of malnutrition as a preliminary stage of malnutrition and overall and oral measurements for sarcopenia in older Japanese adults. METHODS Forty-five participants (79.7 ± 6.1 years) were included in the analysis. The nutrition status of the participants was assessed using the Mini Nutritional Assessment-Short Form (MNA-SF) and classified into two groups: normal and at risk of malnutrition. Overall measurements for sarcopenia in the present study were the skeletal muscle mass index, grip strength, and walking speed, while oral measurements were the cross-sectional area of the geniohyoid muscle, tongue pressure (TP), and oral diadochokinesis. RESULTS MNA-SF correlated with TP (r = 0.347, p = 0.019). We observed decreases of 5.7 kPa in TP and 3.9 kg/cm2 in BMI in the at risk of malnutrition group. A multiple regression analysis of parameters contributing to the risk of malnutrition identified TP as an independent variable (β = 0.913, p = 0.042). CONCLUSIONS The present results demonstrate that the risk of malnutrition is associated with TP as an oral measurement for sarcopenia, but not overall measurements for sarcopenia. Therefore, low TP may be related with the risk of malnutrition.
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Affiliation(s)
- Kentaro Okuno
- Department of Geriatric Dentistry, Osaka Dental University, 1-8, Kuzuhahanazono-cho, Hirakata-shi 573-1121, Japan
- Correspondence: ; Tel./Fax: +81-66910-1050
| | - Ryuichiro Kobuchi
- Department of Geriatric Dentistry, Osaka Dental University, 1-8, Kuzuhahanazono-cho, Hirakata-shi 573-1121, Japan
| | - Suguru Morita
- Department of Geriatric Dentistry, Osaka Dental University, 1-8, Kuzuhahanazono-cho, Hirakata-shi 573-1121, Japan
- Department of Dentistry and Oral-Maxillofacial Surgery, Chikaishi Hospital, Medical Corporation Touhoukai, 2-46, Hikari-machi, Gifu-shi 502-0901, Japan
| | - Ayako Masago
- Department of Geriatric Dentistry, Osaka Dental University, 1-8, Kuzuhahanazono-cho, Hirakata-shi 573-1121, Japan
| | - Masaaki Imaoka
- Department of Geriatric Dentistry, Osaka Dental University, 1-8, Kuzuhahanazono-cho, Hirakata-shi 573-1121, Japan
| | - Kazuya Takahashi
- Department of Geriatric Dentistry, Osaka Dental University, 1-8, Kuzuhahanazono-cho, Hirakata-shi 573-1121, Japan
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Kulvanich S, Sakai H, Takanami R, Yamada M, Sasa A, Ito K, Tsujimura T, Magara J, Inoue M. Impact of oral function on regaining oral intake and adjusting diet forms for acute stroke patients. J Stroke Cerebrovasc Dis 2022; 31:106401. [DOI: 10.1016/j.jstrokecerebrovasdis.2022.106401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Revised: 02/02/2022] [Accepted: 02/05/2022] [Indexed: 10/19/2022] Open
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Shimizu A, Fujishima I, Maeda K, Murotani K, Ohno T, Nomoto A, Nagami S, Nagano A, Sato K, Ueshima J, Inoue T, Shimizu M, Ishida Y, Kayashita J, Suenaga M, Mori N. Delayed Dysphagia May Be Sarcopenic Dysphagia in Patients After Stroke. J Am Med Dir Assoc 2021; 22:2527-2533.e1. [PMID: 34389335 DOI: 10.1016/j.jamda.2021.07.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 07/12/2021] [Accepted: 07/14/2021] [Indexed: 12/18/2022]
Abstract
OBJECTIVE In many cases, swallowing function is impaired after the onset of stroke and gradually improves. However, delayed dysphagia has been reported in some post-stroke patients. Recently, several studies have reported that low muscle strength and decreased muscle mass cause dysphagia. This study aimed to investigate whether these conditions are associated with delayed dysphagia after stroke. DESIGN A multicenter prospective observational cohort study. SETTING AND PARTICIPANTS Participants included 165 patients with post-stroke dysphagia (mean age 79.1 ± 8.0 years, 53.3% women) admitted to rehabilitation wards for post-stroke rehabilitation. METHODS Swallowing function was assessed using the Functional Oral Intake Scale. Delayed dysphagia was defined as dysphagia that occurred more than 7 days after stroke onset. We used logistic regression to examine the independent association between low muscle strength and decreased muscle mass and delayed dysphagia development. Furthermore, we examined the relationship between improvement in dysphagia and delayed dysphagia. RESULTS Delayed dysphagia was observed in 18 (10.9%) patients. The combination of severely low muscle strength and decreased muscle mass was independently associated with the development of delayed dysphagia (adjusted odds ratio: 4.423, 95% confidence interval: 1.400-13.974, P = .011). Delayed dysphagia had an adverse effect on the improvement of dysphagia during in-hospital rehabilitation (adjusted odds ratio: 0.278, 95% confidence interval: 0.078-0.986, P = .047). CONCLUSIONS AND IMPLICATIONS The development of delayed dysphagia was influenced by a combination of severely low muscle strength and decreased muscle mass. Furthermore, delayed dysphagia adversely affects the improvement of dysphagia in patients with stroke and needs to be identified early. Identifying delayed dysphagia using the methods proposed in this study and incorporating early intervention may prevent or delay dependency conditions in this population.
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Affiliation(s)
- Akio Shimizu
- Department of Nutrition, Hamamatsu City Rehabilitation Hospital, Hamamatsu, Japan; Department of Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, Nagakute, Japan; Department of Geriatric Medicine, Hospital, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Ichiro Fujishima
- Department of Rehabilitation Medicine, Hamamatsu City Rehabilitation Hospital, Hamamatsu, Japan
| | - Keisuke Maeda
- Department of Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, Nagakute, Japan; Department of Geriatric Medicine, Hospital, National Center for Geriatrics and Gerontology, Obu, Japan.
| | | | - Tomohisa Ohno
- Department of Dentistry, Hamamatsu City Rehabilitation Hospital, Hamamatsu, Japan
| | - Akiko Nomoto
- Department of Dentistry, Hamamatsu City Rehabilitation Hospital, Hamamatsu, Japan
| | - Shinsuke Nagami
- Department of Speech Language Pathology and Audiology, Faculty of Rehabilitation Kawasaki University of Medical Welfare, Kurashiki, Japan
| | - Ayano Nagano
- Department of Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, Nagakute, Japan; Department of Nursing Care, Nishinomiya Kyoritsu Neurosurgical Hospital, Nishinomiya, Japan
| | - Keisuke Sato
- Department of Rehabilitation, Chuzan Clinical Research Center, Chuzan Hospital, Okinawa, Japan
| | - Junko Ueshima
- Department of Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, Nagakute, Japan; Department of Clinical Nutrition and Food Service, NTT Medical Center Tokyo, Shinagawa, Japan
| | - Tatsuro Inoue
- Department of Geriatric Medicine, Hospital, National Center for Geriatrics and Gerontology, Obu, Japan; Department of Physical Therapy, Niigata University of Health and Welfare, Niigata, Japan
| | - Midori Shimizu
- Department of Nutrition, Hamamatsu University Hospital, Hamamatsu, Japan
| | - Yuria Ishida
- Department of Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, Nagakute, Japan; Department of Nutrition, Aichi Medical University Hospital, Nagakute, Japan
| | - Jun Kayashita
- Department of Health Sciences, Faculty of Human Culture and Science, Prefectural University of Hiroshima, Hiroshima, Japan
| | - Masaki Suenaga
- Okinawa Chuzan Clinical Research Center, Chuzan Hospital, Matsumoto, Okinawa, Japan
| | - Naoharu Mori
- Department of Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, Nagakute, Japan
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