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Suzuki M, Nagano A, Ueshima J, Saino Y, Kawase F, Kobayashi H, Murotani K, Inoue T, Nagami S, Maeda K. Prevalence of dysphagia in patients after orthopedic surgery. Arch Gerontol Geriatr 2024; 119:105312. [PMID: 38101112 DOI: 10.1016/j.archger.2023.105312] [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: 09/12/2023] [Revised: 12/05/2023] [Accepted: 12/11/2023] [Indexed: 12/17/2023]
Abstract
OBJECTIVES Oropharyngeal dysphagia is one of the most prevalent health complications in older adults. The prevalence of postoperative dysphagia is expected to rise with the increasing number of older patients undergoing orthopedic surgery; however, the specific prevalence and contributing factors remain unclear. This scoping review aimed to identify the prevalence and factors related to postoperative dysphagia in older orthopedic patients. METHODS This review included studies published up to September 2022 on postoperative patients aged ≥ 60 years who underwent orthopedic surgery. We searched MEDLINE, EMBASE, CINAHL, CENTRAL, Web of Science, and Ichushi-Web. RESULTS In total, 21 of the 2158 identified studies were reviewed. The studies were classified into the three categories according to the surgical site: cervical spine disease (n = 12), hip fracture (n = 7), and others (n = 2). The estimated dysphagia prevalence rates [95 % confidence interval] of cervical spine disease, hip fractures, and others were 16 % [8-27], 32 % [15-54], and 6 % [4-8], respectively. Factors related to postoperative dysphagia included cervical alignment in cervical spine disease, being older within the cohort, preoperative health status, malnutrition, and sarcopenia in hip fractures. CONCLUSIONS The prevalence of postoperative dysphagia after orthopedic surgery was highest for hip fractures, followed by cervical spine and others. These results suggest non-neurogenic dysphagia in older patients undergoing orthopedic surgery and indicate that sarcopenia may contribute to postoperative dysphagia in this population. Therefore, further research should clarify the trajectory of postoperative dysphagia and the effectiveness of rehabilitation for postoperative dysphagia after orthopedic surgery.
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Affiliation(s)
- Mizue Suzuki
- Department of Rehabilitation, Faculty of Allied Health Sciences, Yamato university, Osaka, Japan
| | - Ayano Nagano
- Department of Nursing, Nishinomiya Kyoritsu Neurosurgical Hospital, Hyogo, Japan
| | - Junko Ueshima
- Department of Nutritional Service, NTT Medical Center Tokyo, Tokyo, Japan
| | - Yoko Saino
- Department of Clinical Nutrition, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Fumiya Kawase
- Department of Nutrition, Asuke Hospital Aichi Prefectural Welfare Federation of Agricultural Cooperatives, Aichi, Japan
| | - Haruko Kobayashi
- General Incorporated Association Manabi Public Library, Aichi, Japan
| | | | - Tatsuro Inoue
- Department of Physical Therapy, Niigata University of Health and Welfare, Niigata, Japan
| | - Shinsuke Nagami
- Department of Speech-Language Pathology and Audiology, Faculty of Rehabilitation, Kawasaki University of Medical Welfare, Okayama, Japan
| | - Keisuke Maeda
- Nutrition Therapy Support Center, Aichi Medical University, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195, Japan.
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Chotirungsan T, Tsutsui Y, Saka N, Kawada S, Dewa N, Magara J, Tsujimura T, Inoue M. Short-term and long-term effects of unilateral external carotid artery ligation on orofacial functions in rats. Am J Physiol Gastrointest Liver Physiol 2024; 326:G318-G329. [PMID: 38226423 DOI: 10.1152/ajpgi.00226.2023] [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: 10/10/2023] [Revised: 12/18/2023] [Accepted: 01/07/2024] [Indexed: 01/17/2024]
Abstract
The external carotid artery (ECA) plays a major role in supplying blood to the head and neck. Although impeded blood flow in the ECA is expected to affect orofacial functions, few studies have shown how blood flow obstruction in the ECA contributes to impairment of these functions, including chewing and swallowing. This study was performed to investigate the effects of ECA ligation (ECAL) on immediate and long-term changes in masticatory and swallowing functions as well as the jaw-opening reflex evoked in the digastric muscle. The experiments were carried out using male Sprague-Dawley rats. In the acute experiment, the digastric reflex evoked by low-threshold electrical stimulation of the inferior alveolar nerve and the swallow reflex, identified by digastric and thyrohyoid electromyographic (EMG) bursts, were compared between before and 1 h after ECAL. The chronic experiment was conducted on freely moving rats. EMGs of the masseter, digastric, and thyrohyoid muscles were chronically recorded. The long-term effects of ECAL on behavior and muscle histology were compared between rats with an intact ECA and rats with ECAL. In the acute experiment, the peak amplitude of the digastric reflex on the ECAL side was significantly decreased 1 h after ECAL. In the chronic experiment, although most parameters of the masticatory and swallowing EMGs were not significantly different between the groups, the results suggest wide variation of the effect of ECAL on the muscles. Blood supply compensation from collaterals of the internal carotid artery may be permanent in some animals.NEW & NOTEWORTHY The inhibitory effect of unilateral external carotid artery ligation (ECAL) on the ipsilateral digastric reflex was small but evident. Most parameters of masticatory and swallowing muscle activity were not significantly different after ECAL. Wide variation was noted in the effect of ECAL on the ipsilateral muscle activity. Blood supply compensation from collaterals of the internal carotid artery may occur in response to the impaired blood flow.
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Affiliation(s)
- Titi Chotirungsan
- Division of Dysphagia Rehabilitation, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
- Department of Oral Diagnosis, Faculty of Dentistry, Naresuan University, Phitsanulok, Thailand
| | - Yuhei Tsutsui
- Division of Dysphagia Rehabilitation, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Nobuaki Saka
- Division of Dysphagia Rehabilitation, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Satomi Kawada
- Division of Dysphagia Rehabilitation, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Nozomi Dewa
- 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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Burger M, Watson F, van Wyk A. A diarized journey: an interpretative phenomenological analysis of the older person's lived experience of a hip or knee replacement within a fast-track programme. BMC Geriatr 2023; 23:592. [PMID: 37743501 PMCID: PMC10518952 DOI: 10.1186/s12877-023-04276-4] [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: 11/21/2022] [Accepted: 09/04/2023] [Indexed: 09/26/2023] Open
Abstract
BACKGROUND For the older person living with end-stage hip or knee osteoarthritis, a hip or knee replacement can be a traumatic event, influencing the physical, physiological, psychological, social and economic facets of daily living. This interpretative phenomenological study aimed to reveal and interpret the daily lived experiences of the older person before, during and after a primary total hip or knee replacement surgery in a fast-track programme in South Africa. METHODS A qualitative interpretive phenomenological study, collecting data through solicited diaries and reflexive member validation interviews from seven participants aged 65-75 years, who underwent a primary elective hip or knee replacement surgery. The surgical fast-track process and data collection process happened simultaneously. Data collection from the solicited diary started before surgery, continued during the surgery process and finished six weeks after surgery and this was followed with reflexive member validation interviews. Interpretative phenomenological analysis was used throughout the three phases of the fast-track programme. RESULTS Three superordinate themes developed during the three phases of surgery: "The holistic impact of pain on daily quality of life", "Finding ways to cope", and "Transition between independence and dependence and back". Although former research confirms the physical impact of osteoarthritis on the older person and the success of fast-track programmes for subsequent hip and knee replacements, this study contributes to the holistic impact of the surgery on participants' daily lives. The diarized journey of individuals through the psychological, psychosocial, physical, professional, and spiritual experience are described and interpreted in this study. CONCLUSIONS Across the solicited diaries, it was clear that pain as catalyst impacted the daily activities of the individual physically, psychologically, and psychosocially. Pain was subjectively present at different intensities during all the phases of the replacement surgery, impairing mobilization and triggering roller-coaster emotions. In order to cope with physical and emotional difficulties while preparing and adjusting to the environment, participants reflected on social support, physical and professional support, and spirituality. Throughout the preparation, hospitalization and the recovery process, the transition between independence, dependence, and back to independence was significant, reinforcing the individual's determination to recover.
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Affiliation(s)
- Marisa Burger
- Quality in Nursing and Midwifery (NuMIQ), Faculty of Health Sciences, North-West University, 11 Hoffman Street, Potchefstroom, 2531, South Africa
| | - Francois Watson
- Quality in Nursing and Midwifery (NuMIQ), Faculty of Health Sciences, North-West University, 11 Hoffman Street, Potchefstroom, 2531, South Africa.
| | - Annemarie van Wyk
- Quality in Nursing and Midwifery (NuMIQ), Faculty of Health Sciences, North-West University, 11 Hoffman Street, Potchefstroom, 2531, South Africa
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Wang L, Qiao J, Sun F, Wei X, Dou Z. Demographic and clinical factors associated with recovery of poststroke dysphagia: A meta-analysis. Brain Behav 2023; 13:e3033. [PMID: 37190927 PMCID: PMC10275539 DOI: 10.1002/brb3.3033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 03/23/2023] [Accepted: 04/17/2023] [Indexed: 05/17/2023] Open
Abstract
BACKGROUND Poststroke dysphagia (PSD) recovery depends on various factors. We aimed to provide evidence concerning predictive variables for the recovery of PSD. METHODS PubMed, Embase, Web of Science, China National Knowledge Infrastructure (CNKI), Wanfang Database, VIP database of Chinese periodicals, Chinese biomedical literature service system (SinoMed), and Cochrane Library databases were systematically searched up to September 21, 2022. According to the inclusion criteria, the literature searched in the database was screened. The methodological quality of included studies was assessed using the Newcastle-Ottawa Scale (NOS). Meta-analysis was performed to identify the factors prognostic for PSD. RESULTS Twenty-eight studies were eligible, and pooled analyses were allowed for 12 potential prognostic factors. We identified older age, higher National Institutes of Health Stroke Scale (NIHSS) score, lower activities of daily living (ADL) score, lower body mass index (BMI), severe dysphagia on admission, aspiration, brainstem stroke, severe cognitive impairment, and bilateral hemispheric stroke were negative factors for the recovery of PSD, while early intervention and Modified Rankin Scale (mRS) = 0 before onset were protective factors for the recovery of PSD. There was no significant association between stroke type and prognosis of PSD. CONCLUSION Prognostic factors of PSD summarized in this meta-analysis could be useful for developing reasonable treatment plan to better promote recovery of swallowing function after stroke.
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Affiliation(s)
- Lian Wang
- Department of Rehabilitation MedicineThe Third Affiliated Hospital of Sun Yat‐sen UniversityGuangzhouChina
| | - Jia Qiao
- Department of Rehabilitation MedicineThe Third Affiliated Hospital of Sun Yat‐sen UniversityGuangzhouChina
| | - Fang Sun
- Clinical Medical of Acupuncture Moxibustion and RehabilitationGuangzhou University of Chinese MedicineGuangzhouChina
| | - Xiaomei Wei
- Department of Rehabilitation MedicineThe Third Affiliated Hospital of Sun Yat‐sen UniversityGuangzhouChina
| | - Zulin Dou
- Department of Rehabilitation MedicineThe Third Affiliated Hospital of Sun Yat‐sen UniversityGuangzhouChina
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Yang RY, Yang AY, Chen YC, Lee SD, Lee SH, Chen JW. Association between Dysphagia and Frailty in Older Adults: A Systematic Review and Meta-Analysis. Nutrients 2022; 14:nu14091812. [PMID: 35565784 PMCID: PMC9105461 DOI: 10.3390/nu14091812] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Revised: 04/23/2022] [Accepted: 04/24/2022] [Indexed: 12/23/2022] Open
Abstract
Background: Increasing bodies of epidemiological evidence indicate potential associations between dysphagia and the risk of frailty in older adults. We hypothesized that older adults with symptoms of dysphagia might have a higher prevalence of frailty or prefrailty than those without dysphagia. Methods: We systematically searched the PubMed, Embase, and Cochrane Library databases for relevant studies published through 20 April 2022. Cross-sectional and longitudinal studies that examined the associations between dysphagia and the existence of frailty or prefrailty in community-dwelling, facility-dwelling, or hospitalized adults aged 50 years or older were synthesized. The Newcastle–Ottawa Scale was used to evaluate study quality. Results: The meta-analysis comprised 12 cohorts, including 5,503,543 non-frailty participants and 735,303 cases of frailty or prefrailty. Random-effect meta-analysis demonstrated a significant association between dysphagia and the risk of frailty and prefrailty (OR, 3.24; 95% CI, 2.51–4.20). In addition, we observed consistent results across the subgroups and heterogeneity assessments. Conclusions: We propose including dysphagia assessment as a critical factor in the cumulative deficit model for identifying frailty in older adults. Understanding dysphagia and the potential role of nutritional supplements in older adults may lead to improved strategies for preventing, delaying, or mitigating frailty.
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Affiliation(s)
- Ru-Yung Yang
- Graduate Institute of Business Administration, Fu Jen Catholic University, New Taipei City 242062, Taiwan;
| | - An-Yun Yang
- Department of Otolaryngology-Head and Neck Surgery, Cardinal Tien Hospital and School of Medicine, Fu Jen Catholic University, New Taipei City 23148, Taiwan;
- Master Program of Big Data in Biomedicine, College of Medicine, Fu Jen Catholic University, New Taipei City 242062, Taiwan;
| | - Yong-Chen Chen
- Master Program of Big Data in Biomedicine, College of Medicine, Fu Jen Catholic University, New Taipei City 242062, Taiwan;
- School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei City 242062, Taiwan
| | - Shyh-Dye Lee
- Fu Jen Affiliated Clinics, Fu Jen Catholic University Hospital, New Taipei City 242062, Taiwan;
- Graduate Program of Long-Term (Custodial) Care, College of Medicine, Fu Jen Catholic University, New Taipei City 242062, Taiwan
| | - Shao-Huai Lee
- Department of Oral Hygiene and Healthcare, Cardinal Tien Junior College of Healthcare and Management, New Taipei City 23143, Taiwan;
| | - Jeng-Wen Chen
- Department of Otolaryngology-Head and Neck Surgery, Cardinal Tien Hospital and School of Medicine, Fu Jen Catholic University, New Taipei City 23148, Taiwan;
- Master Program of Big Data in Biomedicine, College of Medicine, Fu Jen Catholic University, New Taipei City 242062, Taiwan;
- Department of Medical Education and Research, Cardinal Tien Hospital, New Taipei City 23148, Taiwan
- Department of Otolaryngology-Head and Neck Surgery, National Taiwan University Hospital, Taipei 100225, Taiwan
- Correspondence:
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de Sire A, Ferrillo M, Lippi L, Agostini F, de Sire R, Ferrara PE, Raguso G, Riso S, Roccuzzo A, Ronconi G, Invernizzi M, Migliario M. Sarcopenic Dysphagia, Malnutrition, and Oral Frailty in Elderly: A Comprehensive Review. Nutrients 2022; 14:nu14050982. [PMID: 35267957 PMCID: PMC8912303 DOI: 10.3390/nu14050982] [Citation(s) in RCA: 63] [Impact Index Per Article: 31.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 02/23/2022] [Accepted: 02/24/2022] [Indexed: 02/04/2023] Open
Abstract
Frailty is a highly prevalent condition in the elderly that has been increasingly considered as a crucial public health issue, due to the strict correlation with a higher risk of fragility fractures, hospitalization, and mortality. Among the age-related diseases, sarcopenia and dysphagia are two common pathological conditions in frail older people and could coexist leading to dehydration and malnutrition in these subjects. “Sarcopenic dysphagia” is a complex condition characterized by deglutition impairment due to the loss of mass and strength of swallowing muscles and might be also related to poor oral health status. Moreover, the aging process is strictly related to poor oral health status due to direct impairment of the immune system and wound healing and physical and cognitive impairment might indirectly influence older people’s ability to carry out adequate oral hygiene. Therefore, poor oral health might affect nutrient intake, leading to malnutrition and, consequently, to frailty. In this scenario, sarcopenia, dysphagia, and oral health are closely linked sharing common pathophysiological pathways, disabling sequelae, and frailty. Thus, the aim of the present comprehensive review is to describe the correlation among sarcopenic dysphagia, malnutrition, and oral frailty, characterizing their phenotypically overlapping features, to propose a comprehensive and effective management of elderly frail subjects.
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Affiliation(s)
- Alessandro de Sire
- Department of Medical and Surgical Sciences, University of Catanzaro “Magna Graecia”, 88100 Catanzaro, Italy
- Correspondence: (A.d.S.); (M.F.)
| | - Martina Ferrillo
- Department of Health Sciences, University of Catanzaro “Magna Graecia”, 88100 Catanzaro, Italy
- Correspondence: (A.d.S.); (M.F.)
| | - Lorenzo Lippi
- Department of Health Sciences, University of Eastern Piedmont “A. Avogadro”, 28100 Novara, Italy; (L.L.); (M.I.)
| | - Francesco Agostini
- Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University, 00185 Rome, Italy;
| | - Roberto de Sire
- Department of Clinical Medicine and Surgery, University Federico II of Naples, 80126 Naples, Italy;
| | - Paola Emilia Ferrara
- University Polyclinic Foundation Agostino Gemelli IRCSS, Catholic University of Sacred Heart, 00168 Rome, Italy; (P.E.F.); (G.R.)
| | - Giuseppe Raguso
- Department of Otolaryngology-Head and Neck Surgery, University of Verona, 37129 Verona, Italy;
| | - Sergio Riso
- Dietetic and Clinical Nutrition Unit, Maggiore della Carità Hospital, 28100 Novara, Italy;
| | - Andrea Roccuzzo
- Department of Periodontology, School of Dental Medicine, University of Bern, Freiburgstrasse 7, 3010 Bern, Switzerland;
- Department of Oral and Maxillofacial Surgery, Copenhagen University Hospital (Rigshospitalet), 2100 Copenhagen, Denmark
| | - Gianpaolo Ronconi
- University Polyclinic Foundation Agostino Gemelli IRCSS, Catholic University of Sacred Heart, 00168 Rome, Italy; (P.E.F.); (G.R.)
| | - Marco Invernizzi
- Department of Health Sciences, University of Eastern Piedmont “A. Avogadro”, 28100 Novara, Italy; (L.L.); (M.I.)
- Translational Medicine, Dipartimento Attività Integrate Ricerca e Innovazione (DAIRI), Azienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo, 15121 Alessandria, Italy
| | - Mario Migliario
- Dental Clinic, Department of Translational Medicine, University of Eastern Piedmont, 28100 Novara, Italy;
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Järvenpää P, Kuuskoski J, Pietarinen P, Markkanen-Leppänen M, Freiberg H, Ruuskanen M, Rekola J, Ilmarinen T, Kinnari TJ, Autio TJ, Penttilä E, Muttilainen MS, Laaksonen A, Oksanen L, Geneid A, Aaltonen LM. Finnish Version of the Eating Assessment Tool (F-EAT-10): A Valid and Reliable Patient-reported Outcome Measure for Dysphagia Evaluation. Dysphagia 2021; 37:995-1007. [PMID: 34518933 PMCID: PMC9345834 DOI: 10.1007/s00455-021-10362-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 08/30/2021] [Indexed: 12/25/2022]
Abstract
Our aim was to validate a Finnish version of the Eating Assessment Tool (F-EAT-10) for clinical use and to test its reliability and validity in a multicenter nationwide study. Normative data were acquired from 180 non-dysphagic participants (median age 57.0 years, 62.2% female). Dysphagia patients (n = 117, median age 69.7 years, 53.0% female) referred to fiberoptic endoscopic evaluation of swallowing (FEES) completed F-EAT-10 before the examination and after 2 weeks. Patients underwent the 100-ml water swallow test (WST) and FEES was evaluated using the following three scales: the Yale Pharyngeal Residue Severity Rating Scale, Penetration-Aspiration Scale, and the Dysphagia Outcome Severity Scale. An operative cohort of 19 patients (median age 75.8 years, 57.9% female) underwent an endoscopic operation on Zenker's diverticulum, tight cricopharyngeal muscle diagnosed in videofluorography, or both. Patients completed the F-EAT-10 preoperatively and 3 months postoperatively. The cut-off score for controls was < 3 (sensitivity 94.0%, specificity 96.1%) suggesting that ≥ 3 is abnormal. Re-questionnaires for test-retest reliability analysis were available from 92 FEES patients and 123 controls. The intraclass correlation coefficient was excellent for the total F-EAT-10 score (0.93, 95% confidence interval 0.91-0.95). Pearson correlation coefficients were strong (p < 0.001) for each of the questions and the total score. Internal consistency as assessed by Cronbach's alpha was excellent (0.95). Some correlations between findings in FEES and 100-ml WST with F-EAT-10 were observed. The change in subjective symptoms of operative patients paralleled the change in F-EAT-10. F-EAT-10 is a reliable, valid, and symptom-specific patient-reported outcome measure for assessing dysphagia among Finnish speakers.
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Affiliation(s)
- Pia Järvenpää
- Department of Otorhinolaryngology - Head and Neck Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, P.O. Box 263, FI-00029, Finland.
| | - Jonna Kuuskoski
- Department of Otorhinolaryngology - Head and Neck Surgery, Turku University Hospital and University of Turku, Turku, Finland
| | - Petra Pietarinen
- Department of Otorhinolaryngology - Head and Neck Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, P.O. Box 263, FI-00029, Finland
| | - Mari Markkanen-Leppänen
- Department of Otorhinolaryngology - Head and Neck Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, P.O. Box 263, FI-00029, Finland
| | - Hanna Freiberg
- Department of Otorhinolaryngology - Head and Neck Surgery, Turku University Hospital and University of Turku, Turku, Finland
| | - Miia Ruuskanen
- Department of Otorhinolaryngology - Head and Neck Surgery, Turku University Hospital and University of Turku, Turku, Finland
| | - Jami Rekola
- Department of Otorhinolaryngology - Head and Neck Surgery, Turku University Hospital and University of Turku, Turku, Finland
| | - Taru Ilmarinen
- Department of Otorhinolaryngology - Head and Neck Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, P.O. Box 263, FI-00029, Finland
| | - Teemu J Kinnari
- Department of Otorhinolaryngology - Head and Neck Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, P.O. Box 263, FI-00029, Finland
| | - Timo J Autio
- Department of Otorhinolaryngology - Head and Neck Surgery, Oulu University Hospital, Oulu, Finland.,PEDEGO Research Unit, University of Oulu, Oulu, Finland.,Medical Research Center Oulu, Oulu, Finland
| | - Elina Penttilä
- Department of Otorhinolaryngology - Head and Neck Surgery, Kuopio University Hospital and University of Eastern Finland, Kuopio, Finland
| | - Marika S Muttilainen
- Department of Rehabilitation and Psychosocial Support, Tampere University Hospital and Faculty of Social Sciences, University of Tampere, Tampere, Finland
| | - Annika Laaksonen
- Department of Otorhinolaryngology and Phoniatrics - Head and Neck Surgery, Helsinki University, Hospital and University of Helsinki, Helsinki, Finland
| | - Lotta Oksanen
- Department of Otorhinolaryngology and Phoniatrics - Head and Neck Surgery, Helsinki University, Hospital and University of Helsinki, Helsinki, Finland
| | - Ahmed Geneid
- Department of Otorhinolaryngology and Phoniatrics - Head and Neck Surgery, Helsinki University, Hospital and University of Helsinki, Helsinki, Finland
| | - Leena-Maija Aaltonen
- Department of Otorhinolaryngology - Head and Neck Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, P.O. Box 263, FI-00029, Finland
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Bai AV, Agostini F, Bernetti A, Mangone M, Fidenzi G, D'Urzo R, Ruggiero M, Murgia M, Santilli V, Paoloni M, Ruoppolo G, Masiero S. State of the evidence about rehabilitation interventions in patients with dysphagia. Eur J Phys Rehabil Med 2021; 57:900-911. [PMID: 33541045 DOI: 10.23736/s1973-9087.21.06716-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
INTRODUCTION Rather than a separate nosological entity, dysphagia must be considered as a symptom of other pathological conditions, which afflicts patients admitted to numerous medical departments (rehabilitation, neurology, geriatrics, internal medicine, etc.) These disorders share the need for timely access to quality care and multidisciplinary treatment, including rehabilitation. The purpose of this study was to conduct a review of the current guidelines' recommendations in the literature and provide recommendations on the rehabilitative management of the patient with dysphagia. EVIDENCE ACQUISITION The search was carried out through the main databases (Medline, PEDro, Cochrane Database and Google Scholar). All the articles concerning rehabilitation management of dysphagia, published in the last 10 years, have been included. EVIDENCE SYNTHESIS Bibliographic research has provided thirteen guidelines. The literature analysed focuses mainly on the screening, the evaluation and the planning of multidisciplinary treatment. The literature agrees in recommending as cornerstones in the treatment of the dysphagic patient dietary changes, rehabilitation training (particularly muscle strengthening exercises and coordination) and early use of alternative nutrition in patients severely compromised. CONCLUSIONS The dysphagic patient requires the deployment of a range of skills by a multiprofessional and multi-disciplinary team. Speech and language pathologists in cooperation with specialists of rehabilitation have the task of managing the various stages, ranging from the early identification of the symptom to the setting of the treatment plan. Due to the lack of standardized protocols, it is necessary to implement the research path, especially regarding rehabilitation intervention.
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Affiliation(s)
- Arianna V Bai
- Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University of Rome, Rome, Italy
| | - Francesco Agostini
- Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University of Rome, Rome, Italy -
| | - Andrea Bernetti
- Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University of Rome, Rome, Italy
| | - Massimiliano Mangone
- Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University of Rome, Rome, Italy
| | - Gabriele Fidenzi
- Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University of Rome, Rome, Italy
| | - Rossella D'Urzo
- Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University of Rome, Rome, Italy
| | - Marco Ruggiero
- Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University of Rome, Rome, Italy
| | - Massimiliano Murgia
- Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University of Rome, Rome, Italy
| | - Valter Santilli
- Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University of Rome, Rome, Italy
| | - Marco Paoloni
- Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University of Rome, Rome, Italy
| | - Giovanni Ruoppolo
- Department of Sensorial Organs, Sapienza University of Rome, Rome, Italy
| | - Stefano Masiero
- Department of Neuroscience, University of Padua, Padua, Italy
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