Efficacy of a 4-Week Swallowing Rehabilitation Program Combined With Pyriform Sinus Ballooning in Patients With Post-stroke Dysphagia
2
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
Objective To assess the efficacy of a 4-week swallowing rehabilitation program combined with pyriform sinus ballooning in patients with post-stroke dysphagia (PSD). Methods We evaluated a total of 30 patients (n=30) with PSD who were admitted to our medical institution between May of 2014 and October of 2016. These patients were randomly assigned to either the trial group (n=15; a 20-minute conventional rehabilitation followed by a 10-minute pyriform sinus ballooning) or the control group (n=15; a 30-minute conventional rehabilitation). In these patients, the efficacy outcome measures were pharyngeal remnant, the pharyngeal transit time, the Penetration Aspiration Scale (PAS) scores and the Videofluoroscopic Dysphagia Scale (VDS) scores. We compared the differences in efficacy outcome measures at 4 weeks from baseline between the two groups. Results There were significant changes in the pharyngeal remnant, the pharyngeal transit time, the PAS scores and the VDS scores at 4 weeks from baseline between the two groups (p<0.0001, p=0.0001, p<0.0001, and p=0.0048, respectively). There were no treatment-emergent adverse events in our series. Conclusion Our 4-week rehabilitation program combined with pyriform sinus ballooning is an effective and safe modality in patients with PSD. However, further large-scale, long-term, and multi-center studies are needed to corroborate our results.
Abstract
Objective To assess the efficacy of a 4-week swallowing rehabilitation program combined with pyriform sinus ballooning in patients with post-stroke dysphagia (PSD). Methods We evaluated a total of 30 patients (n=30) with PSD who were admitted to our medical institution between May of 2014 and October of 2016. These patients were randomly assigned to either the trial group (n=15; a 20-minute conventional rehabilitation followed by a 10-minute pyriform sinus ballooning) or the control group (n=15; a 30-minute conventional rehabilitation). In these patients, the efficacy outcome measures were pharyngeal remnant, the pharyngeal transit time, the Penetration Aspiration Scale (PAS) scores and the Videofluoroscopic Dysphagia Scale (VDS) scores. We compared the differences in efficacy outcome measures at 4 weeks from baseline between the two groups. Results There were significant changes in the pharyngeal remnant, the pharyngeal transit time, the PAS scores and the VDS scores at 4 weeks from baseline between the two groups (p<0.0001, p=0.0001, p<0.0001, and p=0.0048, respectively). There were no treatment-emergent adverse events in our series. Conclusion Our 4-week rehabilitation program combined with pyriform sinus ballooning is an effective and safe modality in patients with PSD. However, further large-scale, long-term, and multi-center studies are needed to corroborate our results.
참고문헌 (31)
- Shi A, "Epidemiological aspects of heart diseases", Exp Ther Med, 12, pp.1645~1650 (2016)[DOI]
- Arnold M, "Dysphagia in acute stroke: incidence, burden and impact on clinical outcome", PLoS One, 11, pp.e0148424~ (2016)[DOI]
- Gonzalez-Fernandez M, "Dysphagia after stroke: an overview", Curr Phys Med Rehabil Rep, 1, pp.187~196 (2013)[DOI]
- 백남종, "비디오 투시 연하 검사에 기초한 기능적 연하곤란 척도의 임상적 타당도", Annals of Rehabilitation Medicine, 29(1), pp.43~49 (2005), 대한재활의학회
- Marik PE, "Aspiration pneumonia and dysphagia in the elderly", Chest, 124, pp.328~336 (2003)[DOI]
- Sharma JC, "What influences outcome of stroke: pyrexia or dysphagia?", Int J Clin Pract, 55, pp.17~20 (2001)
- Martino R, "Screening for oropharyngeal dysphagia in stroke: insufficient evidence for guidelines", Dysphagia, 15, pp.19~30 (2000)[DOI]
- Speyer R, "Effects of therapy in oropharyngeal dysphagia by speech and language therapists: a systematic review", Dysphagia, 25, pp.40~65 (2010)[DOI]
- Foley N, "Dysphagia treatment post stroke: a systematic review of randomised controlled trials", Age Ageing, 37, pp.258~264 (2008)[DOI]
- Terre R, "Effectiveness of chin-down posture to prevent tracheal aspiration in dysphagia secondary to acquired brain injury: a videofluoroscopy study", Neurogastroenterol Motil, 24, pp.414~419 (2012)[DOI]
- Jung-Ho Kang, "The Effect of Bedside Exercise Program on Stroke Patients with Dysphagia", Annals of Rehabilitation Medicine, 36(4), pp.512~520 (2012), 대한재활의학회
- 김영균, "Effectiveness of Rehabilitative Balloon Swallowing Treatment on Upper Esophageal Sphincter Relaxation and Pharyngeal Motility for Neurogenic Dysphagia", Annals of Rehabilitation Medicine, 39(4), pp.524~534 (2015), 대한재활의학회
- Zheng L, "The individualized rehabilitation interventions for dysphagia: a multidisciplinary case control study of acute stroke patients", Int J Clin Exp Med, 7, pp.3789~3794 (2014)
- Shaker R, "Rehabilitation of swallowing by exercise in tube-fed patients with pharyngeal dysphagia secondary to abnormal UES opening", Gastroenterology, 122, pp.1314~1321 (2002)[DOI]
- Jong Chan Kim, "The Effect of Balloon Dilatation through Video-Fluoroscopic Swallowing Study (VFSS) in Stroke Patients with Cricopharyngeal Dysfunction", Annals of Rehabilitation Medicine, 35(1), pp.23~26 (2011), 대한재활의학회
- 김용균, "Effect of Vallecular Ballooning in Stroke Patients With Dysphagia", Annals of Rehabilitation Medicine, 41(2), pp.231~238 (2017), 대한재활의학회
- Kawada K, "Endoscopyinnovative uses and emerging technologies" (2015), InTech
- Rensink M, "Task-oriented training in rehabilitation after stroke: systematic review", J Adv Nurs, 65, pp.737~754 (2009)[DOI]
- Martin-Harris B, "Breathing and swallowing dynamics across the adult lifespan", Arch Otolaryngol Head Neck Surg, 131, pp.762~770 (2005)[DOI]
- Kim J, "Validation of the videofluoroscopic dysphagia scale in various etiologies", Dysphagia, 29, pp.438~443 (2014)[DOI]
- Vose A, "Dysphagia management in acute and subacute stroke", Curr Phys Med Rehabil Rep, 2, pp.197~206 (2014)[DOI]
- Alfonsi E, "An electrophysiological approach to the diagnosis of neurogenic dysphagia: implications for botulinum toxin treatment", J Neurol Neurosurg Psychiatry, 81, pp.54~60 (2010)[DOI]
- Ferdjallah M, "Spectral analysis of surface electromyography (EMG) of upper esophageal sphincter-opening muscles during head lift exercise", J Rehabil Res Dev, 37, pp.335~340 (2000)
- Rommel N, "Oropharyngeal dysphagia: manifestations and diagnosis", Nat Rev Gastroenterol Hepatol, 13, pp.49~59 (2016)[DOI]
- de Lama Lazzara G, "Impact of thermal stimulation on the triggering of the swallowing reflex", Dysphagia, 1, pp.73~77 (1986)[DOI]
- Matsuo K, "Anatomy and physiology of feeding and swallowing: normal and abnormal", Phys Med Rehabil Clin N Am, 19, pp.691~707 (2008)[DOI]
- Buchholz DW, "Adaptation, compensation, and decompensation of the pharyngeal swallow", Gastrointest Radiol, 10, pp.235~239 (1985)[DOI]
- Martin RE, "Neuroplasticity and swallowing", Dysphagia, 24, pp.218~229 (2009)[DOI]
- Humbert IA, "Tactile, gustatory, and visual biofeedback stimuli modulate neural substrates of deglutition", Neuroimage, 59, pp.1485~1490 (2012)[DOI]
- Crary MA, "Basic concepts of surface electromyographic biofeedback in the treatment of dysphagia: a tutorial", Am J Speech Lang Pathol, 9, pp.116~125 (2000)[DOI]
- Huckabee ML, "Outcomes of swallowing rehabilitation in chronic brainstem dysphagia: a retrospective evaluation", Dysphagia, 14, pp.93~109 (1999)[DOI]
