Rosenbek J C, Robbins J, Fishback B, Levine R L
Veterans Administration Medical Center, Madison, WI.
J Speech Hear Res. 1991 Dec;34(6):1257-68. doi: 10.1044/jshr.3406.1257.
The influence of thermal application on dysphagia for liquid boluses after multiple cerebrovascular accidents was measured. A month-long trial of thermal application organized according to the guidelines of a single-subject withdrawal or ABAB design was replicated across 7 male subjects. After baseline testing, 6 subjects were randomly assigned to begin the study with a week-long period of thermal application (B stage), and 1 subject was randomly assigned to begin the study with a week-long period of no thermal application (A stage). Subsequent week-long A and B stages were then alternated until each subject had completed the 4-week interval of this study. Progress testing occurred at the end of each stage and at follow-up testing 1 month after the study's completion. The influence of thermal application on eight duration and four descriptive measures was determined by three judges using visual inspection of data displays. Two of three judges agreed that 2 of the subjects demonstrated decreased Duration of Stage Transition in the absence of any change in the occurrence of aspiration or penetration. Overall, this study failed to reveal strong evidence that 2 weeks of thermal application alternating with 2 weeks of no thermal application improves dysphagia following multiple strokes. Further replications are needed.
测量了热应用对多次脑血管意外后液体团块吞咽困难的影响。根据单受试者撤药或ABAB设计的指导方针组织了为期一个月的热应用试验，并在7名男性受试者中重复进行。基线测试后，6名受试者被随机分配开始为期一周的热应用期（B阶段），1名受试者被随机分配开始为期一周的无热应用期（A阶段）。随后，为期一周的A阶段和B阶段交替进行，直到每个受试者完成本研究的4周间隔。在每个阶段结束时以及研究完成后1个月的随访测试中进行进展测试。三位评判员通过目视检查数据显示来确定热应用对八个持续时间和四个描述性指标的影响。三位评判员中有两位一致认为，在没有吸入或渗透发生率任何变化的情况下，2名受试者的阶段转换持续时间缩短。总体而言，本研究未能揭示有力证据表明，两周热应用与两周无热应用交替可改善多次中风后的吞咽困难。需要进一步重复研究。
