通过头部姿势练习成功治疗吞咽药丸困难。
Successful treatment of pill-swallowing difficulties with head posture practice.
作者信息
Kaplan Bonnie J, Steiger Roberta A, Pope Jamie, Marsh Ashley, Sharp Maegan, Crawford Susan G
机构信息
Faculty of Medicine, University of Calgary;
出版信息
Paediatr Child Health. 2010 May;15(5):e1-5. doi: 10.1093/pch/15.5.e1.
BACKGROUND
Clinics often encounter neurologically intact patients who are unable to swallow pills. All of the interventions published previously have used traditional behavioural techniques, which are time consuming and often not helpful.
OBJECTIVE
To determine whether children who had never been able to swallow a whole pill could become successful as a result of an intervention based on head posture.
METHOD
A novel intervention was developed based on published research showing that changing head position alters swallowing dynamics. The method was developed in two studies of 240 adults and children, pilot tested in a study of 108 university students with very mild pill-swallowing discomfort, and then evaluated in a study of 41 children who had never successfully swallowed a pill in spite of much instruction and coaxing. Children were recruited from a tertiary paediatric hospital: 34 were clinic patients, four were their siblings or friends, and three were children of hospital staff. The primary intervention involved teaching five head positions (centre, up, down, left and right) followed by a two-week period of daily practice.
RESULTS
EIGHT CHILDREN (ALL CLINIC REFERRALS) WITHDREW WITHOUT PRACTICING: four were too ill to practice (primarily due to sedation or nausea) and four simply refused to do the homework practice. All 33 of the children who were able and willing to practice daily were successful.
CONCLUSION
Practice with head posture variations was successful in treating pill-swallowing difficulties in all 33 children who practiced for 14 days. A training video can be viewed at www.ucalgary.ca/research4kids/pillswallowing.
背景
诊所经常会遇到神经功能正常但无法吞咽药丸的患者。此前发表的所有干预措施都采用了传统的行为技术，这些技术耗时且往往效果不佳。
目的
确定那些从未能够吞咽完整药丸的儿童是否能通过基于头部姿势的干预而成功学会吞咽。
方法
基于已发表的研究开发了一种新的干预措施，该研究表明改变头部位置会改变吞咽动力学。此方法在两项针对240名成人和儿童 的研究中得以发展，在一项针对有非常轻微吞药不适的108名大学生的研究中进行了试点测试，然后在一项针对41名尽管经过多次指导和哄劝仍从未成功吞咽过药丸的儿童的研究中进行了评估。这些儿童是从一家三级儿科医院招募的：34名是门诊患者，4名是他们的兄弟姐妹或朋友，3名是医院工作人员的孩子。主要干预措施包括教授五种头部姿势（正中、向上、向下、向左和向右），然后进行为期两周的每日练习。
结果
8名儿童（均为门诊转诊患者）未进行练习就退出了：4名病情太重无法练习（主要是由于镇静或恶心），4名干脆拒绝进行家庭练习。所有33名能够且愿意每日练习的儿童都成功了。
结论
对于所有进行了14天练习的33名儿童，通过改变头部姿势进行练习成功地解决了吞药困难问题。可在www.ucalgary.ca/research4kids/pillswallowing观看培训视频。
Zotero 插件