Kusumaningsih Widjajalaksmi, Lestari Nur Indah, Harris Salim, Tamin Susyana, Werdhani Retno Asti
Department of Medical Rehabilitation, Faculty of Medicine, University of Indonesia, Jakarta, Indonesia.
Department of Neurology, Faculty of Medicine, University of Indonesia, Jakarta, Indonesia.
J Exerc Rehabil. 2019 Dec 31;15(6):769-774. doi: 10.12965/jer.19.38652.326. eCollection 2019 Dec.
Dysphagia is associated with an increased risk of aspiration pneumonia which often results in death in stroke patients. Therefore, effective and efficient management is important. Behavioral therapy for swallowing rehabilitation based on the principles of neuroplasticity such as oropharyngeal strengthening and range of motion exercises are the alternative ones that often be used. This study aimed to assess the changes in swallowing function in ischemic stroke patients with neurogenic dysphagia after pharyngeal strengthening exercise, hyolaryngeal complex range of motion exercise and swallowing practice. Swallowing function was assessed using Penetration Aspiration Scale (PAS) and Functional Oral Intake Scale (FOIS) based on Flexible Endoscopic Evaluation of Swallowing before and after interventions. The interventions were given every day with a duration of 30-45 minutes for 4 weeks. There were six subjects who completed the study. The PAS before the interventions were 6.00±1.79 and after the interventions was 1.67±0.82 (=0.003). Meanwhile, the FOIS score before the interventions was 3 (1-5) and after the interventions were 5.00±2.10 (=0.041). There was an improvement of PAS and FOIS after the interventions. Therefore, the interventions can be suggested to be used as one of the treatments to improve swallowing function in ischemic stroke patients with neurogenic dysphagia.
吞咽困难与吸入性肺炎风险增加相关,而吸入性肺炎常导致中风患者死亡。因此,有效且高效的管理很重要。基于神经可塑性原则的吞咽康复行为疗法,如口咽强化训练和活动范围练习,是常用的替代疗法。本研究旨在评估缺血性中风伴神经源性吞咽困难患者在进行咽部强化训练、喉复合体活动范围练习及吞咽训练后吞咽功能的变化。在干预前后,基于吞咽功能的纤维内镜评估,使用渗透-误吸量表(PAS)和功能性经口摄食量表(FOIS)评估吞咽功能。干预每天进行,持续30 - 45分钟,共4周。有6名受试者完成了研究。干预前PAS为6.00±1.79,干预后为1.67±0.82(P = 0.003)。同时,干预前FOIS评分为3(1 - 5),干预后为5.00±2.10(P = 0.041)。干预后PAS和FOIS均有改善。因此,可建议将这些干预措施作为改善缺血性中风伴神经源性吞咽困难患者吞咽功能的治疗方法之一。