Tama Oral Rehabilitation Clinic, The Nippon Dental University, Tokyo, Japan.
Division of Rehabilitation for Speech and Swallowing Disorder, The Nippon Dental University Hospital, Tokyo, Japan.
J Oral Rehabil. 2020 Aug;47(8):977-982. doi: 10.1111/joor.13030. Epub 2020 Jul 13.
We considered the effect of dysphagia rehabilitation and investigated parameters associated with the resumption of oral intake in the elderly patients receiving home nursing care who were not eating by mouth.
The participants were 116 patients aged ≥65 years (66 men and 50 women, mean age 79.7 ± 8.9 years) who were receiving home nursing care and not eating by mouth because of dysphagia. All patients underwent dysphagia rehabilitation for 6 months with the objective of resuming oral intake. After 6 months of dysphagia rehabilitation, the patients' eating status was assessed using the Functional Oral Intake Scale (FOIS) and the associations of the post-intervention FOIS score with age, history of pneumonia, duration of enteral nutrition, body mass index (BMI), alertness, physical function (ability to walk) and swallowing function at the initial examination.
Functional Oral Intake Scale scores increased significantly after 6 months rather than those at the initial evaluation (P < .001). Eighty patients (69.0%) resumed oral intake (FOIS score ≥2), thirty patients (25.9%) of whom became capable of daily oral intake (FOIS score ≥3). Swallowing function was associated with the resumption of oral intake. In addition, physical function before dysphagia rehabilitation was an important factor to resume daily oral intake.
The results of the present study suggest that the resumption of oral intake by patients receiving enteral nutrition requires improvement in swallowing function. In addition, anyone who cannot walk may not recover daily oral intake.
我们研究了吞咽障碍康复对经口摄食恢复的影响，并探讨了与不能经口摄食的接受居家护理的老年患者恢复经口摄食相关的参数。
参与者为 116 名年龄≥65 岁（66 名男性，50 名女性；平均年龄 79.7±8.9 岁）的患者，因吞咽障碍而接受居家护理且不能经口摄食。所有患者均接受了 6 个月的吞咽障碍康复治疗，以期恢复经口摄食。经过 6 个月的吞咽障碍康复后，使用功能性经口摄食量表（FOIS）评估患者的摄食状况，并将干预后 FOIS 评分与年龄、肺炎史、肠内营养时间、体重指数（BMI）、意识状态、身体机能（行走能力）和初始检查时的吞咽功能进行关联分析。
与初始评估相比，6 个月后 FOIS 评分显著升高（P＜.001）。80 名患者（69.0%）恢复经口摄食（FOIS 评分≥2），其中 30 名患者（25.9%）能够进行日常经口摄食（FOIS 评分≥3）。吞咽功能与经口摄食的恢复相关。此外，吞咽障碍康复前的身体机能是恢复日常经口摄食的重要因素。
本研究结果表明，接受肠内营养的患者要恢复经口摄食，需要改善吞咽功能。此外，无法行走的患者可能无法恢复日常经口摄食。
