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神经障碍患者吞咽困难严重程度与头颈部本体感觉的关系。

Relationship between dysphagia severity and head and neck proprioception in patients with neurological disorders.

机构信息

Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Altındağ, 06100, Ankara, Turkey.

Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Lokman Hekim University, Ankara, Turkey.

出版信息

Neurol Sci. 2022 Jul;43(7):4511-4518. doi: 10.1007/s10072-022-05998-w. Epub 2022 Mar 9.

Abstract

PURPOSE

The aim of this study was to examine the relationship between dysphagia severity and head and neck proprioception in patients with neurological diseases.

METHODS

Twenty-six patients with neurological diseases who received the modified barium swallowing study (MBSS) were included. Dysphagia severity was assessed with the penetration aspiration scale (PAS). Patients were divided into two groups according to their PAS scores as "with dysphagia" (n = 15) and "without dysphagia" (n = 11). Active range of motion (AROM) and muscle strength were measured. Proprioception measurement of the cervical region was performed with a laser marker placed on the head of the patients, and the deviation from the middle target was noted in centimeters.

RESULTS

There was no difference between groups in terms of gender, age, height, weight, diagnosis, AROM, and the muscle strength of the cervical region (p > 0.05). A moderate, positive correlation was found between dysphagia severity and the results of proprioception in terms of neck flexion, extension, and left rotation (r = 0.48, p = 0.01; r = 0.58, p = 0.002; r = 0.42, p = 0.02, respectively). There was a statistically significant difference in proprioception measurements of neck flexion, extension, and left rotation between groups (p < 0.05).

CONCLUSION

In conclusion, patients' decreased head and neck proprioception is related to severe dysphagia. Therefore, a holistic approach should be followed for swallowing function, and head and neck proprioception should be considered in dysphagia management.

摘要

目的

本研究旨在探讨头颈部本体感觉与神经疾病患者吞咽困难严重程度的关系。

方法

共纳入 26 例接受改良钡吞咽研究(MBSS)的神经疾病患者。采用渗透-误吸量表(PAS)评估吞咽困难严重程度。根据 PAS 评分,将患者分为“有吞咽困难”(n=15)和“无吞咽困难”(n=11)两组。测量主动活动度(AROM)和肌肉力量。使用激光标记器将头颈部放在患者头部,测量颈椎本体感觉的偏差,以厘米为单位记录。

结果

两组间在性别、年龄、身高、体重、诊断、AROM 和颈椎区域肌肉力量方面无差异(p>0.05)。吞咽困难严重程度与颈椎屈伸和左右旋转的本体感觉结果之间存在中度正相关(r=0.48,p=0.01;r=0.58,p=0.002;r=0.42,p=0.02)。两组间颈椎屈伸和左右旋转的本体感觉测量值存在统计学差异(p<0.05)。

结论

总之,患者头颈部本体感觉下降与严重吞咽困难有关。因此,吞咽功能应采取整体方法,吞咽困难管理中应考虑头颈部本体感觉。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cd0c/8906363/d3eea94c145e/10072_2022_5998_Fig1_HTML.jpg

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