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基于临床的口腔康复方案改善了老年痴呆症患者的口腔交替运动和吞咽功能:一项随机对照试验。

Clinical-based oral rehabilitation programme improved the oral diadochokinesis and swallowing function of older patients with dementia: A randomised controlled trial.

机构信息

School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.

Institute of Precision Medicine, National Sun Yat-sen University, Kaohsiung, Taiwan.

出版信息

J Oral Rehabil. 2022 Dec;49(12):1163-1172. doi: 10.1111/joor.13375. Epub 2022 Nov 1.

DOI:10.1111/joor.13375
PMID:36152018
Abstract

OBJECTIVE

To evaluate the effectiveness of a clinical-based oral function intervention on oral function and care behaviours in older patients with mild dementia.

METHOD

Participants were randomly assigned to the experimental group (EG) and control group (CG). Both groups received a leaflet on oral health-related knowledge, and the EG also received an oral function intervention, which was a brief one-on-one lesson concerning oral exercise and preventive oral care. Oral exercise included turning the head, pouting lips, bulging cheeks, stretching tongue, articulation exercise and salivary gland massages. A reminder phone call was made every 2 weeks. Perceived xerostomia and dysphagia, plaque index (PI), Winkel tongue-coating index (WTCI), repetitive saliva-swallowing test (RSST), oral diadochokinesis (DDK) and oral care behaviours were recorded at baseline and at 3-month follow-up. Generalised Estimating Equations (GEE) were used to analyse the indicated effects.

RESULTS

The EG (n = 59) exhibited greater improvement to the CG (n = 55) in RSST [β = 0.7; effect size (ES) = 0.45], the syllables /pa/ (β = 3.1; ES = 0.37) and /ka/ (β = 2.7; ES = 0.40) in oral DDK, PI (β = -0.2; ES = 0.52) and WTCI (β = -0.8; ES = 0.38). Moreover, the EG exhibited better preventive behaviours in regular dental visits [adjusted odds ratio (aOR) = 2.2], daily mouth cleaning frequency (aOR = 1.6) and mouth cleaning before sleep (aOR = 1.3).

CONCLUSION

The brief clinical-based intervention was effective in improving the swallowing function, oral DDK and plaque control of older patients with mild dementia at 3-month follow-up.

摘要

目的

评估基于临床的口腔功能干预对轻度痴呆老年患者口腔功能和护理行为的效果。

方法

参与者被随机分配到实验组(EG)和对照组(CG)。两组均收到有关口腔健康知识的宣传册,EG 还接受了口腔功能干预,即关于口腔运动和预防口腔护理的简短一对一课程。口腔运动包括转头、撅嘴、鼓腮、伸舌、发音练习和唾液腺按摩。每两周打一次提醒电话。在基线和 3 个月随访时记录口干和吞咽困难的感知、菌斑指数(PI)、Winkel 舌苔指数(WTCI)、重复唾液吞咽测试(RSST)、口腔交替发音测试(DDK)和口腔护理行为。使用广义估计方程(GEE)分析上述效果。

结果

EG(n=59)在 RSST 中较 CG(n=55)表现出更大的改善[β=0.7;效应大小(ES)=0.45],口腔 DDK 中 /pa/(β=3.1;ES=0.37)和 /ka/(β=2.7;ES=0.40)的音节,PI(β=-0.2;ES=0.52)和 WTCI(β=-0.8;ES=0.38)。此外,EG 还表现出更好的定期看牙医[调整优势比(aOR)=2.2]、每天口腔清洁频率(aOR=1.6)和睡前口腔清洁(aOR=1.3)的预防行为。

结论

在 3 个月随访时,简短的基于临床的干预措施有效地改善了轻度痴呆老年患者的吞咽功能、口腔 DDK 和菌斑控制。

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