Department of Communication Science and Disorders, University of Pittsburgh, Pittsburgh, Pennsylvania.
Department of Speech, Language, & Hearing Sciences, Purdue University, West Lafayette, Indiana.
Curr Opin Otolaryngol Head Neck Surg. 2023 Dec 1;31(6):362-367. doi: 10.1097/MOO.0000000000000922. Epub 2023 Sep 1.
Dysphagia is a common symptom of sporadic inclusion body myositis (IBM), affecting disease trajectory and patient quality-of-life. Despite this, it is considerably understudied. The purpose of this review is to summarize current evidence related to the evaluation and management of dysphagia in IBM. We highlight a patient case involving a multidisciplinary management approach, and we encourage continued exploration of exercises for delaying progression and improving impairments in patients with IBM and dysphagia.
Recent investigations confirm that dysphagia in IBM is a debilitating and complex symptom that warrants timely evaluation and management. Further, they highlight the lack of validation of standardized swallowing-related metrics specifically for IBM and the limited evidence supporting a consensus of management approaches. Small scale research and clinical anecdotal data support a multidisciplinary and multipronged patient-centered approach, including rehabilitative exercise protocols, for dysphagia management in IBM.
A paucity exists in the literature to effectively guide clinical decision-making for patients with IBM and dysphagia. Given this, it is our belief that a careful multidisciplinary and multipronged patient-centered approach is critical for dysphagia management in IBM. Prospective, longitudinal research on the underlying mechanisms of swallowing dysfunction using advanced and validated swallowing-related outcome measures is urgently needed.
吞咽困难是散发性包涵体肌炎(IBM)的常见症状,影响疾病进程和患者生活质量。尽管如此,它的研究还远远不够。本文的目的是总结与 IBM 患者吞咽困难的评估和管理相关的现有证据。我们重点介绍了一个涉及多学科管理方法的患者病例,并鼓励对 IBM 伴吞咽困难患者的延缓疾病进展和改善功能障碍的锻炼方法进行进一步探索。
最近的研究证实,IBM 患者的吞咽困难是一种使人虚弱且复杂的症状,需要及时进行评估和管理。此外,研究还强调了缺乏针对 IBM 的标准化吞咽相关指标的验证以及支持 IBM 吞咽困难管理的共识管理方法的证据有限。小规模的研究和临床轶事数据支持针对 IBM 吞咽困难的多学科、多管齐下的以患者为中心的方法,包括康复锻炼方案。
目前文献中缺乏有效指导 IBM 伴吞咽困难患者临床决策的方法。因此,我们认为仔细的多学科、多管齐下的以患者为中心的方法对于 IBM 吞咽困难的管理至关重要。迫切需要使用先进和经过验证的吞咽相关结局指标对吞咽功能障碍的潜在机制进行前瞻性、纵向研究。