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渐进性抗阻用力吞咽对脑卒中后吞咽障碍患者吞咽安全性、效率及生活质量的影响:使用DIGEST-FEES和SWAL-QOL进行分析

Impact of Effortful Swallow with Progressive Resistance on Swallow Safety, Efficiency and Quality of Life in Individuals with Post-Stroke Dysphagia: Analysis Using DIGEST- FEES and SWAL-QOL.

作者信息

Chandrashekaraiah Bilvashree, N Swapna, K Prakash T

机构信息

Centre for Swallowing Disorders, All India Institute of Speech and Hearing, Mysuru, India.

Department of ENT, All India Institute of Speech and Hearing, Mysuru, India.

出版信息

Indian J Otolaryngol Head Neck Surg. 2023 Dec;75(4):2836-2841. doi: 10.1007/s12070-023-03846-7. Epub 2023 May 17.

Abstract

: Effortful swallow with progressive resistance has a potential clinical implication in improving the oro-muscular strength, swallow safety, and efficiency in elderly individuals. But to date, no studies have explored its benefits in training individuals with post-stroke dysphagia. The present study investigated the long- term effect of effortful swallow with progressive resistance on swallow safety, efficiency and quality of life in persons with dysphagia following stroke. : The study consisted of 5 males (mean age: 41.80yrs ± 9.6yrs) diagnosed with dysphagia post-stroke.  The participants underwent 20 sessions (5 days/week) of intensive effortful swallow with progressive training spread across four weeks. In the first two weeks, the participants performed 10 × 3 sets of effortful swallows with a 50% of resistance load, which was further increased to 15 × 3 sets with a 70% resistance load. : DIGEST-FEES and overall swallow quality of life significantly improved post-therapy, whereas DIGEST-FEES and overall swallow grades showed no significant changes. Inter-rater reliability of DIGEST-FEES revealed substantial agreement between judges. : The results are promising as the technique improved swallow safety, and swallow quality of life in persons with dysphagia following stroke.

摘要

渐进性阻力的用力吞咽对提高老年人的口肌力量、吞咽安全性和效率具有潜在的临床意义。但迄今为止,尚无研究探讨其对中风后吞咽困难患者的训练益处。本研究调查了渐进性阻力的用力吞咽对中风后吞咽困难患者吞咽安全性、效率和生活质量的长期影响。该研究包括5名被诊断为中风后吞咽困难的男性(平均年龄:41.80岁±9.6岁)。参与者在四周内接受了20次(每周5天)强化的渐进性阻力用力吞咽训练。在前两周,参与者进行10×3组的用力吞咽,阻力负荷为50%,之后进一步增加到15×3组,阻力负荷为70%。治疗后,DIGEST-FEES和总体吞咽生活质量显著改善,而DIGEST-FEES和总体吞咽等级无显著变化。DIGEST-FEES的评分者间信度显示评判者之间有高度一致性。结果很有前景,因为该技术改善了中风后吞咽困难患者的吞咽安全性和吞咽生活质量。

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本文引用的文献

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Approach to the patient with dysphagia.吞咽困难患者的诊疗方法。
Am J Med. 2015 Oct;128(10):1138.e17-23. doi: 10.1016/j.amjmed.2015.04.026. Epub 2015 May 23.
10
Dysphagia after Stroke: an Overview.中风后吞咽困难:概述
Curr Phys Med Rehabil Rep. 2013 Sep;1(3):187-196. doi: 10.1007/s40141-013-0017-y.

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