Nagai Takako, Uei Hiroshi, Nakanishi Kazuyoshi
Department of Rehabilitation Medicine, Nihon University Hospital, Japan.
Department of Rehabilitation Medicine, Tokyo Women's Medical University, Japan.
J Rural Med. 2024 Oct;19(4):291-299. doi: 10.2185/jrm.2024-008. Epub 2024 Oct 1.
In older patients, dysphagia is a major risk factor for aspiration pneumonia and choking as it progresses slowly and recurs repeatedly without awareness. Information and communication technology (ICT) is used in various medical fields. However, no feeding or swallowing disorder prevention program has been developed to date and no reports have verified its effectiveness and safety. This study aimed to develop a dysphagia rehabilitation system using ICT and verify its effectiveness.
Changes in swallowing function and functional prognosis were examined in 120 patients with aspiration pneumonia: 60 in the control and 60 in the ICT group. Physical therapists performed pulmonary rehabilitation in the control group. There were additional activities within the ICT rehabilitation system, such as motor and swallowing function evaluations, training sessions, and provision of dietary instructions, in addition to the rehabilitation content of the control group.
The Functional Oral Intake Scale (FOIS) score, a measure of swallowing function, significantly improved in the ICT group (<0.001). ICT use was considered an influencing factor of FOIS change (β=0.49, 95% confidence interval, 1.47 to 2.97 <0.001). ICT use positively affected the Barthel index gain (β=0.49, 95% confidence interval, 14.73 to 32.72 <0.001).
A rehabilitation program using ICT improved swallowing function and the Barthel index. The system can also be used in sparsely populated and rural areas where there are few rehabilitation professionals, and high ripple effects are expected.
在老年患者中，吞咽困难是吸入性肺炎和窒息的主要危险因素，因为其进展缓慢且反复发生而未被察觉。信息通信技术（ICT）被应用于各个医学领域。然而，迄今为止尚未开发出预防进食或吞咽障碍的项目，也没有报告证实其有效性和安全性。本研究旨在开发一种使用ICT的吞咽困难康复系统并验证其有效性。
对120例吸入性肺炎患者的吞咽功能变化和功能预后进行了检查：对照组60例，ICT组60例。物理治疗师在对照组进行肺部康复。除了对照组的康复内容外，ICT康复系统内还有其他活动，如运动和吞咽功能评估、训练课程以及提供饮食指导。
作为吞咽功能指标的功能性经口进食量表（FOIS）评分在ICT组显著改善（<0.001）。使用ICT被认为是FOIS变化的一个影响因素（β=0.49，95%置信区间，1.47至2.97<0.001）。使用ICT对巴氏指数增益有积极影响（β=0.49，95%置信区间，14.73至32.72<0.001）。
使用ICT的康复项目改善了吞咽功能和巴氏指数。该系统也可用于康复专业人员较少的人口稀少和农村地区，预计会有很高的连锁反应。
