社区居住老年人单纯吞咽训练方案对早期口咽吞咽障碍的效果：一项随机对照研究。

Effect of Simple Swallowing Training Program on Early Oropharyngeal Dysphagia in Community-Dwelling Older Adults: A Randomized Controlled Study.

机构信息

School of Public Health, Zhengzhou University, Zhengzhou, China; Dysphagia Research Institution, Zhengzhou University, Zhengzhou, China.

School of Public Health, Zhengzhou University, Zhengzhou, China.

出版信息

J Am Med Dir Assoc. 2024 Dec;25(12):105297. doi: 10.1016/j.jamda.2024.105297. Epub 2024 Oct 9.

DOI:10.1016/j.jamda.2024.105297

PMID:39393784

Abstract

OBJECTIVES

Oropharyngeal dysphagia (OD) in community-dwelling older adults continues to be a challenge due to its insidious onset. This study developed a simple swallowing training program (SSTP) to address these issues and conducted a randomized controlled trial to explore its effect on swallowing function and quality of life.

DESIGN

Two-arm randomized controlled trial.

SETTING

AND PARTICIPANTS: A total of 248 community-dwelling older adults with OD from were included in 2024 and randomly divided into intervention and control groups.

METHODS

The SSTP was developed through expert consultation. A total of 248 community-dwelling older adults with OD were included in 2024 and randomly divided into intervention and control groups. The intervention group underwent the SSTP twice daily for 21 days, with weekends off, and the control group participants did light physical activities by themselves. The primary outcome was the Gugging Swallowing Screen (GUSS), and the secondary outcomes were the Eating Assessment Tool-10 (EAT-10), Swallowing Quality of Life questionnaire (SWAL-QoL), maximum tongue pressure, masticatory ability, bite force, and meal duration. Assessments were conducted on days 1 and 21, while meal duration was assessed every 3 days for lunch.

RESULTS

Twenty-seven participants withdrew halfway. There were no significant differences in baseline assessments (P > .05). There were significant between-group and interactive effects in the GUSS [(19.07 ± 1.38) vs (17.28 ± 2.17), F = 6.893, P = .009, F = 59.504, P<.001], EAT-10 {[4.00 (3.00, 5.00)] vs [9.00 (7.00, 10.00)], z = -3.502, P<.001; z = -6.252, P<.001}, SWAL-QoL {[166.00 (163.00, 171.50)] vs [154.00 (150.00, 158.00)], z = 2.681, P = .007; z = 5.475, P<.001}, maximum tongue pressure {[33.10 (26.48, 36.86)] vs [28.85 (19.21, 35.77)], z = 3.377, P = .001; z = -6.208, P<.001}, masticatory ability {[176.92 (133.10, 212.91) vs [163.33 (116.66, 189.32)], z = 4.801, P<.001; z = 6.979, P<.001}. Between-group, time, and interactive effects were significant in the meal duration [(23.39 ± 4.32) vs (27.64 ± 5.63), F = 8.692, P = .004, F = 138.683, P< 0.001, P = 73.196, P<.001].

CONCLUSIONS AND IMPLICATIONS

The SSTP can effectively improve early OD and swallowing-related quality of life in community-dwelling older adults.

摘要

目的

社区居住的老年人的口咽吞咽障碍（OD）由于其隐匿性发病，仍然是一个挑战。本研究开发了一种简单的吞咽训练方案（SSTP）来解决这些问题，并进行了随机对照试验，以探讨其对吞咽功能和生活质量的影响。

设计

双臂随机对照试验。

设置和参与者

共有 248 名来自社区的 OD 老年人参与了 2024 年的研究，并随机分为干预组和对照组。

方法

SSTP 通过专家咨询制定。共有 248 名来自社区的 OD 老年人参与了 2024 年的研究，并随机分为干预组和对照组。干预组每天接受 SSTP 两次，共 21 天，周末休息，对照组参与者自行进行轻度体育活动。主要结局指标是 Gugging 吞咽屏幕（GUSS），次要结局指标是进食评估工具-10（EAT-10）、吞咽生活质量问卷（SWAL-QoL）、最大舌压、咀嚼能力、咬合力和进餐时间。在第 1 天和第 21 天进行评估，而午餐的进餐时间每 3 天评估一次。

结果

27 名参与者中途退出。基线评估无显著差异（P >.05）。GUSS 存在组间和交互效应[（19.07 ± 1.38）vs（17.28 ± 2.17），F = 6.893，P =.009，F = 59.504，P <.001]，EAT-10 [4.00（3.00，5.00）] vs [9.00（7.00，10.00）]，z = -3.502，P <.001；z = -6.252，P <.001]，SWAL-QoL [166.00（163.00，171.50）] vs [154.00（150.00，158.00）]，z = 2.681，P =.007；z = 5.475，P <.001]，最大舌压[33.10（26.48，36.86）] vs [28.85（19.21，35.77）]，z = 3.377，P =.001；z = -6.208，P <.001]，咀嚼能力[176.92（133.10，212.91）] vs [163.33（116.66，189.32）]，z = 4.801，P <.001；z = 6.979，P <.001]。进餐时间存在组间、时间和交互效应[（23.39 ± 4.32）] vs [（27.64 ± 5.63）]，F = 8.692，P =.004，F = 138.683，P <.001，P = 73.196，P <.001]。