Best Practice Recommendations for Dysphagia Management in Intensive Care Unit (ICU): A Delphi Study from Multidisciplinary Experts in Turkey
This study includes comprehensive and detailed recommendations, including a broad perspective from diagnosis to treatment and follow-up, as detailed as possible, for management of dysphagia in patients with both oropharyngeal- and esophageal-dysphagia in ICU. (Source: Dysphagia)
Source: Dysphagia - August 5, 2023 Category: Speech-Language Pathology Source Type: research
Technical Success in Performing Esophageal High-Resolution Manometry in Patients with an Epiphrenic Diverticulum
In conclusion, ED is a predictor of unsuccessful HRM. This appears to be mainly related to an inability to traverse the EGJ due to the size of the diverticulum. Consideration should be given to alternative means of evaluating motility, such as endoscopy-assisted HRM, given the high likelihood of failure with traditional HRM. (Source: Dysphagia)
Source: Dysphagia - August 5, 2023 Category: Speech-Language Pathology Source Type: research
Clinical Features and Voxel-Based-Symptom-Lesion Mapping of Silent Aspiration in Acute Infratentorial Stroke
This study is a retrospective observational study based on a prospectively collected FEES and stroke database. Consecutive patient cases with acute ischemic infratentorial stroke and FEES examination between 2017 and 2022 were identified. Group allocation was performed based on PAS scores. Imaging analysis was performed by manual assignment and by VBS/ML. Group comparisons were performed to assess silent aspiration characteristics. Binary logistic regression analysis was performed to determine if baseline clinical, demographic, and imaging parameters were helpful in predicting silent aspiration in patients. In this study...
Source: Dysphagia - August 3, 2023 Category: Speech-Language Pathology Source Type: research
Ultrasonography as Biofeedback to Increase Muscle Activation During the Mendelsohn Maneuver in Healthy Adults
AbstractThe Mendelsohn Maneuver (MM) is a therapeutic strategy that targets reduced laryngeal elevation. Both clinicians and clients identify the MM as one of the more difficult interventions to teach and learn. The purpose of this study was to examine the effect of applying real-time ultrasound as visual feedback in teaching the MM to healthy adults. Twenty-four healthy adults were randomized to two-parallel groups. The standard care group (control group) received verbal instruction, verbal reinforcement, and tactile cueing while practicing the maneuver. The experimental group received the same instruction with additional...
Source: Dysphagia - July 7, 2023 Category: Speech-Language Pathology Source Type: research
Oropharyngeal Dysphagia in Acute Cervical Spinal Cord Injury: A Literature Review
AbstractDysphagia (swallowing impairment) is a frequent complication of cervical spinal cord injury (cSCI). Recently published national guidance in the UK on rehabilitation after traumatic injury confirmed that people with cSCI are at risk for dysphagia and require early evaluation while remaining nil by mouth [National Institute for Health and Care Excellence. Rehabilitation after traumatic injury (NG211), 2022,https://www.nice.org.uk/guidance/ng21]. While the pathogenesis and pathophysiology of dysphagia in cSCI remains unclear, numerous risk factors have been identified in the literature. This review aims to summarize t...
Source: Dysphagia - July 7, 2023 Category: Speech-Language Pathology Source Type: research
Bioenergetic Evaluation of Muscle Fatigue in Murine Tongue
AbstractMuscle fatigue is the diminution of force required for a particular action over time. Fatigue may be particularly pronounced in aging muscles, including those used for swallowing actions. Because risk for swallowing impairment (dysphagia) increases with aging, the contribution of muscle fatigue to age-related dysphagia is an emerging area of interest. The use of animal models, such as mice and rats (murine models) allows experimental paradigms for studying the relationship between muscle fatigue and swallowing function with a high degree of biological precision that is not possible in human studies. The goal of thi...
Source: Dysphagia - July 7, 2023 Category: Speech-Language Pathology Source Type: research
Effect of Modified Pharyngeal Electrical Stimulation on Patients with Severe Chronic Neurogenic Dysphagia: A Single-Arm Prospective Study
AbstractCurrent treatments for severe chronic neurogenic dysphagia (SCND) are limited. Modified pharyngeal electrical stimulation (mPES) was modified from pharyngeal electrical stimulation (PES). This prospective study aimed to explore the efficacy and safety of mPES on SCND. 30 patients with severe chronic neurogenic dysphagia were recruited. mPES was administered to patients once daily until the functional oral intake scale score (FOIS) reach 3. Videofluoroscopic swallow study (VFSS), flexible endoscopic evaluation of swallowing (FEES), and high-resolution manometry (HRM) were utilized for evaluating the swallowing funct...
Source: Dysphagia - July 7, 2023 Category: Speech-Language Pathology Source Type: research
Predictors of Swallowing-Related Quality of Life in United States Veterans with Dysphagia
We examined the following variables in a multivariate analysis to determine the predictors of Swallowing Quality of Life Questionnaire scores: demographic information, Modified Barium Swallow Impairment Profile (MBSImP) scores, Penetration-Aspiration Scale scores, anterior lingual pressures, and Functional Oral Intake Scale scores. MBSImP oral phase score was the only variable that reached statistical significance (p ≤ 0.01), demonstrating that a more severe physiologic impairment in the oral phase of swallowing was independently predictive of worse swallowing-related quality of life. These findings highlight the nee...
Source: Dysphagia - July 6, 2023 Category: Speech-Language Pathology Source Type: research
Improvement in Swallowing Function in Patients with Previous Irradiation for Nasopharyngeal Carcinoma by Expiratory Muscle Strength Training
This study investigates the effectiveness of EMST in a group of post-irradiated NPC patients. This prospective cohort, including twelve patients with previous irradiation for NPC and with swallowing disturbance, was performed between 2019 and 2021 in a single institution. Patients were trained with EMST for 8 weeks. Non-parametric analyses examined effects of EMST on primary outcome, maximum expiratory pressure. Secondary outcomes were measured with Penetration-aspiration scale, Yale pharyngeal residue severity rating scale (YPRSRS) by flexible endoscopic evaluation of swallowing, and Eating Assessment Tool (EAT-10) and ...
Source: Dysphagia - July 1, 2023 Category: Speech-Language Pathology Source Type: research
Acute Dysphagia Following Reperfusion Therapies: A Prospective Pilot Cohort Study
AbstractDysphagia is a well-documented sequela of stroke. Recent advancements in medical treatments for stroke include reperfusion therapies (endovascular thrombectomy (EVT) and thrombolysis). As outcomes following reperfusion therapies are typically measured via general functional scales, the pattern and progression of acute dysphagia following reperfusion therapies is less known. To determine the progression of acute dysphagia (0 –72 h) following reperfusion therapies and relationships between various stroke parameters and dysphagia, twenty-six patients were prospectively recruited across two EVT and thrombolysis cen...
Source: Dysphagia - June 28, 2023 Category: Speech-Language Pathology Source Type: research
The Prevalence and Nature of Eating and Swallowing Problems in Adults with Fibromyalgia: A Systematic Review
AbstractFibromyalgia is a complex chronic pain condition characterized by widespread pain, fatigue, cognitive dysfunction, and sleep disturbances. People with fibromyalgia can experience both autonomic and somatic disturbances, cognitive and mental health symptoms, and hypersensitivity to external stimuli. Fibromyalgia often co-occurs with a range of well-researched comorbidities (e.g., temporomandibular disorders, migraine, and irritable bowel syndrome). However, emerging research suggests that individuals with fibromyalgia also often experience eating, drinking, and swallowing problems (e.g., odynophagia, glossodynia, et...
Source: Dysphagia - June 22, 2023 Category: Speech-Language Pathology Source Type: research
Dysphagia Prevalence and Outcomes Associated with the Evolution of COVID-19 and Its Variants in Critically Ill Patients
AbstractData collected during the 2020 –21 COVID-19 alpha wave indicated dysphagia prevalence rates up to 93%. Whilst many patients recovered during hospital admission, some experienced persistent dysphagia with protracted recovery. To explore (1) prevalence, (2) treatment, and (3) recovery patterns and outcomes for swallowing, in the ICU patient with Delta and subsequent variants of COVID-19. Prospective observational study. Patients admitted to 26 Intensive Care Units (ICUs) over 12 months, diagnosed with COVID-19, treated for survival and seen by Speech–Language Pathology (SLP) for clinical swallowing assessment wer...
Source: Dysphagia - June 22, 2023 Category: Speech-Language Pathology Source Type: research
Biomechanical and Cortical Control of Tongue Movements During Chewing and Swallowing
AbstractTongue function is vital for chewing and swallowing and lingual dysfunction is often associated with dysphagia. Better treatment of dysphagia depends on a better understanding of hyolingual morphology, biomechanics, and neural control in humans and animal models. Recent research has revealed significant variation among animal models in morphology of the hyoid chain and suprahyoid muscles which may be associated with variation in swallowing mechanisms. The recent deployment of XROMM (X-ray Reconstruction of Moving Morphology) to quantify 3D hyolingual kinematics has revealed new details on flexion and roll of the to...
Source: Dysphagia - June 16, 2023 Category: Speech-Language Pathology Source Type: research
Assessing Prevalence and Characteristics of Oro-bulbar Involvement in Children and Adults with SMA Type 2 and 3 Using a Multimodal Approach
AbstractBulbar and jaw muscles are impaired in patients with Spinal Muscular Atrophy (SMA) but the assessment of their severity and progression are limited by the lack of age-appropriate and disease-specific measures. We investigated mastication and swallowing in children and adults with SMA, sitters and walkers. In a 2-year multicentre cross-sectional prospective study, lip and tongue strength (Iowa Oral Performance Instrument), chewing and swallowing (Test of Masticating and Swallowing Solids), active mouth opening (aMMO) were compared to age-appropriate normative data. The perceived burden of oro-bulbar involvement (SMA...
Source: Dysphagia - June 8, 2023 Category: Speech-Language Pathology Source Type: research
Eating Assessment Tool (EAT —10) Scores to Detect Self-Reported Dysphagia in Brazilians
The objective of this investigation was to evaluate the scores, sensitivity, and specificity of the method to define self-reported dysphagia in Brazilians. EAT-10 scores were evaluated in 443 healthy individuals (273 women and 170 men), aged 20 to 84 years, with no swallowing difficulties or diseases, and 72 patients with diseases that cause dysphagia (35 women and 37 men), aged 29 to 88 years. Each of the 10 instrument items has a 0–4 rating scale, in which 0 indicates no problem and 4, a severe problem; total results range from 0 to 40. T he median EAT-10 score of healthy subjects was 0 (range: 0–20), and that of ...
Source: Dysphagia - June 5, 2023 Category: Speech-Language Pathology Source Type: research
