ABSTRACT
Objective To explore the effect of early neuromuscular electrical stimulation (NMES) combined with sour taste therapy on dysphagia in the oral phase of acute/subacute ischemic stroke patients. Methods From January, 2013 to June, 2015, 90 patients with oral phase dysphagia after stroke were randomly assigned into NMES group (NM group), sour taste group (ST group ) and NMES combined with sour taste group (TO group) with 30 patients in each group. The swallowing function was evaluated with Functional Oral Intake Scale (FOIS) at baseline, three weeks and twelve weeks treatment. Results The change of FOIS was better in TO group than in ST group three weeks after treatment (P<0.01), and was better in TO group than in ST group and NM group twelve weeks after treatment (P<0.05). Conclu-sion An early application of NMES combined with sour taste therapy could improve the swallowing coordination, and reduce the the poten-tial complications in oral phase of acute/subacute ischemic stroke patients with dysphagia.
ABSTRACT
Dysphagia is a dysfunction that occurs during the swallowing process, which involves the oral, pharyngeal, and esophageal stages of the swallowing route. Dysphagia is a prevalent symptom in elderly patients with degenerative diseases such as stroke, dementia, and Parkinson's disease. Dysphagia that occurs in the elderly is often caused by oral phase dysfunction. Oral phase dysfunction is a problem that occurs during the first stage of swallowing. The symptoms of age-associated dysphagia are the following signs: increased oral residual and longer mastication with slower oral bolus transit movement. Dysphagia can lead to malnutrition, dehydration, weight loss, functional decline, and fear of eating and drinking as well as a decrease in quality of life (QOL). Modification in viscosity and texture of food is usually helpful in resolving the nutritional problem of patients presenting signs of oral phase dysfunction. The degree of dietary modification can affect compliance of the diet. Adequate assessment and dietary modifications are important for successful dietary intervention for the elderly patients.
Subject(s)
Aged , Humans , Aging , Compliance , Deglutition , Deglutition Disorders , Dehydration , Dementia , Diet , Drinking , Eating , Feeding Behavior , Malnutrition , Mastication , Parkinson Disease , Quality of Life , Stroke , Viscosity , Weight LossABSTRACT
@# Objective To investigate the effect of acupuncture combined with buccal electrical stimulation on dysphagia at oral phase after stroke. Methods 40 patients with oral-phase dysphasia after stroke were randomly divided into treatment group (n=20) and control group (n=20). The control group received routine therapy and swallowing training, and the treatment group received acupuncture and electrical stimulation on buccinator in addition. They were assessed with Oral Function Scale and Kubota's Drinking Test before and 20 d after treatment.Results There was no significant difference between both groups before treatment (P>0.05). Both groups improved after treatment (P<0.01), and improved more in the treatment group than in the control group (P<0.05). Conclusion Acupuncture combined with buccal electrical stimulation is satisfactory for oral-phase dysphagia after stroke.
ABSTRACT
Desde la etapa prenatal, la organización neuro-fisiológica del bebé lo prepara para realizar con efectividad los procesos vitales de succión, deglución y respiración. Los reflejos y experiencias intrauterinas le permitirán poder alimentarse inmediatamente al nacer. Se estima que cerca del término de la gestación, el feto humano deglute entre 500-1000cc de líquido amniótico cada día. El pico de sinaptogénesis sucede entre 34 y 36 semanas de edad gestacional, que es el tiempo donde la succión nutritiva es segura. El ritmo de la succión se establece a las 32 semanas. El proceso de alimentarse sufre encefalización cuando los reflejos son integrados, entonces pasa de un ritmo de alimentación reflejo, a tener la capacidad de alterar voluntaria y cualitativamente la estrategia de alimentación. Este proceso se consolida debido a la integración sensoriomotora de la deglución con la respiración, la coordinación ojo-mano, el tono muscular normal, la postura y un apropiado ambiente psicosocial. Alimentarse, especialmente en los primeros años de vida, es un proceso mutuo, se necesitan dos personas para lograrlo, y por eso, si alguna de las dos carece de las habilidades necesarias, esto puede generar problemas de la alimentación. Nada sustituye la valoración realizada con una historia clínica y un examen físico dirigidos a valorar cuán efectiva es la fase oral y faríngea mientras el bebé es alimentado. Cuando se presenten dificultades, la intervención debe ser activa, eso incluye la toma de decisiones médicas y quirúrgicas, protección de la vía aérea, suministro del aporte calórico idóneo para las necesidades del infante. Se deben además brindar estrategias maduracionales para su nivel de desarrollo alimentario actual y para ir adquiriendo las habilidades esperadas en elfuturo cercano y tardío