Résumé
The objective of this preliminary study is to investigate the effects of various head turn in hemiplegic stroke patients with pharyngeal dysphagia. Twenty hemiplegic stroke patients with dysphagia participated in this study. A patient with dysphagia from an upper esophageal sphincter disorder was excluded. All participants underwent a videofluoroscopic swallow study (VFSS) with a 3 mL liquid diet, and their heads were randomly turned to a neutral position, toward the weaker side, toward the stronger side, or to a chin tuck posture. To assess patient swallowing function with VFSS, the videofluoroscopic dysphagia scale (VDS) and penetration-aspiration scale (PAS) were conducted by a physiatrist blinded to the participant's characteristics. No significant improvements in the VDS and PAS were observed in patients with heads rotated toward the weaker or stronger side when compared with heads in the neutral position. However, there was a significant improvement in the VDS for heads in the chin tuck position when compared with those in the neutral position (p < 0.05). These preliminary results revealed that the head turn practice without VFSS, as a compensatory strategy, could not improve dysphagia in hemiplegic stroke patients. Therefore, compensatory postures might be re-considered with in hemiplegic stroke patients with pharyngeal dysphagia.
Sujets)
Humains , Menton , Déglutition , Troubles de la déglutition , Régime alimentaire , Sphincter supérieur de l'oesophage , Tête , Posture , Accident vasculaire cérébralRésumé
Medical applications for 3-dimensional (3D) printing are rapidly expanding and are expected to revolutionize health care. Two patients with chronic stroke participated in a training program with the 3D printing pen (3Doodler 2.0; WobbleWorks, Inc.). This training program consisted of 12 sessions for 4 weeks. The training program consisted of a 4-step protocol. In 2 patients with chronic stroke who showed impaired visuospatial function and hand function, each function improved without any serious adverse effects after completing training. This case study suggests the therapeutic potential of the 3D printing pen to improve visual-perceptual and hand functions in stroke patients.