Article

OBJECTIVE: To report the 5-year course of a patient's swallowing disorder in the
context of progressive neuromuscular disease and the effectiveness of a lingual
strengthening treatment program. This is a case report that describes a
lingual treatment protocol that was repeated 3 times over a 5-year period with
and without maintenance periods. SETTING:
The study was completed in 2
settings-an outpatient swallowing clinic at an acute care hospital and the
patient's home. PARTICIPANT: The subject was a 77-year-old woman who was
diagnosed with inclusion body myositis and Sjogren's syndrome. INTERVENTION: The
patient participated in an intensive 8-week lingual strengthening protocol 3
times (at years 1, 4, and 5) and a subsequent maintenance program twice (at years
4 and 5). MAIN OUTCOME MEASURES: Three outcome measures were collected during the
study: (1) lingual manometric pressures at the anterior and posterior tongue,
measured by using a lingual manometric device, (2) airway invasion measured by
using an 8-point Penetration-Aspiration Scale, and (3) clearance of the bolus
measured by using a 3-point residue scale. RESULTS: Isometric lingual
strengthening was effective in maintaining posterior tongue lingual pressure and
Penetration-Aspiration Scale scores during the treatment periods. Residue scale
scores did not significantly change during treatment. CONCLUSIONS: We conclude
that, in this patient, lingual strengthening slowed the progression of
disease-related lingual strength loss and extended functional swallowing
performance. Thus, this type of intervention may hold promise as an effective
swallowing treatment option for patients with neurodegenerative inflammatory
diseases such as inclusion body myositis and Sjogren's syndrome.
CI - Copyright (c) 2012 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS