Article

OBJECTIVE: To investigate the effect of motor swallowing exercises on swallowing
dynamic, quality of life and swallowing complaints in Parkinson's disease (PD).
DESIGN: A before-after trial. SETTING: University Medical Center. PARTICIPANTS:
Parkinson's disease patients with dysphagia complaints. INTERVENTIONS: Motor
swallowing exercises designed to increase the strength and range of motion of the
mouth, larynx and pharyngeal structures, coordination between breathing and
swallowing, and airway protection. Patients should perform the exercises twice a
day, five days a week, for five weeks. MAIN OUTCOME MEASURE(S): The primary
outcome was the difference before and after the intervention in number of
swallowing videofluoroscopic events (Swallowing Score). The secondary outcomes
were quality of life (QOL) and swallowing complaints. RESULTS: Fifteen patients
concluded the study (10 man/5 woman; mean age 59.2 +/- 9.17). The
videofluoroscopic events with greater improvement were loss of bolus control (P <
0.03), piecemeal swallow (P = 0.05) and residue on the tongue (P < 0.01),
valleculae (P = 0.01) and pyriform sinuses (P = 0.05). Lingual pumping and dental
absence were interfering factors associated with treatment failure (beta
standardized coefficient = -16.6, 26.2; P = 0.02, 0.002, respectively). The
domains with greater improvements in QOL were fear (P = 0.02) and symptom
frequency (P = 0.05). Regarding swallowing complaints, patients reported to have
reduced mainly their difficulty in moving food in the mouth when chewing (P =
0.02). Reduction in swallowing disorders was not related with QOL improvement
(cor = 0.13, [95% CI, 0.6-0.4],
P = 0.63). CONCLUSIONS:
Motor swallowing
exercises may reduce swallowing disorders in PD patients without lingual pumping
and dental absence and impact positively QOL and swallowing complaints in individuals with PD.

Langue : ANGLAIS