Article

OBJECTIVE: To examine the effects of the Intensive Dysphagia Rehabilitation
approach on physiological and functional swallowing outcomes in adults with
neurogenic dysphagia. DESIGN: Intervention study;
before-after trial with 4-week
follow-up through an online survey. SETTING: Outpatient university clinics.
PARTICIPANTS: A consecutive sample of subjects (N=10) recruited from outpatient
university clinics. All subjects were diagnosed with adult-onset neurologic
injury or disease. Dysphagia diagnosis was confirmed through clinical and
endoscopic swallowing evaluations. No subjects withdrew from the study.
INTERVENTIONS: Participants completed the 4-week Intensive Dysphagia
Rehabilitation protocol, including 2 oropharyngeal exercise regimens, a targeted
swallowing routine using salient stimuli, and caregiver participation. Treatment
included hourly sessions twice per week and home practice for approximately
45min/d. MAIN OUTCOME MEASURES: Outcome measures assessed pre- and posttreatment
included airway safety using an 8-point Penetration Aspiration Scale, lingual
isometric pressures, self-reported swallowing-related quality of life (QOL), and
level of oral intake. Also, patients were monitored for adverse dysphagia-related
effects. QOL and adverse effects were also assessed at the 4-week follow-up
(online survey). RESULTS: The Intensive Dysphagia Rehabilitation approach was
effective in improving maximum and mean Penetration Aspiration Scale scores
(P<.05, eta(2)=.8146 and P<.05, eta(2)=.799708, respectively) and level of oral
intake (P<.005, Cohen d=-1.387). Of the 5 patients who were feeding tube
dependent initially, 2 progressed to total oral nutrition, and 2 progressed to
partial oral nutrition. One patient remained tube dependent. QOL was
significantly improved at the 4-week follow-up (95% confidence interval,
6.38-14.5; P<.00), but not at the posttreatment. No adverse effects were
observed/reported. CONCLUSIONS: The Intensive Dysphagia Rehabilitation approach
was safe and improved physiological and some functional swallowing outcomes in
our sample; however, further investigation is needed before it can be widely applied.
CI - Copyright (c) 2016 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS