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Titre : | Functional and Physiological Outcomes from an Exercise-Based Dysphagia Therapy: A Pilot Investigation of the McNeill Dysphagia Therapy Program (2012) |
Auteurs : | Michaël Crary ; Giselle Carnaby ; Lisa Lagorio ; Pamela Carvajal |
Type de document : | Article |
Dans : | Archives of Physical Medicine and Rehabilitation (2012/7, 2012) |
Article en page(s) : | pp. 1173-1178 |
Langues: | Anglais |
Descripteurs : |
HE Vinci Déglutition ; Exercice physique ; Physiologie ; Rééducation et réadaptation ; Troubles de la déglutition |
Mots-clés: | Deglutition disorders ; Exercise ; Physiology |
Résumé : |
Objective To investigate functional and physiological changes in swallowing performance of adults with chronic dysphagia after an exercise-based dysphagia therapy. Design Intervention study: before-after trial with 3-month follow-up evaluation. Setting Outpatient clinic within a tertiary care academic health science center. Participants Adults (N=9) with chronic (>12mo) dysphagia after unsuccessful prior therapies. Subjects were identified from among patients referred to an outpatient dysphagia clinic. Subjects had dysphagia secondary to prior treatment for head/neck cancer or from neurologic injury. All subjects demonstrated clinical and fluoroscopic evidence of oropharyngeal dysphagia. No subject withdrew during the course of this study. Interventions All subjects completed 3 weeks of an intensive, exercise-based dysphagia therapy. Therapy was conducted daily for 1h/d, with additional activities completed by subjects each night between therapy sessions. Main Outcome Measures Primary outcomes were clinical and functional change in swallowing performance with maintenance at 3 months after intervention. Secondary, exploratory outcomes included physiological change in swallow performance measured by hyolaryngeal elevation, lingual-palatal and pharyngeal manometric pressure, and surface electromyographic amplitude. Results Clinical and functional swallowing performances improved significantly and were maintained at the 3-month follow-up examination. Subject perspective (visual analog scale) on functional swallowing also improved. Four of 7 subjects who were initially feeding tube dependent progressed to total oral intake after 3 weeks of intervention. Physiological indices demonstrated increased swallowing effort after intervention. Conclusions Significant clinical and functional improvement in swallowing performance followed a time-limited (3wk) exercise-based intervention in a sample of subjects with chronic dysphagia. Physiological changes after therapy implicate improved neuromuscular functioning within the swallow mechanism. |
Disponible en ligne : | Oui |
En ligne : | http://www.archives-pmr.org/article/S0003-9993%2811%2900972-5/abstract |