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Titre : | Respiratory-Swallow Training in Patients With Head and Neck Cancer (2015) |
Auteurs : | Bonnie Martin-Harris ; David McFarland ; Elizabeth G. Hill |
Type de document : | Article |
Dans : | Archives of Physical Medicine and Rehabilitation (2015/5, 2015) |
Article en page(s) : | p. 885-893 |
Langues: | Anglais |
Descripteurs : |
HE Vinci Rééducation et réadaptation ; Rétroaction ; Troubles de la déglutition ; Tumeurs de la tête et du cou |
Mots-clés: | Deglutition disorders ; sensory ; Rétroaction sensorielle ; Head and neck neoplasms ; Respiratory aspiration ; Inhalation bronchique |
Résumé : |
Objective To test a novel intervention to train swallowing to occur in the midexpiratory to low expiratory phase of quiet breathing to improve swallowing safety and efficiency. Design Safety and efficacy nonrandomized controlled trial with 1-month follow-up. Setting Ambulatory clinics. Participants Patients (N=30) with head and neck cancer (HNC) and chronic dysphagia completed the intervention. Fifteen of these patients participated in a 1-month follow-up visit. Interventions Training protocol based on hierarchy of motor skill acquisition to encourage autonomous and optimal respiratory-swallowing coordination. Visual feedback of respiratory phase and volume for swallowing initiation was provided by nasal airflow and rib cage/abdomen signals. Main Outcome Measures Respiratory-swallow phase pattern, Modified Barium Swallow Impairment Profile (MBSImP) scores, Penetration-Aspiration Scale (PAS) scores, and MD Anderson Dysphagia Inventory scores. Results Using visual feedback, patients were trained to initiate swallows during the midexpiratory phase of quiet breathing and continue to expire after swallowing. This optimal phase patterning increased significantly after treatment (P<.0001 changes in respiratory-swallowing coordination were associated with improvements mbsimp component scores: laryngeal vestibular closure tongue base retraction and pharyngeal residue significant also seen pas scores relative to pretreatment values patients participating follow-up had increased optimal phase patterning improved> Conclusions Improvements in respiratory-swallowing coordination can be trained using a systematic protocol and respiratory phase-lung volume-related biofeedback in patients with HNC and chronic dysphagia, with favorable effects on airway protection and bolus clearance. |
Disponible en ligne : | Oui |
En ligne : | https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/article/pii/S0003999314012866 |