Oropharyngeal dysphagia, a clinical condition that indicates difficulty in moving food and liquid from the oral cavity to the esophagus, has a markedly high prevalence in the elderly. The number of elderly people with oropharyngeal dysphagia is expected to increase due to the aging of the world’s population. Understanding the current situation of dysphagia screening is crucial when considering future countermeasures. We report findings from a literature review including citations on current objective dysphagia screening tests: the Water Swallowing Test, Mann Assessment of Swallowing Ability, and the Gugging Swallowing Screen. Pneumonia can be predicted using the results of the screening tests discussed in this review, and the response after the screening tests is important for prevention. In addition, although interdisciplinary team approaches prevent and reduce aspiration, optimal treatment is a challenging. Intervention studies with multiple factors focusing on the elderly are needed.
Cancer is one of the most common causes of death worldwide. Along with the advances in diagnostic technology achieved through industry–academia partnerships, the survival rate of cancer patients has improved dramatically through treatments that include surgery, radiation therapy, and pharmacotherapy. This has increased the population of cancer “survivors” and made cancer survivorship an important part of life for patients. The senses of taste and smell during swallowing and cachexia play important roles in dysphagia associated with nutritional disorders in cancer patients. Cancerous lesions in the brain can cause dysphagia. Taste and smell disorders that contribute to swallowing can worsen or develop because of pharmacotherapy or radiation therapy; metabolic or central nervous system damage due to cachexia, sarcopenia, or inflammation can also cause dysphagia. As the causes of eating disorders in cancer patients are complex and involve multiple factors, cancer patients require a multifaceted and long-term approach by the medical care team.
Whenever you prescribe for an abnormality of one of the reflexes, you should think about the effect of the prescription on the other reflex.
We concluded that LLLT at the wavelength and parameters used in the present study was effective for chronic pain of the elbow, wrist, and fingers.
Facial nerve palsy is one of the most frequent cranial neuropathies among disorders of the 12 cranial nerves. Since this nerve runs along the temporal bone and spreads to the superficial part of the face, the facial nerve can be easily affected by injury or physical pressure, or inflammation. Among those affected patients we have come across, Bell's palsy was frequently noted when the patients had an upper respiratory tract infection, or when they felt fatigue or exposed to stress. In many cases, we could not find the exact causes. The facial nerves control the facial expression muscles, and therefore the face in affected patients becomes asymmetrical. Especially among female patients, they are not satisfied by the conventional treatment from a cosmetic point of view. The present study was designed to investigate the treatment efficacy of Low Level Laser Therapy (LLLT) for Bell's palsy. Subjects and Methods Twenty-three consecutive cases with Bell's palsy were enrolled in the present study who visited either the Department of Otorhinolaryngology, or Department of Neurology our university hospital between April 2002 to March 2006. They underwent 2 weeks of steroid administration before attending the Department of Rehabilitation. All cases were in the subacute or chronic stage. Twelve patients were female, and 11 were male. The age distribution ranged from 21 to 82 years, with an average of 51.7. There were 10 cases with right side facial palsy, and 13 with facial palsy of the left side (Table 1). We used a 1 watt semiconductor laser device (Fig. 1, MDL2001, Matsushita Electric Corporation, Tokyo, Japan), the specifications of which are seen in Table 2. The area over the stellate ganglion was irradiated with the laser for 30 seconds per shot, giving a radiant flux of 20.1 J/cm 2. Three shots 135
Background and Aims:In previous studies we have reported the benefits of low level laser therapy (LLLT) for chronic shoulder joint pain, elbow, hand and finger pain, and low back pain. The present study is a report on the effects of LLLT for chronic neck pain. Materials and Methods: Over a 3 year period, 26 rehabilitation department outpatients with chronic neck pain, diagnosed as being caused by cervical disk hernia, underwent treatment applied to the painful area with a 1000 mW semi-conductor laser device delivering at 830 nm in continuous wave, 20.1 J/cm²/point, and three shots were given per session (1 treatment) with twice a week for 4 weeks. Results: 1. A visual analogue scale (VAS) was used to determine the effects of LLLT for chronic pain and after the end of the treatment regimen a significant improvement was observed (p<0.001). 2. After treatment, no significant differences in cervical spine range of motion were observed. 3. Discussions with the patients revealed that in order to receive continued benefits from treatment, it was important for them to be taught how to avoid postures that would cause them neck pain in everyday life. Conclusion:The present study demonstrates that LLLT was an effective form of treatment for neck and back pain caused by cervical disk hernia, reinforced by postural training.
Spasticity following cerebral vascular accidents (CVAs) is a common occurrence, but remains a problematic entity to treat and interferes with mobility and self-care activities which are critical for successful rehabilitative outcomes. Low reactive-level laser therapy (LLLT) has attracted attention in a number of areas including spasticity associated with cerebral palsy. In the case of post CVA therapy, LLLT has been reported for pain treatment, but not spasticity. The present study examined the efficacy of LLLT in attenuating triceps surae muscle spasticity in CVA patients. The study subjects comprised 15 chronic CVA patients with spasticity, treated at our university hospital between 2002 and 2006. The LLLT device we used was a near infrared (830 nm) semiconductor laser device delivering 1 W in continuous wave (irradiance, 670 mW/cm 2). The laser probe was applied with mild pressure to the skin over the tibial nerve on the affected side, 30 sec/point (dose/point 20.1 J/cm 2) repeated 3 times with a 5 sec interval between irradiations. Two sessions were given per week for 1 week. At the end of the week, we recognized LLLT effects in 11 cases out of 15. The other 4 patients had little or no effect but were in their fifties, and had successive bouts of ankle clonus. LLLT is a promising medical treatment for the attenuation of CVA-related spasticity of the triceps surae muscle spasticity, and facilitate voluntary movements in such patients. Further studies are warranted to elucidate the mechanisms by which LLLT can attenuate spasticity.
The efficacy of low level laser therapy (LLLT) in general pain relief and in various arthroses has been established in the literature 1) , however no study has been published which has concentrated on shoulder periarthritis. The current study was thus designed to investigate the effectiveness of LLLT for pain relief and improved range of motion (ROM) in shoulder periarthritis, and serum prostaglandin E2 (PGE2) levels were also measured in this study. PGE2 plays an important role in the delineation of nociception in the peripheral nerve system as well as in the spinal cord 2)-8) . We examined the correlations among the parameters such as pain relief, improved joint function, and serum PGE2 level to evaluate the action of LLLT. Subjects and MethodsThis study included 40 women with a mean age of 62.7 years (range: 31 to 86 years) and mean symptom duration of 2.8 months (range: 12 days to 11 months). Patients with rotator cuff injury, impingement syndrome, and calcific tendinitis were excluded.A diode semiconductor laser (830 nm, output: 1 W) was used for treatment. A trigger point and the sur- The effectiveness of low level laser therapy (LLLT) for pain relief and improved range of motion (ROM) in shoulder periarthritis was investigated, and serum prostaglandin E2 (PGE2) levels were measured to evaluate the underlying mechanism of LLLT action. This study included 40 women with a mean age of 62.7 years and mean symptom duration of 2.8 months. LLLT was effective in 32 patients (80%). In the "effective" treatment group, visual analog scale (VAS) pain scores, range of abduction, flexion, and internal rotation, and serum PGE2 levels improved significantly. A correlation was observed between improvement in each ROM and VAS scores, and both were useful as indices of symptom improvement and treatment efficacy. PGE2 also decreased significantly after laser therapy and played a role in pain symptoms, but there was no correlation with improvement in the ROM or VAS scores. Thus, serum PGE2 levels did not reflect the degree of shoulder function or pain. In the "ineffective" treatment group, no improvement, no correlation between ROM and VAS scores, and no change in serum PGE2 levels after laser therapy were observed. This seems to represent a special group. 39 ORIGINAL ARTICLES THE EFFECTIVENESS OF LOW LEVEL LASER THERAPY (LLLT) FOR SHOULDER PERIARTHRITIS
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