Background: An abdominal binder (AB) is routinely used for patients who have suffered a spinal cord injury (SCI) resulting in tetraplegia. It is thought to restore abdominal pressure and consequently improve breathing capacity and reduce postural hypotension in patients who do not have functioning abdominal muscles. Objective: To examine the early effects of an AB on respiratory and speech outcomes. Methods: Thirteen individuals who sustained an acute motor complete SCI between C3 and T1 were assessed after a 6-week trial of using an elasticized AB from the time of first mobilizing in an upright wheelchair. Assessments were made using spirometry and perceptual and acoustics speech measures based on sustained phonation, sentence recitation, and passage reading. Results: Significant improvements were found in the AB-on condition for 3 of 5 respiratory parameters (vital capacity, forced vital capacity, and forced expiratory volume in 1 second). Predominantly mild voice and speech dysfunction were noted in participants. No significant difference was found for any of the acoustic and perceptual speech parameters (maximum phonation time, vocal intensity for sentence recitation, perceptual speech characteristics, or vocal quality) between the AB conditions. Conclusions: Despite the finding that an AB results in significant improvements in respiratory function for individuals with tetraplegic SCI, the current study did not provide evidence that an AB improves speech production.
Objective: There are few studies concerning the differences in quality-of-life (QOL) between palliative care patients with and without dysphagia to date. We aimed to compare the QOL and symptoms in palliative patients with and without dysphagia using Swallowing Quality of Life (SWAL-QOL). Methods: Eighty-one palliative patients with and without dysphagia underwent the SWAL-QOL questionnaire. A series of Mann Whitney U tests were performed between non-dysphagic and dysphagic groups for the total SWAL-QOL score and the 11 SWAL-QOL domains. Results: Dysphagia significantly impacted patients’ QOL in the dysphagic group (mean, 69.5; SD 21.9) than non-dysphagic group (mean, 83.2; SD 14.8) ( P = 0.006). Significant differences were observed between both groups for the domains of burden, eating desire, eating duration, symptoms, food selection, communication and mental health. The results also showed that the dysphagic group had lower symptom score across all symptoms, suggesting higher symptom burdens. Conclusions: This study is the first to examine QOL and swallow symptoms in palliative care patients with and without dysphagia. Dysphagia causes significantly worse QOL in palliative care patients. Screening for dysphagia and managing its impact on symptoms and QOL domains is important in palliative care.
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