Abstract:Introduction: The rehabilitation in oropharyngeal dysphagia evidence-based implies the relationship between the interventions and their results.
Objective: Analyze level of dysphagia, oral ingestion, anxiety levels and nutritional status of patients with stroke diagnosis, before and after speech therapy.
Method: Clinical assessment of dysphagia partially using the Protocol of Risk Assessment for Dysphagia (PARD), applying the scale Functional Oral Intake Scale for Dysphagia in Stroke Patients (FOIS), Beck Anxi… Show more
“…The professional groups carrying out the screenings were reported in only 6 studies (Nursing staff/study nurse: Cabre et al 2010; Carrión et al 2015; Mateos-Nozal et al 2017; Shimazu et al 2020; SLT: Crary et al 2006; Moncayo-Hernandéz et al 2023) [ 10 , 43 – 46 , 49 ]; 7 studies used exclusively self-reported tools (Manas-Martinez et al 2018; Matsuo et al 2017; Popman et al 2016; Tran et al 2021; Vidal Casariego et al 2020; Wakabayashi & Matsuhima 2016; Wham et al 2017) [ 41 , 47 , 50 , 57 , 58 , 60 , 67 ] and the remaining 14 did not specify the profession [ 13 , 42 , 48 , 51 – 56 , 59 , 61 , 68 – 70 ].…”
Section: Resultsmentioning
confidence: 99%
“…Both describe the screening process as part of routine patient care and report on specific measures derived from the screening results, such as a referral to swallowing of nutritional specialists or a recommendation on texture for oral nutrition. Five studies reported that screening was systematically repeated, either after an intervention, after a certain amount of time or right before discharge [ 51 , 55 , 56 , 68 , 69 ]. Table 5 provides an overview of the subsequent intervention following positive screening results.…”
Background
Dysphagia affects about 40% of patients admitted to acute geriatric wards, as it is closely associated with diseases that rise in prevalence with advancing age, such as stroke, Parkinson’s disease, and dementia. Malnutrition is a highly associated predictive factor of dysphagia as well as one of the most common symptoms caused by dysphagia. Thus, the two conditions may exist simultaneously but also influence each other negatively and quickly cause functional decline especially in older adults. The purpose of this review was to determine whether institutions have established a protocol combining screenings for dysphagia and malnutrition on a global scale. If combined screening protocols have been implemented, the respective derived measures will be reported.
Methods
A scoping review was conducted. A systematic database search was carried out in January and February 2024. Studies were included that examined adult hospitalized patients who were systematically screened for dysphagia and malnutrition. The results were managed through the review software tool Covidence. The screening of titles and abstracts was handled independently by two reviewers; conflicts were discussed and resolved by consensus between three authors. This procedure was retained for full-text analysis and extraction. The extraction template was piloted and revised following feedback prior to extraction, which was carried out in February 2024.
Results
A total of 2014 studies were found, 1075 of which were included for abstract screening, 80 for full text screening. In the end, 27 studies were extracted and reported following the reporting guideline PRISMA with the extension for Scoping Reviews.
Conclusion
Most of the studies considered the prevalence and association of dysphagia and malnutrition with varying outcomes such as nutritional status, pneumonia, oral nutrition, and swallowing function. Only two studies had implemented multi-professional nutrition teams.
“…The professional groups carrying out the screenings were reported in only 6 studies (Nursing staff/study nurse: Cabre et al 2010; Carrión et al 2015; Mateos-Nozal et al 2017; Shimazu et al 2020; SLT: Crary et al 2006; Moncayo-Hernandéz et al 2023) [ 10 , 43 – 46 , 49 ]; 7 studies used exclusively self-reported tools (Manas-Martinez et al 2018; Matsuo et al 2017; Popman et al 2016; Tran et al 2021; Vidal Casariego et al 2020; Wakabayashi & Matsuhima 2016; Wham et al 2017) [ 41 , 47 , 50 , 57 , 58 , 60 , 67 ] and the remaining 14 did not specify the profession [ 13 , 42 , 48 , 51 – 56 , 59 , 61 , 68 – 70 ].…”
Section: Resultsmentioning
confidence: 99%
“…Both describe the screening process as part of routine patient care and report on specific measures derived from the screening results, such as a referral to swallowing of nutritional specialists or a recommendation on texture for oral nutrition. Five studies reported that screening was systematically repeated, either after an intervention, after a certain amount of time or right before discharge [ 51 , 55 , 56 , 68 , 69 ]. Table 5 provides an overview of the subsequent intervention following positive screening results.…”
Background
Dysphagia affects about 40% of patients admitted to acute geriatric wards, as it is closely associated with diseases that rise in prevalence with advancing age, such as stroke, Parkinson’s disease, and dementia. Malnutrition is a highly associated predictive factor of dysphagia as well as one of the most common symptoms caused by dysphagia. Thus, the two conditions may exist simultaneously but also influence each other negatively and quickly cause functional decline especially in older adults. The purpose of this review was to determine whether institutions have established a protocol combining screenings for dysphagia and malnutrition on a global scale. If combined screening protocols have been implemented, the respective derived measures will be reported.
Methods
A scoping review was conducted. A systematic database search was carried out in January and February 2024. Studies were included that examined adult hospitalized patients who were systematically screened for dysphagia and malnutrition. The results were managed through the review software tool Covidence. The screening of titles and abstracts was handled independently by two reviewers; conflicts were discussed and resolved by consensus between three authors. This procedure was retained for full-text analysis and extraction. The extraction template was piloted and revised following feedback prior to extraction, which was carried out in February 2024.
Results
A total of 2014 studies were found, 1075 of which were included for abstract screening, 80 for full text screening. In the end, 27 studies were extracted and reported following the reporting guideline PRISMA with the extension for Scoping Reviews.
Conclusion
Most of the studies considered the prevalence and association of dysphagia and malnutrition with varying outcomes such as nutritional status, pneumonia, oral nutrition, and swallowing function. Only two studies had implemented multi-professional nutrition teams.
“…OD is identified as a major contributor to malnutrition according to a resolution of the Council of Europe ( 19 ) and some other investigators ( 20 – 22 ). Therefore, it is impertinent to identify patients who are at risk of malnutrition and to initiate appropriate nutritional treatment.…”
BackgroundOropharyngeal dysphagia is one of the major complications of stroke and a risk factor for malnutrition and prolonged in-hospital stay.ObjectiveThe overall aim was to describe to what extent nutritional assessments (i.e. BMI kg/m2, eating problem, and weight loss) were performed and documented in the records of older stroke patients treated with enteral nutrition by percutaneous endoscopic gastrostomy (PEG). A secondary aim was to identify documented post-procedural complications after PEG insertion during hospital stay.DesignThe study is retrospective. Data were collected from records of 161 stroke patients ≥65 years, who received PEG, admitted to three stroke units during a 4-year period.ResultsMean age of the patients was 82.2 (±7) years, and 86% of the patients were ≥75 years old. On admission, body weight was documented in 50% of the patients and at discharge in 38% of the patients. BMI data were not documented at all at discharge in one of the units. Almost 80% of the patients fulfilled the European Network criteria for multimorbidity. Morbidity and multimorbidity correlated to the length of stay (p<0.0005). Complications were reported in 111 (69%) of the patient records. In 53 patients (33%) more than one complication was reported. A total of 116 pressure ulcers were reported and 30 patients had more than one pressure ulcer. The number of complications was related to weight loss (p=0.046) and BMI change (p=0.018).ConclusionsEssential information of the patient's nutritional status was poorly recorded which could affect the patient's nutritional treatment during the hospital stay. This study indicates that implementation of guidelines in patients with stroke is needed. The high number of pressure ulcers was an unexpected finding.
Abstract-Traumatic Brain Injury or injuries involving the posterior region of the brain can cause orofacial apraxia. Rehabilitation and diagnosis of pathologies associated with apraxias require better tools to evaluate and quantify the muscles activation during praxis performing. Developing a protocol to acquire surface electromyography (sEMG) from small muscles associated with orofacial praxis is necessary for the quantitative valuation of apraxias. In this paper we aim to test the use of Ag/AgCl electrodes with 20 mm diameter respect to Au electrodes with 7 mm diameter to acquire sEMG from orofacial muscles. Our findings show that there is not statistically significant difference between medians of Ag/AgCl and Au measures. We recommend the use of Ag/AgCl in the masseter region and Au electrodes in the orbicularis oris and other small muscles.
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