Effects of Biofeedback Training on Esophageal Peristalsis in Amyotrophic Lateral Sclerosis Patients with Dysphagia

Abstract

Esophageal manometry (EM) could serve as an objective method for the detection of esophageal peristalsis in patients with amyotrophic lateral sclerosis (ALS). In this group of patients, biofeedback training (BT) using the EM procedure is a promising method for the rehabilitation of swallowing function. A total of 20 ALS patients with clinical evidence of dysphagia and who met WFN criteria were recruited for this study. The standard transnasal EM with solid-state transducers was performed, and swallows with water and saliva were initiated in all subjects and repeated at 30-s intervals. The median upper esophageal contractile amplitude, duration, and velocity results during the wet and dry swallows were evaluated and compared in both the ALS and the control groups. In ALS patients, in contrast to the control, significant abnormalities in all EM parameters were recorded, which implies a specific pattern of esophageal peristalsis. Twelve months after BT, the body mass index (BMI) of ALS patients who underwent BT (ALSBT) was compared to the BMI of those who did not (ALS1)—compared to the ALS1 group, ALSBT patients showed a slightly smaller drop in BMI value. We presume that BT using EM can be a promising tool for the improvement of the swallowing mechanism in ALS patients.

Best Practice Recommendations for Geriatric Dysphagia Management with 5 Ws and 1H

“… 22 , 92 ) In addition, a recent study in patients with amyotrophic lateral sclerosis and ED showed that biofeedback is a promising method. 93 ) However, our experts made a weak recommendation in the presence of OPD because of the requirement for special training and equipment and serious patient cognitive skills. Among other modalities, it can be used in the presence of suitable conditions and patients.…”

Esophageal Peristalsis Disorders in ALS Patients with Dysphagia

“…In the BP group, there were 13 patients: 8 women and 5 men; the mean age of patients at disease onset was 63.0 ± 6.7 years. Mean values in the ALSSSS were: 6.7 ± 1.9 (7-5 range), mean duration of dysphagia was correspondingly: 7.9 ± 3.7 months (range: [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19]. Mean disease duration from the occurrence of first symptoms to the date of inclusion in the study was 7-70 months (mean: 16.4 ± 12.3).…”

“…It is well documented that dysphagia in amyotrophic lateral sclerosis (ALS) is presented with changes in the oral and pharyngeal phase of swallowing [3][4][5][6]. The occurrence of the changes in the esophageal phase of swallowing is rarely described in the literature, and there are controversial data regarding its pathology and the involvement of UES in the impaired swallowing mechanism in ALS patients.…”

Biofeedback eletromiográfico como coadjuvante pode ajudar a manter os resultados da terapia profilática de deglutição em longo prazo na doença de Parkinson? Um estudo piloto

“…O biofeedback EMG na disfagia neurogênica tem sido usado em casos de acidente vascular cerebral (AVC) (16) , doença de Alzheimer (17) , e esclerose lateral amiotrófica (18) , apresentando melhora da função de deglutição e redução da incidência de resultados adversos. Uma revisão sistemática recente sobre casos de DP incluiu apenas dois estudos abordando o uso de biofeedback EMG para tratar disfagia nessa população (19) .…”