Intensive Stepwise Method for Oral Intake Using a Combination of Transient Receptor Potential Stimulation and Olfactory Stimulation Inhibits the Incidence of Pneumonia in Dysphagic Older Adults

Ebihara, Takae; Ebihara, Satoru; Yamazaki, Miyako; Asada, Masanori; Yamanda, Shinske; Arai, Hiroyuki

doi:10.1111/j.1532-5415.2009.02648.x

Cited by 32 publications

(33 citation statements)

References 9 publications

(11 reference statements)

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“…In our studies, we found significant therapeutic effects at 150 μM for piperine (and maximal therapeutic effect at 1 mM) and at 150 μM for natural capsaicinoids . In addition, capsaicin boluses also improved the efficacy of swallow by reducing the prevalence of oropharyngeal residue via increasing the tongue propulsion force, and the midterm use of these strategies seem to improve brain plasticity . All of these studies included groups of patients with poststroke OD, where these agonists showed significant effects on VFS signs of swallow response.…”

Section: Advances In Treatmentmentioning

confidence: 58%

Neurorehabilitation strategies for poststroke oropharyngeal dysphagia: from compensation to the recovery of swallowing function

Cabib

Ortega

Kumru

et al. 2016

Annals of the New York Academy of Sciences

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Oropharyngeal dysphagia (OD) is very prevalent among poststroke patients, causing severe complications but lacking specific neurorehabilitation treatment. This review covers advances in the pathophysiology, diagnosis, and physiologically based neurorehabilitation strategies for poststroke OD. The pathophysiology of oropharyngeal biomechanics can be assessed by videofluoroscopy, as delayed laryngeal vestibule closure is closely associated with aspiration. Stroke may affect afferent or efferent neuronal circuits participating in deglutition. The integrity of oropharyngeal-cortical afferent pathways can be assessed by electroencephalography through sensory-evoked potentials by pharyngeal electrical stimulation, while corticopharyngeal efferent pathways can be characterized by electromyography through motor-evoked potentials by transcranial magnetic stimulation. Dysfunction in both cortico-mediated evoked responses is associated with delayed swallow response and aspiration. Studies have reported hemispherical asymmetry on motor control of swallowing and the relevance of impaired oropharyngeal sensitivity on aspiration. Advances in treatment include improvements in compensatory strategies but are mainly focused on (1) peripheral stimulation strategies and (2) central, noninvasive stimulation strategies with evidence of their clinical benefits. Characterization of poststroke OD is evolving from the assessment of impaired biomechanics to the sensorimotor integration processes involved in deglutition. Treatment is also changing from compensatory strategies to promoting brain plasticity, both to recover swallow function and to improve brain-related swallowing dysfunction.

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Section: Advances In Treatmentmentioning

confidence: 58%

Neurorehabilitation strategies for poststroke oropharyngeal dysphagia: from compensation to the recovery of swallowing function

Cabib

Ortega

Kumru

et al. 2016

Annals of the New York Academy of Sciences

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“…3). This sheet easily and stably provides olfactory stimulation using the aroma component of black pepper oil by changing the aroma patch sheet daily (31). It is almost equally as effective as direct black pepper oil stimulation.…”

Section: Swallowing Improvement By Olfactory Stimulation Using Black mentioning

confidence: 94%

“…The most important and challenging step in aspiration pneumonia treatment is restarting eating after recovery using antibiotic treatment. We developed a protocol to restart eating in patients with feeding and swallowing disorders by a combination of aromatherapy, spices, oral care, and swallowing rehabilitation (31). Implementation of this protocol helped avoid re-aspiration as well as gastrostomy in many elderly people.…”

Section: Future Perspectivesmentioning

confidence: 99%

“…Since olfactory stimulation using essential oil is inconvenient for the caregiver and conducting daily aromatherapy is a large caregiver burden, we developed an easier method to conduct black pepper aromatherapy using a new drug gas delivery system (DGDS) (31). DGDS is a novel drug delivery system of transdermal absorption, which takes a volatile bioactive component into the body in a gaseous condition safely and steadily.…”

Section: Swallowing Improvement By Olfactory Stimulation Using Black mentioning

confidence: 99%

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Sensory Stimulation to Improve Swallowing Reflex and Prevent Aspiration Pneumonia in Elderly Dysphagic People

et al. 2011

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Abstract. Morbidity and mortality from aspiration pneumonia continues to be a major health problem in the elderly. A swallowing disorder, such as a delayed triggering of the swallowing reflex, exists in patients with aspiration pneumonia. We found that the swallowing reflex in elderly people was temperature-sensitive. The swallowing reflex was delayed when the temperature of the food was close to body temperature. The actual swallowing time shortened when the temperature difference increases. The improvement of swallowing reflex by temperature stimuli could be mediated by the temperature-sensitive transient receptor potential (TRP) channel. The administration of a pastille with capsaicin as an agonist stimulus of TRPV1, a warm-temperature receptor, decreased the delay in swallowing reflex. Food with menthol, an agonist of TRPM8, a cold-temperature receptor, also decreased the delay in swallowing reflex. Olfactory stimulation such as black pepper was useful to improve the swallowing reflex for people with low activity of daily living (ADL) levels or with decreased consciousness. Oral care also shortened the latent time of swallowing reflex presumably due to stimulating the nociception of the oral cavity. A combination of these sensory stimuli may improve the swallowing disorders and prevent aspiration pneumonia.

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“…Using this protocol, the incidence of pneumonia and the number of febrile days for 1 month from the start of oral intake were signiˆcantly reduced. 30) Implementation of this protocol would help avoid reaspiration in many elderly people with aspiration pneumonia. In addition, this protocol is also applicable to feeding training and rehabilitation of all feeding and swallowing disorders.…”

Section: Discussionmentioning

confidence: 99%

Stimulating Oral and Nasal Chemoreceptors for Preventing Aspiration Pneumonia in the Elderly

Ebihara

Yamasaki

et al. 2011

YAKUGAKU ZASSHI

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Aspiration pneumonia remains a major cause of death in the elderly. However, fundamental and eŠective treatment has not been established yet. Onset of aspiration pneumonia is based on the presence of dysphagia, such as delayed triggering of the swallowing re‰ex. The swallowing re‰ex in the elderly is temperature sensitive, even if it is impaired. Swallowing re‰ex was delayed when the temperature of the food was close to body temperature. The actual swallowing time shortened when the temperature diŠerence increases. The improvement of swallowing re‰ex by temperature stimuli could be mediated by the temperature-sensitive TRP channel. Administration of the TRPV1 agonists improves the delay of the swallowing re‰ex. Red wine polyphenols have been suggested to improve the swallowing re‰ex by increasing TRPV1 response. Food with menthol, an agonist of TRPM8 which is a cold temperature receptor, also decreased the delay in swallowing re‰ex. Olfactory stimuli, such as black pepper, can be a useful tool to improve swallowing re‰ex in people with lower ADL and consciousness levels. By combining these various sensory stimuli, we developed a protocol to start oral intake in patients with aspiration pneumonia This protocol shall continue to contribute to the ingestion of many older people.

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Intensive Stepwise Method for Oral Intake Using a Combination of Transient Receptor Potential Stimulation and Olfactory Stimulation Inhibits the Incidence of Pneumonia in Dysphagic Older Adults

Cited by 32 publications

References 9 publications

Neurorehabilitation strategies for poststroke oropharyngeal dysphagia: from compensation to the recovery of swallowing function

Neurorehabilitation strategies for poststroke oropharyngeal dysphagia: from compensation to the recovery of swallowing function

Sensory Stimulation to Improve Swallowing Reflex and Prevent Aspiration Pneumonia in Elderly Dysphagic People

Stimulating Oral and Nasal Chemoreceptors for Preventing Aspiration Pneumonia in the Elderly

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