<p>The therapeutic effect and complications of oro-esophageal tube training in stroke patients</p>

Abstract

Background: Patients with severe dysphagia after stroke are usually fed using a nasogastric tube. However, this method is inconvenient and causes complications. The oro-esophageal (OE) tube has been used as an alternative parenteral feeding method for patients for whom safe oral feeding is impossible. This study aimed to evaluate the therapeutic effects and complications of OE tube feeding in stroke patients with dysphagia. Methods: This study was designed as a retrospective medical chart review of dysphagic stroke patients who were recommended for OE tube feeding. Thirty-eight stroke patients were recommended for OE tube feeding according to videofluoroscopic swallowing study (VFSS) findings. Of those patients, 17 received OE tube feeding training and conventional dysphagia therapy. Follow-up VFSSs were performed sequentially based on the patients’ conditions. When a patient was able to swallow therapeutic foods with specific viscosities during the VFSS, oral feeding was considered to be initiated. Patients were divided into two groups according to final feeding methods. Results: Seventeen patients attempted OE tube feeding. Among them, 64.7% of the patients could change to full oral feeding at their follow-up VFSS evaluation. Additionally, 70.6% of the patients showed gastroesophageal reflux disease regardless of whether they changed to oral feeding. On individual items of the Functional Dysphagia Scale, both groups showed significant improvements in the triggering of pharyngeal swallowing, the amount of residue, and the pharyngeal transit time. These functions were better improved in the patients who could change to oral feeding than in those who could not. Both groups showed significant aggravation of nasal penetration. Conclusion: Our study quantitatively shows the therapeutic effects and complications of OE tube training. OE tube feeding can facilitate the swallowing process and assist patients in transitioning to oral feeding. This easy-to-apply technique may significantly impact future treatment strategies in stroke patients with severe dysphagia.

Effect of Intermittent Oro-Esophageal Tube Feeding in Bulbar Palsy After Ischemic Stroke: A Randomized Controlled Study

“…This strengthened upward movement of the larynx, promoting the restoration of coordinated swallowing movements. 27 Moreover, the bending of the tube also stimulated the pharyngeal wall, affecting the pharyngeal branch of the vagus nerve and triggering the pharyngeal reflexes. 26 By simulating the normal swallowing process, each insertion of the IOE tube provided physiological training for the swallowing-related muscles, which helped promote the recovery of oral and pharyngeal motor function in patients.…”

Intervensi Oral Neuromuscular Training untuk Pasien Lansia dengan Disfagia Pasca Stroke

“…during the videofluoroscopic swallowing study (8) Qiuping Ye, Yu Xie, Junheng Shi, Zhenhua Xu, Aihua Ou, dan Nenggui Xu (2017) (3) Acupuncture Akupunktur adalah metode yang efektif dan banyak diterapkan pada pasien sebagai pengobatan disfagia setelah stroke secara internasional.…”

“…Beberapa laporan telah menunjukkan bahwa efek terapi jarum api lebih unggul dari akupunktur biasa pada beberapa penyakit termasuk infark serebral akut. (8) Pada penelitian Surface Electromyographic Biofeedback and the Effortful Swallow Exercise telah menunjukkan untuk pertama kalinya bahwa pasien disfagia post-stroke dapat meningkatkan aktivitas otot mereka secara signifikan untuk latihan fungsi menelan. Memasukkan biofeedback sEMG dapat menyebabkan peningkatan amplitudo getaran yang dapat menstimulasi gerakan otot motorik menelan pasien.…”

A new approach of estimating insertion length for intermittent orogastric tube feeding in adult patients

“…Intermittent orogastric tube feeding is a method of nutrition support in which patients are fed food, water, and medicine through feeding tubes, which are inserted into the upper esophagus through the mouth when feeding and pulled out during nonfeeding 1,2 . Compared with other enteral feeding methods, including continuous nasogastric tube feeding and gastrostomy 3 , intermittent orogastric tube feeding has been increasingly applied in adults with dysphagia given the following advantages [4][5][6] . First, it reduces the risk of nasopharyngeal and esophageal inflammation due to decreased oropharyngeal stimulation and the short opening time of the upper esophageal sphincter.…”

“…In addition, it enables the patient to maintain normal physiological and anatomic structures, which is helpful for the rehabilitation of swallowing and facilitates the improvement of swallowing function. Limited but suggestive trials have supported that intermittent orogastric tube feeding is associated with decreased severity of gastroesophageal reflux (GER), improved swallowing function, and earlier transition to a normal oral diet [3][4][5][6][7] .…”