Management of dysphagia in Parkinson's disease and amyotrophic lateral sclerosis

Luchesi, Karen Fontes; Kitamura, Satoshi; Mourão, Lúcia Figueiredo

doi:10.1590/s2317-17822013000400010

Cited by 29 publications

(47 citation statements)

References 19 publications

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“…8 However, it is not always that the subject who has had the disease for a longer duration or is at an older age shows the worst progression or impairments. 13 Oliveira et al, 14 who evaluated the mortality rate of patients with ALS in relation to time, location and gender, did not find significant differences between the percentage of mortality between men and women, and concluded that there was no significant difference between the age associated with time of progression and death. It was clear from our study that subject 1, who has had the disease for two years, was the one who presented fewer sequels, both concerning space and time variables in relation to angular kinematics.…”

Section: Discussionmentioning

confidence: 98%

Kinematic gait analysis of patients with amyotrophic lateral sclerosis: presentation of three cases / Análise cinemática da marcha em pacientes com esclerose lateral amiotrófica: apresentação de três casos

Cechetti

Farias²,

Sangali³

et al. 2017

Rev Cienc Saude

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Amyotrophic Lateral Sclerosis is a degenerative disorder of the central nervous system involving motor neurons, which directly affect the gait of a person. The aim of this study was to analyze the gait kinematics of patients affected by this pathology in different stages. A descriptive cross-sectional research was designed with three subjects who were classified in stages I, II and III proposed by Sinaki & Mulder. Regarding the spatialtemporal variables, it was observed that the more the stage of the pathology progresses, the further the values get from normality. In the angular kinematic parameters, there was a greater hip flexion to achieve ambulation, together with a decrease in the extension in the three joints studied. The results showed that the data from the subjects presenting amyotrophic lateral sclerosis differ from normal at all stages and the losses caused by the disease have direct influence on gait kinematics mainly with the progress of the disease when the overall symptoms become more incapacitating. Palavras-Chave:Esclerose lateral amiotrófica Marcha Cinemática RESUMO A Esclerose Lateral Amiotrófica é um distúrbio degenerativo do sistema nervoso central envolvendo neurônios motores que afetam diretamente a marcha. O objetivo deste estudo foi analisar a cinemática da marcha de indivíduos afetados por esta patologia, em diferentes estágios. Trata-se de uma pesquisa descritiva transversal em três sujeitos classificados entre os estágios I, II e III propostos por Sinaki e Mulder. Em relação às variáveis espaço-temporais, observa-se que conforme o estágio da patologia avança, mais os valores se distanciam da normalidade. Nos parâmetros cinemáticos angulares, observa-se maior flexão de quadril para conseguir deambular, somada a uma diminuição na extensão nas três articulações estudadas. Os resultados demostram que os dados destes indivíduos diferem da normalidade em todos os estágios e as perdas causadas pela doença têm influência direta na cinemática da marcha, principalmente com o progresso da doença, quando os sintomas gerais se tornam mais incapacitantes.CC BY-NC-SA 4.0 2017 RCSFMIt

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Section: Discussionmentioning

confidence: 98%

Kinematic gait analysis of patients with amyotrophic lateral sclerosis: presentation of three cases / Análise cinemática da marcha em pacientes com esclerose lateral amiotrófica: apresentação de três casos

Cechetti

Farias²,

Sangali³

et al. 2017

Rev Cienc Saude

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“…21 Furthermore, other studies reported that pharyngeal residues are commonly observed in food of pasty and liquid consistencies. 7,18,22 Based on the data, it was possible to observe that function inefficiency was present in the oral phase and the pharyngeal phases, the most compromised. Due to the motor loss and muscular weakness caused by the disease, the structures elicited for the preparation of the food bolus are also compromised, what may justify the reduced tongue mobility and, consequently, the increased oral transit time.…”

Section: Acta Fisiatr 2016;23(3):120-124mentioning

confidence: 99%

“…7 In the late stages of the disease, the indication of an alternative feeding pathway is required, once, due to the severe dysphagia, the muscle fatigue, and/or respiratory insufficiency the food ingestion solely by the oral pathway become unfeasible, what justifies the relevance of a precise evaluation of deglutition.…”

mentioning

confidence: 99%

“…[6][7][8] Some studies elect the videofluoroscopy as the most useful exam for diagnostical investigation of patients with deglutition disorders and suggest that this method can identify the deglutition degree with high precision.…”

mentioning

confidence: 99%

“…These findings are also equivalent to the literature, which reports that the principal characteristics of patients with ALS are: losses in the oral phase, decreased period of voluntary deglutition phase, and oral residues. 5,7,20 In the pharyngeal phase, there was evidence of: premature posterior escape, deglutition reaction triggered in the The deglutition of patients with amyotrophic lateral sclerosis those who did not report being assisted by a phonoaudiologist. Given that the patients with phonoaudiology assistance had longer diagnosis time, this result may assure that the phonoaudiologist interference may extend a safe oral pathway feeding, postponing the need to use alternative pathways.…”

mentioning

confidence: 99%

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The deglutition of patients with amyotrophic lateral sclerosis

Paim¹,

Jarces²,

Zart³

et al. 2016

Acta Fisiátrica

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Objective: Evaluate the deglutition characteristics of patients with Lateral Amiotrophic Sclerosis by videofluoroscopy. Methods: 20 patients were included, aging 43 -75 years, with no other concomitant disease, without the use of tracheostomy or other alternative feeding tubes. After an anamnesis, the patients received three servings of food, one liquid, one pasty and one solid, and underwent the deglutition videofluoroscopy. The exam was filmed for further analysis. Results: In the liquid consistency, the most significant alteration was the presence of residues on the vallecula of 11 patients. The pasty consistency caused reduction in the larynx elevation in 12 patients and residues in pharyngoesophageal transition of 12 patients. In the solid consistency, 10 patients had tongue mobility reduction and residues in the oral cavity was found in 10 patients. Out of the 20 included patients, 11 had discrete dysphagia. Conclusion: All patients had dysphagia, most of them at a discrete degree. The pharyngeal phase was the most compromised for the pasty and liquid phases, with residues in vallecula and pharyngoesophageal transition, followed by the oral phase, with increased oral transit time and reduced tongue mobility in the solid consistency.

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Impact of Fiberoptic Endoscopic Evaluation of Swallowing Outcomes and Dysphagia Management in Neurodegenerative Diseases

et al. 2020

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Objectives/Hypothesis: To determine the incidence of abnormal fiberoptic endoscopic evaluation of swallowing (FEES) findings in patients with progressive neurologic disorders and identify the most commonly implemented dysphagia management strategies. Study Design: Retrospective Review. Methods: A retrospective review was performed of patients with neurodegenerative disease who underwent FEES at a tertiary-care center between 2008 and 2019. Patient demographics, diagnosis, and Eating Assessment Tool-10 (EAT-10) scores were recorded. Rates of penetration, aspiration, and functional change in management (FCIM) to include dietary modifications, home exercises, swallow therapy, surgical intervention (injection augmentation or esophageal dilation), or alternative means of nutrition (i.e., percutaneous enteral gastrostomy [PEG] tube) were calculated. Results: Two hundred nine FEES assessments were performed in 178 patients with a mean age of 64.8 years (standard deviation = AE14). The most common diagnoses were amyotrophic lateral sclerosis (32%) followed by Parkinson's disease or Parkinsonism (26%). FEES demonstrated penetration in 72.5% of patients and aspiration in 14.6%. Mean EAT-10 scores differed between patients with aspiration versus penetration versus normal FEES (24.7 vs. 14.9 vs. 13.9, respectively, P < .001). An FCIM was recommended in 88% of patients and most commonly included self-directed modifications (43%). Overall, 4.5% of patients underwent surgical intervention. A PEG tube was recommended for either supplemental or sole form of nutrition in 19% of the entire cohort. Conclusions: Most patients with neurodegenerative diseases presenting with dysphagia demonstrated abnormal FEES findings necessitating an FCIM, suggesting early dysphagia evaluation may be warranted in this cohort. These findings correlate with worsened EAT-10 scores in patients with aspiration or penetration on FEES.

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Management of dysphagia in Parkinson's disease and amyotrophic lateral sclerosis

Abstract: Compensatory and sensorial maneuvers are more recommended to rehabilitee program in both diseases. The physiopathology of the diseases determined the choice of therapeutic approaches. The disease duration of the patients did not interfere directly in the therapeutic approaches.

Cited by 29 publications

References 19 publications

Kinematic gait analysis of patients with amyotrophic lateral sclerosis: presentation of three cases / Análise cinemática da marcha em pacientes com esclerose lateral amiotrófica: apresentação de três casos

Kinematic gait analysis of patients with amyotrophic lateral sclerosis: presentation of three cases / Análise cinemática da marcha em pacientes com esclerose lateral amiotrófica: apresentação de três casos

The deglutition of patients with amyotrophic lateral sclerosis

Impact of Fiberoptic Endoscopic Evaluation of Swallowing Outcomes and Dysphagia Management in Neurodegenerative Diseases

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