State of the evidence about rehabilitation interventions in patients with dysphagia

Bai, Arianna V.; Agostini, Francesco; Bernetti, Andrea; Mangone, Massimiliano; Fidenzi, Gabriele; D’Urzo, Rossella; Ruggiero, Marco; Murgia, Massimiliano; Santilli, Valter; Paoloni, Marco; Ruoppolo, Giovanni; Masiero, Stefano

doi:10.23736/s1973-9087.21.06716-2

Cited by 10 publications

(4 citation statements)

References 45 publications

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“…To date, it has been widely recognized that malnutrition is related to poor health outcomes due to its clinical consequences in both acute and chronic diseases [ 62 , 63 ]. Moreover, malnutrition is currently considered as one of the main modifiable prognostic factors for worsening outcomes and mortality in elderly patients [ 64 , 65 ].…”

Section: Malnutrition and Aging: A Close But Unclear Link In The Elderlymentioning

confidence: 99%

Sarcopenic Dysphagia, Malnutrition, and Oral Frailty in Elderly: A Comprehensive Review

et al. 2022

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Frailty is a highly prevalent condition in the elderly that has been increasingly considered as a crucial public health issue, due to the strict correlation with a higher risk of fragility fractures, hospitalization, and mortality. Among the age-related diseases, sarcopenia and dysphagia are two common pathological conditions in frail older people and could coexist leading to dehydration and malnutrition in these subjects. “Sarcopenic dysphagia” is a complex condition characterized by deglutition impairment due to the loss of mass and strength of swallowing muscles and might be also related to poor oral health status. Moreover, the aging process is strictly related to poor oral health status due to direct impairment of the immune system and wound healing and physical and cognitive impairment might indirectly influence older people’s ability to carry out adequate oral hygiene. Therefore, poor oral health might affect nutrient intake, leading to malnutrition and, consequently, to frailty. In this scenario, sarcopenia, dysphagia, and oral health are closely linked sharing common pathophysiological pathways, disabling sequelae, and frailty. Thus, the aim of the present comprehensive review is to describe the correlation among sarcopenic dysphagia, malnutrition, and oral frailty, characterizing their phenotypically overlapping features, to propose a comprehensive and effective management of elderly frail subjects.

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Section: Malnutrition and Aging: A Close But Unclear Link In The Elderlymentioning

confidence: 99%

Sarcopenic Dysphagia, Malnutrition, and Oral Frailty in Elderly: A Comprehensive Review

et al. 2022

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“…Prosthodontists and dentists can sometimes also be involved in identifying structural problems related to swallowing, and social workers can be involved in discharge plans. The goal of the multidisciplinary team approach is to identify patients at risk for dysphagia, evaluate the severity of dysphagia, and provide appropriate treatment [173][174][175].…”

Section: Kq 19 Is the Multidisciplinary Team Approach (Doctor Nurse T...mentioning

confidence: 99%

Clinical Practice Guidelines for Oropharyngeal Dysphagia

et al. 2023

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Objective: Dysphagia is a common clinical condition characterized by difficulty in swallowing. It is sub-classified into oropharyngeal dysphagia, which refers to problems in the mouth and pharynx, and esophageal dysphagia, which refers to problems in the esophageal body and esophagogastric junction. Dysphagia can have a significant negative impact one’s physical health and quality of life as its severity increases. Therefore, proper assessment and management of dysphagia are critical for improving swallowing function and preventing complications. Thus a guideline was developed to provide evidence-based recommendations for assessment and management in patients with dysphagia. Methods: Nineteen key questions on dysphagia were developed. These questions dealt with various aspects of problems related to dysphagia, including assessment, management, and complications. A literature search for relevant articles was conducted using Pubmed, Embase, the Cochrane Library, and one domestic database of KoreaMed, until April 2021. The level of evidence and recommendation grade were established according to the Grading of Recommendation Assessment, Development and Evaluation methodology.Results: Early screening and assessment of videofluoroscopic swallowing were recommended for assessing the presence of dysphagia. Therapeutic methods, such as tongue and pharyngeal muscle strengthening exercises and neuromuscular electrical stimulation with swallowing therapy, were effective in improving swallowing function and quality of life in patients with dysphagia. Nutritional intervention and an oral care program were also recommended. Conclusion: This guideline presents recommendations for the assessment and management of patients with oropharyngeal dysphagia, including rehabilitative strategies.

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“…The associated consequences of dysphagia including dehydration, malnutrition, and aspiration pneumonia can put them at a higher mortality risk [3][4][5][6]. Timely diagnosis, detailed assessment, and selection of appropriate therapeutic techniques for swallowing disorders are, therefore, essential in the clinical management of MS [7,8]. However, the published literature on the outcomes of swallowing rehabilitation in people with MS is rather scarce.…”

Section: Introductionmentioning

confidence: 99%

Neuromuscular Electrical Stimulation in Conjunction with Conventional Swallowing Therapy in the Treatment of Dysphagia Caused by Multiple Sclerosis: A Single-Case Experimental Design

Tavakoli¹,

Poorjavad²,

Taheri³

et al. 2023

Folia Phoniatr Logop

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Introduction: Dysphagia as a consequence of multiple sclerosis (MS) puts individuals at higher risk of dehydration, malnutrition, and aspiration pneumonia. This study intended to investigate the effects of a combined program of neuromuscular electrical stimulation (NMES) and conventional swallowing therapy to improve swallow safety and efficiency, oral intake, and physical, emotional, and functional impacts of dysphagia in people with dysphagia and MS. Methods: In this single-case experimental study with ABA design, two participants with dysphagia caused by MS underwent 12 sessions therapy during 6 weeks following a baseline of 4 evaluation sessions. They were evaluated 4 more times in the follow-up phase after therapy sessions. Scores of Mann Assessment of Swallowing Ability (MASA), DYsphagia in MUltiple Sclerosis (DYMUS), and timed test of swallowing capacity were obtained at baseline, during treatment, and in the follow-up phases. The Dysphagia Outcome and Severity Scale (DOSS) based on videofluoroscopic swallow studies, Persian-Dysphagia Handicap Index (Persian-DHI), and Functional Oral Intake Scale (FOIS) were also completed before and after treatment. Visual analysis and percentage of nonoverlapping data were calculated. Results: MASA, DYMUS, FOIS, and DHI scores indicated significant improvement in both participants. Although the scores of the timed test of swallowing capacity in participant 1 (B.N.) and DOSS in participant 2 (M.A.) showed no changes, considerable improvements including reducing the amount of residue and the number of swallows required to clear bolus were seen in the posttreatment videofluoroscopic records of both participants. Conclusion: NMES in conjunction with conventional dysphagia therapy based on motor learning principles could improve the swallowing function and decrease disabling effects of dysphagia on different aspects of life in participants with dysphagia caused by MS.

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State of the evidence about rehabilitation interventions in patients with dysphagia

Cited by 10 publications

References 45 publications

Sarcopenic Dysphagia, Malnutrition, and Oral Frailty in Elderly: A Comprehensive Review

Sarcopenic Dysphagia, Malnutrition, and Oral Frailty in Elderly: A Comprehensive Review

Clinical Practice Guidelines for Oropharyngeal Dysphagia

Neuromuscular Electrical Stimulation in Conjunction with Conventional Swallowing Therapy in the Treatment of Dysphagia Caused by Multiple Sclerosis: A Single-Case Experimental Design

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