Swallowing therapy of neurologic patients: Correlation of outcome with pretreatment variables and therapeutic methods

Neumann, Stefanie; Bartolome, Gudrun; Buchholz, David W.; Prosiegel, Mario

doi:10.1007/bf00261272

Cited by 95 publications

(54 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…These findings were supported in an additional study by Neumann et al [15] in which the outcome of treatment on 58 patients who were on nonoral feedings secondary to neurologic disease was presented. For this study, the median time postonset was 10 weeks, with a range of 3-156 weeks.…”

supporting

confidence: 76%

“…Neumann and colleagues published a series of papers reporting on the efficacy of intervention in a large group of patients with dysphagia of neurogenic origin [14][15][16]. The initial study [14] reported on a group of 66 patients with dysphagia subsequent to a broad range of neurologic etiologies, including brainstem and cortical stroke, tumor, trauma, Parkinson's disease, amyotrophic lateral sclerosis (ALS), and cerebellar ataxia.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Outcomes of Swallowing Rehabilitation in Chronic Brainstem Dysphagia: A Retrospective Evaluation

1999

View full text Add to dashboard Cite

This study examines the functional and physiologic outcomes of treatment in a group of 10 patients with chronic dysphagia subsequent to a single brainstem injury. All patients participated in a structured swallowing treatment program at a metropolitan teaching hospital. This program differs from more traditional swallowing treatment by the inclusion of surface electromyography biofeedback as a treatment modality and the completion of 10 hr of direct treatment in the first week of intervention. A retrospective analysis of medical records and patient questionnaires was used to gain information regarding medical history, site of lesion, prior interventions, and patient perception of swallowing recovery. Physiologic change in swallowing treatment, as measured by severity ratings of videofluoroscopic swallowing studies, was demonstrated in nine of 10 patients after 1 week or 10 sessions of treatment. Functional change was measured by diet level tolerance after 1 week of treatment, at 6 months, and again at 1 year posttreatment. Eight of the 10 patients were able to return to full oral intake with termination of gastrostomy tube feedings, whereas two demonstrated no long-term change in functional swallowing. Of the eight who returned to full oral intake, the average duration of tube feedings following treatment until discontinuation was 5.3 months, with a range of 1-12 months. Six patients who returned to oral intake maintained gains in swallowing function, and two patients returned to nonoral nutrition as the result of a new unrelated medical condition.

show abstract

supporting

confidence: 76%

mentioning

confidence: 99%

Outcomes of Swallowing Rehabilitation in Chronic Brainstem Dysphagia: A Retrospective Evaluation

1999

View full text Add to dashboard Cite

show abstract

“…This step is critical when focusing on intervention programs to reduce the incidence of pneumonia, as clinical outcomes will be more effective if we target the most important risk factors in all critical areas. A few studies have applied specific treatments such as swallowing therapy [52][53][54][55][56], but with mixed results, perhaps because other risk factors were not addressed.…”

mentioning

confidence: 99%

Predictors of Aspiration Pneumonia: How Important Is Dysphagia?

et al. 1998

View full text Add to dashboard Cite

Aspiration pneumonia is a major cause of morbidity and mortality among the elderly who are hospitalized or in nursing homes. Multiple risk factors for pneumonia have been identified, but no study has effectively compared the relative risk of factors in several different categories, including dysphagia. In this prospective outcomes study, 189 elderly subjects were recruited from the outpatient clinics, inpatient acute care wards, and the nursing home care center at the VA Medical Center in Ann Arbor, Michigan. They were given a variety of assessments to determine oropharyngeal and esophageal swallowing and feeding status, functional status, medical status, and oral/dental status. The subjects were followed for up to 4 years for an outcome of verified aspiration pneumonia. Bivariate analyses identified several factors as significantly associated with pneumonia. Logistic regression analyses then identified the significant predictors of aspiration pneumonia. The best predictors, in one or more groups of subjects, were dependent for feeding, dependent for oral care, number of decayed teeth, tube feeding, more than one medical diagnosis, number of medications, and smoking. The role that each of the significant predictors might play was described in relation to the pathogenesis of aspiration pneumonia. Dysphagia was concluded to be an important risk for aspiration pneumonia, but generally not sufficient to cause pneumonia unless other risk factors are present as well. A dependency upon others for feeding emerged as the dominant risk factor, with an odds ratio of 19.98 in a logistic regression model that excluded tube-fed patients.

show abstract

“…Other scales use too few severity, as presented. Separation by severity was initially chosen and has remained over a 5-year period for the categories [20,34,36], such as the presence or absence of aspiration or a feeding tube. Narrow-perspective scales following reasons.…”

Section: Discussionmentioning

confidence: 99%

A Functional Outcome Swallowing Scale for Staging Oropharyngeal Dysphagia

Salassa

1999

Dig Dis

176

123

View full text Add to dashboard Cite

Objective: To develop a simple and straightforward functional outcome swallowing scale (FOSS) for patients with oropharyngeal dysphagia to determine the severity of the disorder and the effectiveness of therapy or outcome. Design: Five years ago, the author developed a dysphagia staging scale based on personal experience and a review of the English literature. This scale was shared with colleagues from the specialties of otolaryngology, speech pathology, neurology, and gastroenterology, both within and outside the author’s institution. Minor modifications have been made. The scale has been used in clinical management and retrospective studies. Setting: Patients were seen in a multispecialty, tertiary care, academic center. Patients: The patient population included the full spectrum of oropharyngeal dysphagia in adults, but was weighted heavily toward aging patients and patients with head and neck cancer, neurologic disorders, gastroesophageal conditions, and psychiatric problems. Results: The stages are as follows: stage 0 = normal function and asymptomatic; stage I = normal function but with episodic or daily symptoms of dysphagia; stage II = compensated abnormal function manifested by significant dietary modifications or prolonged mealtime (without weight loss or aspiration); stage III = decompensated abnormal function with weight loss of 10% or less of body weight over 6 months due to dysphagia, or daily cough, gagging, or aspiration during meals; stage IV = severely decompensated abnormal function with weight loss of more than 10% of body weight over 6 months due to dysphagia, or severe aspiration with bronchopulmonary complications, nonoral feeding recommended for most of nutrition, and stage V = nonoral feeding for all nutrition. Conclusions: The FOSS was successful for staging various adult patients with dysphagia into clinically useful, overall performance categories. It has been applied successfully to retrospective outcome studies and to clinical management by clinicians from different specialties.

show abstract

Swallowing therapy of neurologic patients: Correlation of outcome with pretreatment variables and therapeutic methods

Cited by 95 publications

References 11 publications

Outcomes of Swallowing Rehabilitation in Chronic Brainstem Dysphagia: A Retrospective Evaluation

Outcomes of Swallowing Rehabilitation in Chronic Brainstem Dysphagia: A Retrospective Evaluation

Predictors of Aspiration Pneumonia: How Important Is Dysphagia?

A Functional Outcome Swallowing Scale for Staging Oropharyngeal Dysphagia

Contact Info

Product

Resources

About