The Intensive Dysphagia Rehabilitation Approach Applied to Patients With Neurogenic Dysphagia: A Case Series Design Study

Malandraki, Georgia A.; Rajappa, Akila; Kantarcigil, Çagla; Wagner, Elise; Ivey, Chandra M.; Youse, Kathleen M.

doi:10.1016/j.apmr.2015.11.019

Cited by 43 publications

(35 citation statements)

References 22 publications

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“…fNIRS has already been used to correlate neuronal activity during pharyngeal and esophageal swallows (65). Neurogenic dysphagia requires intensive exercise regiments (66), and the combination of these approaches may clarify the effects of therapies on integrity of structure and functions of neural circuitry.…”

Section: Discussionmentioning

confidence: 99%

Brain Lesions among Orally Fed and Gastrostomy-Fed Dysphagic Preterm Infants: Can Routine Qualitative or Volumetric Quantitative Magnetic Resonance Imaging Predict Feeding Outcomes?

et al. 2017

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IntroductionThe usefulness of qualitative or quantitative volumetric magnetic resonance imaging (MRI) in early detection of brain structural changes and prediction of adverse outcomes in neonatal illnesses warrants further investigation. Our aim was to correlate certain brain injuries and the brain volume of feeding-related cortical and subcortical regions with feeding method at discharge among preterm dysphagic infants.Materials and methodsUsing a retrospective observational study design, we examined MRI data among 43 (22 male; born at 31.5 ± 0.8 week gestation) infants who went home on oral feeding or gastrostomy feeding (G-tube). MRI scans were segmented, and volumes of brainstem, cerebellum, cerebrum, basal ganglia, thalamus, and vermis were quantified, and correlations were made with discharge feeding outcomes. Chi-squared tests were used to evaluate MRI findings vs. feeding outcomes. ANCOVA was performed on the regression model to measure the association of maturity and brain volume between groups.ResultsOut of 43 infants, 44% were oral-fed and 56% were G-tube fed at hospital discharge (but not at time of the study). There was no relationship between qualitative brain lesions and feeding outcomes. Volumetric analysis revealed that cerebellum was greater (p < 0.05) in G-tube fed infants, whereas cerebrum volume was greater (p < 0.05) in oral-fed infants. Other brain regions did not show volumetric differences between groups.ConclusionThis study concludes that neither qualitative nor quantitative volumetric MRI findings correlate with feeding outcomes. Understanding the complexity of swallowing and feeding difficulties in infants warrants a comprehensive and in-depth functional neurological assessment.

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Section: Discussionmentioning

confidence: 99%

Brain Lesions among Orally Fed and Gastrostomy-Fed Dysphagic Preterm Infants: Can Routine Qualitative or Volumetric Quantitative Magnetic Resonance Imaging Predict Feeding Outcomes?

et al. 2017

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“…Another work mentioned that all patients who underwent complete therapy achieved satisfactory level of oral intake while those who underwent the therapy partially, increased this level by 1 or 2 points on the FOIS scale (18) . The management of dysphagia aims to protect airways and provide safe swallowing, for better quality of life, in addition to maximizing function or compensatory potentials (25) and, hence, patient's awareness is important to the completion of the proposed treatment plan.…”

Section: Discussionmentioning

confidence: 99%

Biofeedback eletromiográfico no tratamento das disfunções orofaciais neurogênicas: revisão sistemática de literatura

Freitas

Mituuti

Furkim

et al. 2016

Audiol., Commun. Res.

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Purpose:To determine whether the use of electromyographic biofeedback in the therapy of orofacial functions (facial expression, chewing, swallowing, phonation and speech) will result in beneficial effects for individuals with neurological diseases. Research strategy: A keyword search was conducted in the MEDLINE, LILACS and SciELO databases, using the terms "electromyographic biofeedback", "swallowing", "speech", "chewing", "phonation", and "facial expression". The database search and the selection of papers were conducted independently by two researchers. In case of any disagreement, there was a discussion based on the inclusion and exclusion criteria, so that they could reach a common ground. Selection criteria: This work has included experimental studies in humans, in English and Portuguese, which described and discussed the use of electromyographic biofeedback in the treatment of orofacial function diseases resulting from neurological illness. Results: A total of 175 papers were found, wherein only 10 fitted the inclusion criteria. Most works were case studies, followed by case series, case control, and only one randomized controlled trial. Most of studies addressed the therapy with electromyographic biofeedback in the swallowing function, followed by speech function, and only one study addressed the use of electromyographic biofeedback in therapy to improve facial expression. No studies addressing speech therapy using electromyographic biofeedback in patients with neurological diseases in the functions of phonation and chewing were found. Conclusion: The use of electromyographic biofeedback in the therapy for orofacial functions can result in beneficial effects for individuals with neurological diseases in the swallowing, speech, and facial expression functions.Keywords: Electromyography; Deglutition; Speech; Mastication; Phonation; Facial expression RESUMO Objetivo: Investigar se o uso do biofeedback eletromiográfico na terapia voltada às funções orofaciais (expressão facial, mastigação, deglutição, fonação e fala) produz efeitos benéficos para os indivíduos com doenças neurológicas. Estratégia de pesquisa: Foi realizada busca nas bases de dados MEDLINE, LILACS e SciELO, por meio dos descritores "electromyographic biofeedback", "swallowing", "speech" "chewing", "phonation", e "facial expression". A busca nas bases de dados e a seleção dos artigos foram realizadas independentemente, por duas pesquisadoras e, nos casos de não concordância, houve discussão fundamentada nos critérios de inclusão e exclusão para que chegassem a um consenso. Critérios de seleção: Foram incluídos estudos experimentais em seres humanos, em inglês e português, que descreveram e discutiram a utilização do biofeedback eletromiográfico no tratamento das alterações das funções orofaciais provenientes de doenças neurológicas. Resultados: Foram encontrados 175 artigos, sendo que somente 10 se adequaram aos critérios de inclusão. A maioria dos trabalhos relacionou-se a estudo de caso, seguido por estudos de série de casos, caso c...

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“…Individualized or personalized intensive neuroplasticity driven approaches and "boot camp" approaches that couple functional skill training with progressive resistance exercise paradigms have started to surface. 158,159 These approaches tailor or match interventions to the individual patient and their specific physiologic and pathophysiological profile, while systematically combining interventions in an evidence-based manner following neuroplasticity-driven paradigms. Although offering early evidence that a personalized model in dysphagia management is feasible and may be beneficial, more research in this direction is needed.…”

Section: Individualized Therapymentioning

confidence: 99%

Dysphagia Practice in 2035: Beyond Fluorography, Thickener, and Electrical Stimulation

Ciucci¹,

Jones

Malandraki

et al. 2016

Semin Speech Lang

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Dysphagia evaluation and management has rapidly become the primary practice area of medical speech pathologists since its adoption in our field less than three decades ago. As a specialty, swallowing and swallowing disorders comprise the largest represented discipline with 10,059 specialty interest group members within the American Speech-Language-Hearing Association and 298 board-certified specialists in the American Speech Hearing Association. There are national and international organizations, such as the Dysphagia Research Society and its interdisciplinary journal Dysphagia, that provide continuing education for clinicians and a platform for dysphagia researchers. Despite this rapid growth, herein we identify some significant needs for improving the science and practice of dysphagia clinical care, including a deeper understanding of physiology and neurophysiology, standardization of evaluation, consensus on core sets of dysphagia parameters for clinical and research reporting, personalized algorithms for implementation of evidenced-based practice, metrics for therapy efficacy, and increased buy-in and funding from agencies. The goals of this article are to summarize the status quo of dysphagia research, evaluation, and treatment as well as to make predictions about the future. Medical trends that we speculate will influence dysphagia research and care in the future include, among others, imaging advances, personalized medicine, regenerative medicine, and telehealth.

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The Intensive Dysphagia Rehabilitation Approach Applied to Patients With Neurogenic Dysphagia: A Case Series Design Study

Cited by 43 publications

References 22 publications

Brain Lesions among Orally Fed and Gastrostomy-Fed Dysphagic Preterm Infants: Can Routine Qualitative or Volumetric Quantitative Magnetic Resonance Imaging Predict Feeding Outcomes?

Brain Lesions among Orally Fed and Gastrostomy-Fed Dysphagic Preterm Infants: Can Routine Qualitative or Volumetric Quantitative Magnetic Resonance Imaging Predict Feeding Outcomes?

Biofeedback eletromiográfico no tratamento das disfunções orofaciais neurogênicas: revisão sistemática de literatura

Dysphagia Practice in 2035: Beyond Fluorography, Thickener, and Electrical Stimulation

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