Do swallowing exercises improve swallowing dynamic and quality of life in Parkinson's disease?
Do swallowing exercises improve swallowing dynamic and quality of life in Parkinson's disease?
复制标题
DOI：
10.3233/nre-130918
复制
发表时间：
2013-01-01
影响因子：
2
通讯作者：
Nobrega, Ana Caline
中科院分区：
文献类型：
--
作者：
Argolo, Natalie;Sampaio, Marilia;Nobrega, Ana Caline
目的：探讨运动吞咽训练对帕金森病（PD）患者吞咽动力、生活质量和吞咽症状的影响。设计：前后对照试验。单位：大学医学中心。参与者：有吞咽困难主诉的帕金森病患者。干预措施：运动吞咽练习，旨在增加口腔、喉部和咽部结构的运动强度和范围，呼吸和吞咽的协调，以及气道保护。患者应每天进行两次锻炼，每周五天，持续五周。主要观察指标(S)：主要观察指标是干预前后吞咽透视事件次数的差异（吞咽评分）。次要结局为生活质量（QOL）和吞咽不适。结果：15例患者（10男5女，平均年龄59.2±9.17岁）完成研究。改善较大的x线镜事件为丸状失控（P < 0.03）、片状吞咽（P = 0.05）和舌部残留（P < 0.01）、小静脉（P = 0.01）和梨状窦（P = 0.05）。舌泵和缺牙是治疗失败的干扰因素（β标准化系数分别为-16.6、26.2;P = 0.02、0.002）。生活质量改善较大的领域是恐惧（P = 0.02）和症状频次（P = 0.05）。关于吞咽方面的抱怨，患者报告主要减少了咀嚼时口中移动食物的困难（P = 0.02）。吞咽障碍的减少与生活质量的改善无关（cor = 0.13, [95% CI, 0.6-0.4], P = 0.63）。结论：运动吞咽练习可以减少PD患者的吞咽障碍，无舌泵和缺牙，并对PD患者的生活质量和吞咽投诉产生积极影响。
OBJECTIVE: To investigate the effect of motor swallowing exercises on swallowing dynamic, quality of life and swallowing complaints in Parkinson's disease (PD).DESIGN: A before-after trial.SETTING: University Medical Center.PARTICIPANTS: Parkinson's disease patients with dysphagia complaints.INTERVENTIONS: Motor swallowing exercises designed to increase the strength and range of motion of the mouth, larynx and pharyngeal structures, coordination between breathing and swallowing, and airway protection. Patients should perform the exercises twice a day, five days a week, for five weeks.MAIN OUTCOME MEASURE(S): The primary outcome was the difference before and after the intervention in number of swallowing videofluoroscopic events (Swallowing Score). The secondary outcomes were quality of life (QOL) and swallowing complaints.RESULTS: Fifteen patients concluded the study (10 man/5 woman; mean age 59.2 +/- 9.17). The videofluoroscopic events with greater improvement were loss of bolus control (P < 0.03), piecemeal swallow (P = 0.05) and residue on the tongue (P < 0.01), valleculae (P = 0.01) and pyriform sinuses (P = 0.05). Lingual pumping and dental absence were interfering factors associated with treatment failure (beta standardized coefficient = -16.6, 26.2; P = 0.02, 0.002, respectively). The domains with greater improvements in QOL were fear (P = 0.02) and symptom frequency (P = 0.05). Regarding swallowing complaints, patients reported to have reduced mainly their difficulty in moving food in the mouth when chewing (P = 0.02). Reduction in swallowing disorders was not related with QOL improvement (cor = 0.13, [95% CI, 0.6-0.4], P = 0.63).CONCLUSIONS: Motor swallowing exercises may reduce swallowing disorders in PD patients without lingual pumping and dental absence and impact positively QOL and swallowing complaints in individuals with PD.