Advances in the Treatment of Dysphagia in Neurological Disorders: A Review of Current Evidence and Future Considerations.
Advances in the Treatment of Dysphagia in Neurological Disorders: A Review of Current Evidence and Future Considerations.
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DOI：
10.2147/ndt.s371624
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发表时间：
2022
影响因子：
3.2
通讯作者：
Hamdy, Shaheen
中科院分区：
文献类型：
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作者：
Cheng, Ivy;Hamad, Adeel;Sasegbon, Ayodele;Hamdy, Shaheen
吞咽困难是指吞咽困难和/或吞咽障碍，是与各种神经系统疾病如中风、运动神经元疾病和神经退行性疾病相关的常见问题。传统上，吞咽困难的治疗是补偿性的，包括修改食团质地或进食姿势，或康复性的，包括行为练习和感官刺激。尽管在临床实践中被广泛采用，但由于主要非对照研究支持的证据水平较低，最近的观点对这些治疗的临床疗效提出了挑战。因此，随着技术和科学研究方法的进步，近年来新型吞咽困难治疗方法的开发激增，并且越来越多的随机对照临床试验。在这篇综述中，我们将回顾过去二十年来新引入的几种吞咽困难治疗方法的临床证据，包括康复训练，生物反馈，药物治疗，神经调节治疗和软机器人。尽管最近吞咽困难治疗有效性的证据质量有所改善，但仍有几个关键问题，包括治疗方案的异质性、长期治疗效果、某些神经调节治疗的潜在机制以及这些技术在非卒中性吞咽困难中的作用，仍有待于在未来的临床试验中解决。
Dysphagia, which refers to difficult and/or disordered swallowing, is a common problem associated with various neurological diseases such as stroke, motor neuron diseases and neurodegenerative diseases. Traditionally, dysphagia treatments are either compensatory, which includes modifications of bolus texture or feeding posture, or rehabilitative, which includes behavioral exercises and sensory stimulation. Despite being widely adopted in clinical practice, recent views have challenged the clinical efficacy of these treatments due to the low level of evidence supported by mainly non-controlled studies. As such, with advancements in technology and scientific research methods, recent times have seen a surge in the development of novel dysphagia treatments and an increasing number of robust randomized controlled clinical trials. In this review, we will review the clinical evidence of several newly introduced treatments for dysphagia in the last two decades, including rehabilitative exercises, biofeedback, pharmacological treatments, neuromodulation treatments and soft robotics. Despite the recent improvements in the quality of evidence for the efficacy of dysphagia treatments, several critical issues, including heterogeneity in treatment regimens, long-term treatment effects, underlying mechanisms of some neuromodulation treatments, and the effects of these techniques in non-stroke dysphagia, remain to be addressed in future clinical trials.
DOI：
10.1007/s13311-021-01032-7
发表时间：
2021-01
期刊：
Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics
影响因子：
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作者：
St Louis EK;Videnovic A
通讯作者：
Videnovic A