ESTUDIOS INTERESANTES EN DISFAGIA

21 de agosto de 2012 a las 21:41

PúblicoAmigosSolo yoPersonalizadoMejores amigosUniversidad Santiago de CaliVer todas las listas...FonoaudiologiaFonoaudiólogaUniversidad Santa Paulabogotacalimedellínvalleduparempresas y cursosCentro de Habla y VozAgregar "Centro en Fonoaudiología Clínica de Colombia. CFCC"FonoaudiólogaFonoaudiólogaÁrea de Río de JaneiroÁrea de ValleduparÁrea de México, D. F.Área de BucaramangaCentro de Habla y VozÁrea de PereiraÁrea de San José De Cùcuta, Norte De Santander, ColombiaFonoactivaVolver

Estudios interesantes en disfagia:  http://www.journaltocs.hw.ac.uk/api/jass/zotero.php?rfr_id=info:sid/journaltocs.ac.uk:suncat&rft.issn=1432-0460&maximumRecords=100&rft_volume=&rft_issue=&range=&select=&query_issn=Submit+Query

• Readability of Patient-Reported Outcome Questionnaires for Use with Persons with Swallowing DisordersAbstract 
  The purposes of this study were to examine the readability of published patient-related outcome (PRO) questionnaires for persons with swallowing problems, and to compare the readability results to existing data about average reading levels of English-speaking adults living in the United States. A search was conducted to identify published PRO questionnaires related to swallowing problems that traditionally are completed by patients in a self-administered format. Reading grade levels were analyzed separately for four different swallowing-related PRO questionnaires using the Flesch Reading Ease, FOG, and FORCAST formulas as computed by a readability calculations software package. Descriptive statistics were also computed across the questionnaires. The results of this study demonstrate that all four PRO questionnaires exceeded the fifth- to sixth-grade reading levels recommended by health literacy experts regardless of the formula applied. In the demand for standardization of swallowing-related quality-of-life assessment tools, developers should consider readability as another testable construct, since poor readability may affect validity, reliability, and sensitivity. The swallowing clinician should consider the average reading level needed to understand a particular PRO questionnaire when administering it to a patient or his or her proxy. Developers of PRO questionnaires should consider the reading level of respondents and include information about this when reporting psychometric data.
  
  DOI: 10.1007/s00455-011-9373-x
• Evaluation of Dysphagia After Cervical Surgery Using Laryngeal ElectromyographyAbstract 
  The purpose of this study was to investigate the causes of dysphagia after cervical surgery using laryngeal electromyography (LEMG), and the effect of laryngeal neuropathy on the severity of dysphagia. Seventeen patients with dysphagia evident after cervical surgery were included. Video fluoroscopic swallow study (VFSS) parameters evaluated included the volume of residue in the vallecular pouch and the pyriform sinus, the Rosenbek penetration-aspiration scale (PAS), and the swallowing function scoring system (SFSS). By VFSS findings, patients were classified into a mild or severe dysphagia group. Nine of 17 patients showed voice change. SFSS scores were 0 in 2 patients, 3 in 1 patient, 4 in 1 patient, 5 in 1 patient, and 6 in 12 patients. PAS scores were 1 in 8 patients, 2 in 5 patients, 7 in 3 patients, and 8 in 1 patient. Laryngeal neuropathy was evident in seven patients (41.2%). Of these, all patients exhibited recurrent laryngeal neuropathy and 28.6% had superior laryngeal neuropathy. When we evaluated LEMG findings with respect to the severity of dysphagia, the severe dysphagia group showed significant association with the presence of laryngeal neuropathy ( p  = 0.006). Although the level of residue in the vallecular pouch was not associated with the presence of laryngeal neuropathy ( p  = 0.442), the amount of residue in the pyriform sinus did show a significant association ( p  = 0.020).
  
  DOI: 10.1007/s00455-011-9368-7
• Brain Activation During Oral Exercises Used for Dysphagia Rehabilitation in Healthy Human Subjects: A Functional Magnetic Resonance Imaging StudyAbstract
  Oral exercises, including tongue, lip, and jaw movements, are commonly used in clinical practice as training to improve oral and pharyngeal swallowing in dysphagia patients. These rehabilitation exercises are believed to affect the peripheral and central nervous system at various levels. However, few studies have examined healthy subjects’ brain activity while performing oral exercises used in dysphagia rehabilitation. The current study sought to measure brain activation during oral exercises in healthy subjects using functional magnetic resonance imaging (fMRI). Lip-pursing and lip-stretching, tongue protrusion, lateral tongue movement, and oral ball-rolling were selected as tongue and lip exercise tasks. The tasks were performed by eight healthy subjects, and the fMRI data were submitted to conjunction analyses. The results confirmed that head movements during all tasks exhibited translation of <1 .0="" and="" em="" in="" mm="" nbsp="" of="" rotation="">x 

, y , and z coordinates. We found several clear regions of increased brain activity during all four oral exercises. Commonly activated regions during tongue and lip exercises included the precentral gyrus and cerebellum. Brain activation during ball-rolling was more extensive and stronger compared to the other three oral exercises.
DOI: 10.1007/s00455-011-9374-9

Physiological Characteristics of Dysphagia Following Thermal Burn InjuryAbstract 
The study aim was to document the acute physiological characteristics of swallowing impairment following thermal burn injury. A series of 19 participants admitted to a specialised burn centre with thermal burn injury were identified with suspected aspiration risk by a clinical swallow examination (CSE) conducted by a speech-language pathologist and referred to the study. Once medically stable, each then underwent more detailed assessment using both a CSE and fiberoptic evaluation of swallowing (FEES). FEES confirmed six individuals (32%) had no aspiration risk and were excluded from further analyses. Of the remaining 13, CSE confirmed that two had specific oral-phase deficits due to orofacial scarring and contractures, and all 13 had generalised oromotor weakness. FEES revealed numerous pharyngeal-phase deficits, with the major findings evident in greater than 50% being impaired secretion management, laryngotracheal edema, delayed swallow initiation, impaired sensation, inadequate movement of structures within the hypopharynx and larynx, and diffuse pharyngeal residue. Penetration and/or aspiration occurred in 83% ( n  = 10/12) of thin fluids trials, with a lack of response to the penetration/aspiration noted in 50% ( n  = 6/12 penetration aspiration events) of the cases. Most events occurred post swallow. Findings support the fact that individuals with dysphagia post thermal burn present with multiple risk factors for aspiration that appear predominantly related to generalised weakness and inefficiency and further impacted by edema and sensory impairments. Generalised oromotor weakness and orofacial contractures (when present) impact oral-stage swallow function. This study has identified a range of factors that may contribute to both oral- and pharyngeal-stage dysfunction in this clinical population and has highlighted the importance of using a combination of clinical and instrumental assessments to fully understand the influence of burn injury on oral intake and swallowing.