Screening for oropharyngeal dysphagia in adult patients with neuromuscular diseases using the Sydney Swallow Questionnaire ( SSQ )

2021 ◽  
Author(s):  
Nicolas Audag ◽  
Giuseppe Liistro ◽  
Christophe Goubau ◽  
Laure Vandervelde ◽  
William Poncin ◽  
...  
2017 ◽  
Vol 9 (1) ◽  
pp. 5-21 ◽  
Author(s):  
Lorena Molina ◽  
Susana Santos-Ruiz ◽  
Pere Clavé ◽  
Luis González-de Paz ◽  
Esther Cabrera

Author(s):  
Catherine Forgues ◽  
Julie Fortin ◽  
Cynthia Gagnon ◽  
Jean-Denis Brisson ◽  
Jean Mathieu ◽  
...  

Purpose: To document the nutritional risk in adults with oculopharyngeal muscular dystrophy (OPMD) and its association with oropharyngeal dysphagia. Methods: In this cross-sectional study, 33 adults with molecular confirmation of OPMD between 50 and 75 years old were recruited from the registry of a university-affiliated neuromuscular clinic. Nutritional risk was assessed with the French version of Seniors in the Community: Risk Evaluation for Eating and Nutrition II (SCREEN II), whereas the severity of dysphagia was assessed using the French-Canadian version of the Sydney Swallow Questionnaire. Anthropometric measurements were performed with standardized procedures. Results: SCREEN II scores showed high nutritional risk for 81.8% of OPMD participants with 6 factors contributing to nutritional risk in at least 50% of the sample. Pearson’s correlational analysis showed a significant moderate relationship between dysphagia and nutritional risk (r = −0.470; P = 0.006). Conclusion: To our knowledge, this study is the first to investigate the nutritional risk of adults with OPMD. Our results indicate that individuals with OPMD may be at high nutritional risk mostly associated with swallowing difficulty, in the absence of a low body mass index. The present study highlights the need for dietary counseling in OPMD.


Author(s):  
Kuang-Hua Huang ◽  
Chih-Jaan Tai ◽  
Yu-Hsiang Kuan ◽  
Yu-Chia Chang ◽  
Tung-Han Tsai ◽  
...  

Most patients with Parkinson’s disease (PD) gradually develop oropharyngeal dysphagia which is often associated with pneumonia risk. The possible association of benzodiazepine (BZD) and benzodiazepine related drugs (BZRD) use with pneumonia risk has received increasing attention but remains controversial. We investigated pneumonia risk associated with the use of BZDs and BZRDs in older adult patients with PD. This case-control study analyzed data of 551,975 older adult patients with PD between 2001 and 2018 in Taiwan. To minimize potential confounding, we used 1:4 propensity score matching to include older adult patients without pneumonia as controls. Incident pneumonia risk was significantly higher in current (adjusted odds ratio (aOR) = 1.25, 95% CI = 1.23–1.27) and past (aOR = 1.13, 95% CI = 1.11–1.15) users of BZDs. Regarding BZRDs, recent (aOR = 1.08, 95% CI = 1.06–1.11) and past (aOR = 0.89, 95% CI = 0.88–0.91) users had higher and lower risks of incident pneumonia, respectively. Pneumonia risk varied based on their use of BZDs and BZRDs. In these individuals, incident pneumonia risk was high in users of BZDs, such as midazolam, lorazepam, flunitrazepam, estazolam, and clonazepam. Regarding the use of BZRDs, zopiclone increased incident pneumonia risk.


Author(s):  
Lisa Wahlgren ◽  
Anna-Karin Kroksmark ◽  
Mar Tulinius ◽  
Kalliopi Sofou

AbstractDuchenne muscular dystrophy (DMD) is a severe neuromuscular disorder with increasing life expectancy from late teens to over 30 years of age. The aim of this nationwide study was to explore the prevalence, life expectancy and leading causes of death in patients with DMD in Sweden. Patients with DMD were identified through the National Quality Registry for Neuromuscular Diseases in Sweden, the Swedish Registry of Respiratory Failure, pathology laboratories, neurology and respiratory clinics, and the national network for neuromuscular diseases. Age and cause of death were retrieved from the Cause of Death Registry and cross-checked with medical records. 373 DMD patients born 1970–2019 were identified, of whom 129 patients deceased during the study period. Point prevalence of adult patients with DMD on December 31st 2019 was 3.2 per 100,000 adult males. Birth prevalence was 19.2 per 100,000 male births. Median survival was 29.9 years, the leading cause of death being cardiopulmonary in 79.9% of patients. Non-cardiopulmonary causes of death (20.1% of patients) mainly pertained to injury-related pulmonary embolism (1.3 per 1000 person-years), gastrointestinal complications (1.0 per 1000 person-years), stroke (0.6 per 1000 person-years) and unnatural deaths (1.6 per 1000 person-years). Death from non-cardiopulmonary causes occurred at younger ages (mean 21.0 years, SD 8.2; p = 0.004). Age at loss of independent ambulation did not have significant impact on overall survival (p = 0.26). We found that non-cardiopulmonary causes contribute to higher mortality among younger patients with DMD. We present novel epidemiological data on the increasing population of adult patients with DMD.


2020 ◽  
pp. 014556132095164
Author(s):  
Brandon J. Wang ◽  
Felicia L. Carter ◽  
Kenneth W. Altman

There is a high prevalence of dysphagia in patients with neuromuscular diseases and stroke, and consequences can be profound. However, the correlation of dysarthria and oral-oropharyngeal dysphagia remains unclear. This review aimed to define the clinical co-presentation of dysarthria and dysphagia in this population. A PubMed search to identify literature on the prevalence of dysarthria and dysphagia was systematically conducted in the English language literature since 1995. Subjective and objective outcomes instruments were identified for both dysarthria and dysphagia. Studies that included prevalence and co-presentation were included. Inclusion and exclusion criteria were applied according to the Preferred Reporting Items for Systematic Reviews and Meta Analyses (PRISMA). Of the 1,056 articles identified in the search, 20 articles met the search criteria. An additional 4 articles were examined for a total of 24 articles for analysis. Dysarthria and dysphagia were found to be highly prevalent among patients with neuromuscular disease (NMD). Overall, there was a higher prevalence of dysarthria than dysphagia. Of those patients with dysphagia, some reports estimate 76-90% of patients with NMD also had dysarthria. Dysarthria is a strong clinical clue to the presence of dysphagia. Existing subjective questionnaires may not reveal the presence of oropharyngeal dysphagia, but objective measures are more revealing. Further study to correlate the degree of dysarthria and severity of oral-oropharyngeal dysphagia are warranted.


2015 ◽  
Vol 24 (2) ◽  
pp. 71-74
Author(s):  
Ali Meier

In the last decade or more, dysphagia research has investigated the effect of lingual strengthening on oropharyngeal dysphagia with promising results. Much of this research has utilized strengthening devices such as the Iowa Oral Performance Instrument (IOPI) or the Madison Oral Strengthening Therapeutic (MOST) Device. Patients are often given a device to use, and are able to complete an exercise protocol daily or multiple times per day. This case study was completed to determine the effectiveness of using the IOPI in an outpatient clinic where therapy was conducted two to three times per week. The patient was seen post tongue resection due to oropharyngeal cancer. From initiation of IOPI use to patient discharge, the patient demonstrated a 71% increase in lingual strength at the anterior position, a 61% increase at the posterior position, and a 314% increase at the base of tongue position. His diet advanced from NPO to general based on gains in lingual strength and bolus propulsion.


2008 ◽  
Vol 17 (2) ◽  
pp. 43-49
Author(s):  
James L. Coyle

Abstract The modern clinician is a research consumer. Rehabilitation of oropharyngeal impairments, and prevention of the adverse outcomes of dysphagia, requires the clinician to select interventions for which evidence of a reasonable likelihood of a successful, important outcome exists. The purpose of this paper is to provide strategies for evaluation of published research regarding treatment of oropharyngeal dysphagia. This article utilizes tutorial and examples to inform and educate practitioners in methods of appraising published research. It provides and encourages the use of methods of efficiently evaluating the validity and clinical importance of published research. Additionally, it discusses the importance of the ethical obligation we, as practitioners, have to use evidence-based treatment selection methods and measurement of patient performance during therapy. The reader is provided with tactics for evaluating treatment studies to establish a study's validity and, thereby, objectively select interventions. The importance of avoiding subjective or unsubstantiated claims and using objective methods of generating empirical clinical evidence is emphasized. The ability to evaluate the quality of research provides clinicians with objective intervention selection as an important, essential component of evidence-based clinical practice. ASHA Code of Ethics (2003): Principle I, Rule F: “Individuals shall fully inform the persons they serve of the nature and possible effects of services rendered and products dispensed…” (p. 2) Principle I, Rule G: “Individuals shall evaluate the effectiveness of services rendered and of products dispensed and shall provide services or dispense products only when benefit can reasonably be expected.” (p. 2) Principle IV, Rule G: “Individuals shall not provide professional services without exercising independent professional judgment, regardless of referral source or prescription.” (p. 4)


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