SWALLOWING ACTIVATION USING SENSORY STIMULATION IN PATIENTS WITH SEVERE DISORDERS OF CONSCIOUSNESS.

Abstract

ObjectiveSwallowing disorders are systematically present in patients with severe brain injury, disorders of consciousness, and subsequently poor quality of life. The study hypothesis was that taste and smell could improve swallowing function and quality of life in such patients, who are fed by gastrostomy tube.MethodsEight patients with unresponsive wakefulness syndrome were included in this study. All patients had been in a stable state for at least 2 years, and the delay between the neurological event and the study was always more than 2 years. Strong tastes and smells were selected using the Pfister olfactory classification. Taste and smell stimulations were performed every weekday, Monday to Friday, for 1 week (5 sessions) by a speech and language therapist. Evaluation of swallowing was performed before the first session and after the fifth session, and included the number of spontaneous swallows during 10 min, the presence of drooling, and spontaneous tongue and velum mobility.ResultsThe number of spontaneous swallows at the initial evaluation was 6.8 ± 5.1 n/min. At the final evaluation there was a significant increase in the number of spontaneous swallows (9.1 ± 4.1 n/min, p < 0.01).ConclusionThis clinical observation has shown that taste and smell stimulations are relevant in clinical practice to improve spontaneous swallowing.LAY ABSTRACTSwallowing disorders are systematically present in patients with severe brain injury, disorders of consciousness, and subsequent poor quality of life. The study hypothesis was that taste and smell could improve swallowing function in such patients who require exclusive feeding by gastrostomy tube. The study showed that, in patients with severe DoC, taste and smell stimulations increased the number of spontaneous swallows. Based on these findings, taste and smell stimulations could be used in clinical practice to improve swallowing function and overall quality of life.