Nature Of Dysphagia Research Articles

Perceptions of Dysphagia Evaluation and Treatment Among Individuals with Parkinson's Disease.

Dysphagia is a leading cause of morbidity and mortality among individuals with Parkinson's disease (PD). The primary objectives of the present study were to explore patients' narrative reports focused on what information and evaluation and treatment experiences they identified as they manage dysphagia, and to identify practice patterns relevant to dysphagia management. A secondary objective was to produce an educational resource for this population that addressed their questions about dysphagia. A sample of individuals with oropharyngeal dysphagia secondary to PD (n = 25) across all regions of the United States were interviewed using open- and closed questions and a written questionnaire. Verbatim interview transcripts were interrogated using qualitative content analysis (QCA) with an inductive approach to identify themes from the participants' reported knowledge of dysphagia and experiences with swallowing evaluation and treatment. Authors developed a pamphlet addressing common questions that participants posed in the interviews and conducted a member check to revise it with their feedback. Most participants reported having been asked about their swallowing function by a healthcare professional. 60% of the sample reported having had a swallowing evaluation. Only 20% (5/25) of participants reported having completed swallowing therapy. Some participants did not know that swallowing therapy exists. Nearly all participants reported having a strong desire to know more about dysphagia and preferred a pamphlet as a resource format. Few of the study participants had received swallowing therapy, and nearly all participants were eager to learn about the nature of dysphagia, its progression, and treatment options. Given the physical, emotional, and social ramifications of living with dysphagia, access to swallowing education and treatment needs to be a stronger focus of PD management.

Treatment for dysphagia (swallowing difficulties) in hereditary ataxia.

Hereditary ataxias are a heterogeneous group of disorders resulting in progressive inco-ordination. Swallowing impairment, also known as dysphagia, is a common and potentially life threatening sequel of disease progression. The incidence and nature of dysphagia in these conditions is largely unknown. The loss of an effective and safe swallow can dramatically affect the health and well-being of an individual. Remediation of difficulties of eating and drinking is an important goal in the clinical care of people with hereditary ataxia. To assess the effects of interventions for swallowing impairment (dysphagia) in people with hereditary ataxias. We searched the Cochrane Neuromuscular Disease Group Specialized Register, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, CINAHL Plus, PsycINFO, and the Education Resources Information Center (ERIC) on 14 September 2015. We also searched Linguistics and Language Behavior Abstracts (LLBA), Dissertation Abstracts, and Trials Registries on 24 September 2015. We considered all randomised controlled trials (RCTs) and quasi-RCTs that compared treatments for hereditary ataxia with placebo or no treatment. We only included studies measuring dysphagia. Three review authors (ES, KJ, MK) independently screened all titles and abstracts. In the event of any disagreement or uncertainty over the inclusion of a particular paper, the review authors planned to meet and reach consensus. We identified no RCTs from the 519 titles and abstracts screened. We excluded papers primarily for not including participants with a hereditary ataxia (that is, being focused on other neurological conditions), being theoretical reviews rather than intervention studies, or being neither randomised nor quasi-randomised trials.We identified five papers of various design that described treatment for dysphagia, or improvement to swallow as a by-product of treatment, in people with hereditary ataxia. None of these studies were RCTs or quasi-RCTs. There is an absence of any significant evidence supporting the use of any dysphagia intervention in hereditary ataxia. The lack of evidence highlights the critical need for well-controlled treatment trials in the field.

Swallowing Dysfunction and Autonomic Nervous System Dysfunction in Alzheimer's Disease: A Scoping Review of the Evidence

To describe, synthesize, and interpret literature on swallowing impairment (dysphagia) and autonomic nervous system (ANS) dysfunction in Alzheimer's disease (AD) and to identify gaps in the existing literature. Scoping review of literature covering several study designs. Literature review. Individuals with AD. Systematic searches of the PubMed, EBSCOhost, PsychINFO, Cochrane, EMBASE, and Scopus databases were conducted. Literature was identified and organized into categories. Studies were then evaluated using the Oxford Centre for Evidence-Based Medicine Levels of Evidence criteria. After evaluation, the literature was synthesized to form conclusions and identify knowledge gaps. Ninety-five articles met the study criteria and were included in the review. Thirty-one studies examining dysphagia in AD provide preliminary evidence on the prevalence, nature, and treatment of dysphagia in AD; knowledge gaps were identified with respect to demographic characteristics, nature of dysphagia, functional significance, assessment, treatment, and underlying mechanisms of dysphagia in AD. Sixty-four studies of ANS dysfunction in AD were reviewed, of which 49 identified at least one variable reflecting ANS dysfunction in AD. Knowledge gaps were identified related to demographics, functional significance, and underlying neural mechanisms. No studies were found that examined both dysphagia and ANS dysfunction in AD. Current evidence indicates that swallowing impairment, as well as ANS dysfunction, may occur in AD. Potential relationships between dysphagia and ANS dysfunction in AD have not been examined. Future research should explore the possibility that swallowing and ANS dysfunction in AD are related.

Dysphagia and Nutrition Problems in Infants with Apert Syndrome

The purpose of this study was to identify and describe the nature of dysphagia and nutrition difficulties in infants with Apert syndrome. The study comprised a review of the medical, nutrition, and feeding records of 13 consecutive infants still feeding by the bottle who had been referred to the Craniofacial Unit and analyses of swallow function from videofluoroscopic swallow investigations. Outcome measures included qualitative analyses of bottle-feeding and nutritional status and quantitative functional severity ratings of dysphagia based on videofluoroscopic swallow investigations using the O'Neil et al. (1999) Dysphagia Outcome Severity Scale. The main qualitative descriptors of oral feeding in this cohort included uncoordinated suck-swallow-breathe patterns, inability to maintain sucking bursts, and changes in respiratory patterns as the feed progressed. Videofluoroscopic evaluations (N = 7) showed silent laryngeal penetration or aspiration in more than half of the cohort. Failure to thrive was a frequent occurrence seen in seven infants, and 9 of the 10 required dietetic intervention and enteral supplements. (Nutritional records were not located for three infants.) In view of the small sample size and retrospective nature of the study, the results need to be interpreted with caution. However, the study adds to current limited knowledge on feeding and nutrition in Apert syndrome. Further prospective multidisciplinary and objective research is clearly warranted.

Prevalence and nature of dysphagia in va patients with copd referred for videofluoroscopic swallow examination

This retrospective study investigated the prevalence and nature of dysphagia in 78 male outpatients whose primary diagnosis was chronic obstructive pulmonary disease (COPD) and who were referred for modified barium swallow studies at the Veterans Affairs Medical Center (VAMC) in Tucson, Arizona, 1992–1995. Nearly 85% of these patients evidenced some degree of dysphagia, and laryngeal penetrations or aspirations were observed in 44 of them. Agreement between VAMC swallow assessments and those of a three-judge panel of certified speech-language pathologists supported the reliability and validity of the information extracted from VAMC records. The high percentage of silent laryngeal penetrations and aspirations observed in this sample suggests that COPD patient's respiratory status should be considered as well as overt symptoms of a swallowing disorder, such as coughing, in making referrals for video-fluoroscopic swallow studies for such patients.

Swallowing disorders after traumatic brain injury

This article briefly reviews normal swallowing physiology and the nature of dysphagia in the traumatically brain-injured population. Traumatically brain-injured Individuals may demonstrate oral and pharyngeal stage dysphagia. Typically, more than one abnormality in swallowing is observed. Aspiration can occur before, during, and after the pharyngeal swallow as a result of these swallowing problems. Tongue control for speech and swallowing, and the oral and pharyngeal effects of the tongue during swallowing are compared. Effects of head injury on lingual control for swallowing and speech are different. Oral tongue functioning appears to be a poor predictor of tongue base retraction during the pharyngeal stage of swallowing.

Preliminary findings on the nature of dysphagia in patients with chronic obstructive pulmonary disease.

Findings on 14 patients referred for swallowing evaluations from the pulmonary unit of a rehabilitation hospital are presented. Patients were admitted to the hospital with the primary diagnosis of chronic obstructive pulmonary disease (COPD). Thirteen patients had tracheostomy tubes, and five were ventilator-dependent. Each patient received a bedside evaluation to assess the oral phase of the swallow, as well as videofluoroscopy to examine the pharyngeal phase. Results indicated that nearly all of the patients experienced some difficulty with both phases of swallowing. Oral and pharyngeal transit times were consistently slower than normal. Most patients demonstrated diminished coordination and strength of the oral and pharyngeal musculature. The overall picture was one of reduced strength in all aspects of the swallow, coupled with a reduced ability to use pulmonary air to clear the larynx and ensure airway protection. Consistent aspiration was observed in only 3 of the 14 patients, but 10 of the patients were judged to have a moderate swallowing dysfunction.

Recognition of the diverse and complex nature of neuromuscular swallowing disorders: a basis for treatment

Ten dysphagic patients referred to speech therapy were assessed using clinical bedside examination and radiographic investigation. The results of these comprehensive assessments confirm the diverse and complex nature of dysphagia, providing a basis for more effective management.