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Treatment of dysphagia improves nutritional conditions in stroke patients

Elmståhl, Sölve LU ; Bülow, Margareta LU ; Ekberg, Olle LU ; Petersson, Marie and Tegner, Hans LU (1999) In Dysphagia 14(2). p.61-66
Abstract
Dysphagia is a common symptom in stroke patients, and malnutrition is prevalent among these patients. Thus far, nutritional effects of dysphagic treatment have not been evaluated. The aim of the present report was to study the effects of swallowing techniques on nutritional and anthropometric variables. A survey with follow-up was performed at the Departments of Geriatric Medicine and Neurology, Malmo University Hospital, Sweden. Thirty-eight stroke patients, 53-89 years of age, with subjective complaints of dysphagia and oral/pharyngeal dysfunction according to videofluoroscopic barium swallowing examination (VSBE), were given swallowing treatment. The treatment included oral motor exercise, different swallowing techniques, positioning,... (More)
Dysphagia is a common symptom in stroke patients, and malnutrition is prevalent among these patients. Thus far, nutritional effects of dysphagic treatment have not been evaluated. The aim of the present report was to study the effects of swallowing techniques on nutritional and anthropometric variables. A survey with follow-up was performed at the Departments of Geriatric Medicine and Neurology, Malmo University Hospital, Sweden. Thirty-eight stroke patients, 53-89 years of age, with subjective complaints of dysphagia and oral/pharyngeal dysfunction according to videofluoroscopic barium swallowing examination (VSBE), were given swallowing treatment. The treatment included oral motor exercise, different swallowing techniques, positioning, and diet modification. Plasma protein levels, body composition, VSBE, and a viso-analogical scale for subjective complaints were repeated before and after treatment. At baseline, 94% of cases had signs of penetration and 50-72% had plasma protein levels below recommended levels. Treatment reduced the degree of oral dysfunction, (dissociation) and pharyngeal dysfunction (penetration and constrictor paresis). Sixty percent of cases showed an improved overall VSBE score, and improved levels of albumin and total iron-binding capacity were restricted to this group. In cases with unchanged or decreased VSBE score, body weight was reduced and a negative correlation to total iron-binding capacity was noted (r = -0.60, p < 0.05). Changes of subjective complaints did not correlate with swallowing function or nutritional improvements. Swallowing treatment improves swallowing function, and improved swallowing function is associated with improvements in nutritional parameters. Subjective complaints is not sufficient to evaluate the clinical course, and nutritional parameters should be monitored in patients with oral or pharyngeal dysfunction. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Dysphagia, Swallowing, Stroke, Nutrition, Treatment, Swallow maneuvers, Deglutition, Deglutition disorders
in
Dysphagia
volume
14
issue
2
pages
61 - 66
publisher
Springer
external identifiers
  • pmid:10028034
  • scopus:0032973384
ISSN
1432-0460
DOI
10.1007/PL00009588
language
English
LU publication?
yes
id
6ee81ec4-02a4-47f6-9611-8efb18003d04 (old id 1114899)
date added to LUP
2008-07-07 10:38:45
date last changed
2017-10-22 03:33:06
@article{6ee81ec4-02a4-47f6-9611-8efb18003d04,
  abstract     = {Dysphagia is a common symptom in stroke patients, and malnutrition is prevalent among these patients. Thus far, nutritional effects of dysphagic treatment have not been evaluated. The aim of the present report was to study the effects of swallowing techniques on nutritional and anthropometric variables. A survey with follow-up was performed at the Departments of Geriatric Medicine and Neurology, Malmo University Hospital, Sweden. Thirty-eight stroke patients, 53-89 years of age, with subjective complaints of dysphagia and oral/pharyngeal dysfunction according to videofluoroscopic barium swallowing examination (VSBE), were given swallowing treatment. The treatment included oral motor exercise, different swallowing techniques, positioning, and diet modification. Plasma protein levels, body composition, VSBE, and a viso-analogical scale for subjective complaints were repeated before and after treatment. At baseline, 94% of cases had signs of penetration and 50-72% had plasma protein levels below recommended levels. Treatment reduced the degree of oral dysfunction, (dissociation) and pharyngeal dysfunction (penetration and constrictor paresis). Sixty percent of cases showed an improved overall VSBE score, and improved levels of albumin and total iron-binding capacity were restricted to this group. In cases with unchanged or decreased VSBE score, body weight was reduced and a negative correlation to total iron-binding capacity was noted (r = -0.60, p &lt; 0.05). Changes of subjective complaints did not correlate with swallowing function or nutritional improvements. Swallowing treatment improves swallowing function, and improved swallowing function is associated with improvements in nutritional parameters. Subjective complaints is not sufficient to evaluate the clinical course, and nutritional parameters should be monitored in patients with oral or pharyngeal dysfunction.},
  author       = {Elmståhl, Sölve and Bülow, Margareta and Ekberg, Olle and Petersson, Marie and Tegner, Hans},
  issn         = {1432-0460},
  keyword      = {Dysphagia,Swallowing,Stroke,Nutrition,Treatment,Swallow maneuvers,Deglutition,Deglutition disorders},
  language     = {eng},
  number       = {2},
  pages        = {61--66},
  publisher    = {Springer},
  series       = {Dysphagia},
  title        = {Treatment of dysphagia improves nutritional conditions in stroke patients},
  url          = {http://dx.doi.org/10.1007/PL00009588},
  volume       = {14},
  year         = {1999},
}