Dysphagia, Stroke
Conditions
Keywords
dysphagia, post-stroke dysphagia, rehabilitation, ultrasonography
Brief summary
Swallowing disorder in stroke patients is a significant cause of morbidity and mortality as it can cause aspiration pneumonia. Electrical stimulation has proven to be effective in post-stroke dysphagic patients.10 patients who have symptoms of post-stroke dysphagia, meet the inclusion criteria and volunteer to participate will be included in the study. Included patients will be randomized into 2 groups. The exercise program will be applied to both groups as a home program for 4 weeks.
Detailed description
A randomized, prospective, controlled study will include 10 patients with post-stroke dysphagia. Groups will be randomized into 2 groups. 1. st group; One electrode will be connected to the suprahyoid region and the other electrode will be connected between the thyroid and hyoid cartilages. Superficial neuromuscular stimulation will be applied by the physiotherapist at 80 Hz, 0-25 µA (microampere) current range for 20 minutes, for 5 days for the patient, for a total of 4 weeks. At the same time, each patient will be taught the exercises included in traditional swallowing treatment and will be advised to practice them for 30 minutes every day. 2. nd group; Exercises such as progressively resistant oral-facial, lingual, laryngeal exercises, tongue strengthening exercises, effortful swallowing maneuver, thermal/tactile stimulation to oropharyngeal muscles, Masako maneuver, Mendelson maneuver, Shaker maneuver, which are included in traditional swallowing treatment, will be taught and practiced for 30 minutes will be recommended for one month. Patients' dysphagia scales, quality of life survey and ultrasonography measurements will be performed before and after treatment. Tests to be applied * Functional Oral Intake Scale (FOAS) * Swallowing Function Screening Test (EAT-10) * GUSS (Gagging Swallowing Screening Test) * Modified Mann Swallowing Ability Assessment Test (MMASA) * SWAL-QOL (The impact of swallowing disorders on quality of life questionnaire), * Measurements made by ultrasonography (measurement of tongue thickness, measurement of hyoid-larynx distance and measurements of other anatomical structures) Clinic Responsible for Research: Physical Therapy and Rehabilitation Clinic of Kayseri City Hospital
Interventions
DEVICENMES (neuromuscular electrical stimulation)
With this application, swallowing muscles are stimulated and muscle strength increases.
BEHAVIORALExercise
Traditional Conservative swallowing treatment
Sponsors
Kayseri City Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
40 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
* Male and female patients over 40 years of age with post-stroke dysphagia * Patients with Functional Oral Intake Scale (FOAS) 1-6
Exclusion criteria
* Patients younger than 40 years old * Dementia, impaired consciousness or hypoesthetic /anesthetic patients * Patients with low body mass * Patients with pacemakers and severe heart disease * Severe hypertension and hypotension * Thrombosis or thrombophlebitis * Pregnancy * Epilepsy
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Ultrasonographic measurements | at baseline, 4th week | Measurements made by ultrasonography (measurement of tongue thickness, measurement of hyoid-larynx distance and measurements of other anatomical structures) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Functional Oral Intake Scale (FOIS) | at baseline, 4th week | Functional Oral Intake Scale (FOIS) is an ordinal scale with validity and reliability designed to evaluate the current status and functional change in oral intake of patients with neurogenic dysphagia. This scale consists of 7 items. Items 1 to 3 are related to inability to feed orally, items 4 to 7 are related to oral feeding. |
| Swallowing Function Screening Test (EAT-10) | at baseline, 4th week | It is a useful questionnaire consisting of 10 questions with Turkish validity and reliability and which patients can easily fill out. |
| GUSS (Gagging Swallowing Screening Test) | at baseline, 4th week | GUSS is one of the approved swallowing screening tests in acute stroke patients. It provides dietary recommendations as well as screening for aspiration risk. It consists of two main parts; In the first part, conditions such as alertness, salivation, and cough are evaluated as an indirect swallowing test. In the second part, the direct swallowing test, swallowing trials are performed with three different consistencies: semi-solid, liquid and solid. 5 points are achieved in each subgroup. Scores between 0 and 9 are considered as severe dysphagia and special diet and videofluoroscopic examination are recommended. 10-14 points are considered moderate dysphagia, 5-19 points are considered mild dysphagia, and 20 points are considered normal. |
| Modified Mann Swallowing Ability Assessment Test (MMASA) | at baseline, 4th week | It is a bedside test that evaluates parameters such as alertness, cooperation, respiration, expressive speech, auditory perception, dysarthria, salivation, tongue movement, tongue strength, gagging, cough reflex and palate movement. The highest score is 100. It is recommended that patients who score 94 or below as a result of the evaluation should not be fed orally and should be referred to a speech-language pathologist. |
| SWAL-QOL (The impact of swallowing disorders on quality of life questionnaire) | at baseline, 4th week | Swallow Quality of Life Questionnaire (SWAL-QOL) is one of the most widely known patient based and dysphagia specific item questionnaire. It is a valid and reliable scale in the evaluation of dysphagia. |
Countries
Turkey (Türkiye)
Outcome results
None listed