Best Practice Recommendations for Stroke Patients with Dysphagia: A Delphi-Based Consensus Study of Experts in Turkey-Part II: Rehabilitation

Umay, Ebru; Eyigör, Sibel; Ertekin, Çumhur; Ünlü, Zeliha; Selçuk, Barın; Bahat, Gülistan; Karahan, Ali Yavuz; Seçıl, Yaprak; Gürçay, Eda; Kıylıoğlu, Nefati; Keleş, Betül Yavuz; Giray, Esra; Tıkız, Canan; Gezer, İlknur Albayrak; Yalıman, Ayşe; Şen, Ekin İlke; Vural, Meltem; Saylam, Güleser; Akaltun, Mazlum Serdar; Sarı, Aylin; Alıcura, Sibel; Karaahmet, Fatih; İnanır, Murat; Demirhan, Aylin; Aydeniz, Banu; Filiz, Meral Bilgilisoy; Yüksel, Arif; Özçete, Zeynep Alev; Çalık, Yalkın; Alemdaroğlu, Ebru; Keskin, Dilek; Şahin, Sevnaz; Öztekin, Mehmet Fevzi; Sezgin, Baha; Karaahmet, Özgür Zeliha

doi:10.1007/s00455-020-10218-8

Cited by 20 publications

(15 citation statements)

References 131 publications

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“…The rehabilitation specialist nurse observed the patient's response, provided timely guidance, and gave positive affirmation and feedback. Studies [ 30 , 31 ] have revealed that repeated ice stimulation increases the excitability of the cortical swallowing motor pathway, which is beneficial to rebuild the neural function network between the cortex and the medulla and restores the cortical regulation of the brainstem swallowing center. Drinking ice water can shorten the pharyngeal reaction time, prolong the laryngeal elevation time, and accelerate the laryngeal closure speed [ 30 , 31 ].…”

Section: Discussionmentioning

confidence: 99%

“…Studies [ 30 , 31 ] have revealed that repeated ice stimulation increases the excitability of the cortical swallowing motor pathway, which is beneficial to rebuild the neural function network between the cortex and the medulla and restores the cortical regulation of the brainstem swallowing center. Drinking ice water can shorten the pharyngeal reaction time, prolong the laryngeal elevation time, and accelerate the laryngeal closure speed [ 30 , 31 ]. Pharyngeal cold stimulation can effectively improve the sensitivity of the soft palate and pharynx, make swallowing easier, attract patients' attention on feeding and swallowing, and reduce aspiration.…”

Section: Discussionmentioning

confidence: 99%

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Effect of Cold Fluid Compensatory Swallowing Combined with Balloon Dilation on the Treatment of Poststroke Cricopharyngeal Achalasia: A Pilot Randomized Controlled Trial

Li¹,

Jin

Gu³

et al. 2022

BioMed Research International

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Objective. This study is aimed at comparing the treatment efficacy between catheter balloon dilation combined with cold fluid compensatory swallowing training and catheter balloon dilation alone on poststroke cricopharyngeal achalasia (CPA). Methods. We conducted a single-blind, randomized controlled trial (RCT). Poststroke patients with CPA were divided into two groups: the control group (treated with catheter balloon dilation) and the trial group (catheter balloon dilation combined with cold fluid compensatory swallowing). Videofluoroscopic swallowing study (VFSS) was performed, and functional oral intake scale (FOIS) was used to evaluate and compare the swallowing function of patients in the 2 groups before and after intervention. Posttreatment VAS pain scores and recovery time were also measured. Results. VFSS and FOIS scores in the two groups were improved after treatment ( P < 0.05 ). In the trial group, VFSS scores in the pharyngeal phase and aspiration degree were significantly higher compared with the control group ( P < 0.05 ) but not in the oral phase ( P > 0.05 ). The difference in FOIS scores and patients’ recovery time from intervention to eating mushy food between the trial and control groups was significant ( P < 0.05 ), but not the VAS scores ( P > 0.05 ). Conclusion. The catheter balloon dilation combined with cold fluid compensatory swallowing was superior to catheter balloon dilation alone in terms of relieving dysphagia and reducing aspiration in patients with CPA following stroke. Long-term efficacy should be followed up with more objective and quantitative indicators in future studies.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Effect of Cold Fluid Compensatory Swallowing Combined with Balloon Dilation on the Treatment of Poststroke Cricopharyngeal Achalasia: A Pilot Randomized Controlled Trial

Li¹,

Jin

Gu³

et al. 2022

BioMed Research International

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“… 39 This finding encouraged us to include this theme as a priority knowing its enormous importance in the daily care of the patient with OD. 30 , 40 As for the psychosocial skills, it was ranked 7th by the participants. The result of the ranking reveals that the psychosocial aspect of OD is less taken into consideration reflecting the reality of OD intervention where mostly the bioclinical aspects are considered.…”

Section: Discussionmentioning

confidence: 99%

Consensus on the Objectives of an Educational Intervention for Patients with Oropharyngeal Dysphagia and Their Informal Caregivers: A Delphi Study

Ghaddar¹,

Matar²,

Noujaim³

et al. 2022

PPA

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Purpose In the absence of literature allowing for an evidence-based approach to therapeutic patient education (TPE) in Oropharyngeal Dysphagia (OD), this study aims to reach a consensus of experts on the content of a competency framework of an educational program for OD patients and their informal caregivers (ICGs). Methods We used the Delphi consensus-building method. Four categories of experts were recruited: 12 patients, 17 ICGs, 46 healthcare professionals (HCP) (experienced in OD, not necessarily certified in TPE), and 19 experts in TPE (trained individuals to set up and run TPE programs not necessarily HCPs). The content of the questionnaire of the first round (R) was established according to the result of a scoping review and the opinion of an expert committee. We carried out three rounds. In R1 and R2, we collected the opinions on the relevance (7-point Likert-type scale) and on comprehensiveness (YES/No question and asking participants to propose additional content). Participants were also invited to leave comments on each objective. In R3, we asked the participants to give their opinion about the relevance of the objectives again and asked them to rank the themes from highest to lowest priority. Results Objectives were considered relevant for all participants if they reached consensus when the interquartile (IQR) ≤ 1, and if the median indicated agreement (Mdn ≥ 6) (6= appropriate, 7 = totally appropriate). Following three rounds, the final content of the educational program is composed of 23 educational objectives organized in 13 themes with an agreement about relevance amongst all participants (Mdn ≥ 6; IQR ≤ 1). The comprehensiveness criterion received also a consensus (IQR ≤ 1). The participants ranked the theme “normal swallowing vs difficulty swallowing” as the highest priority. Conclusion This Delphi study resulted in a consensus, on the content of a competency framework of an educational program for OD patients and their ICGs. Further steps are needed to construct learning activities based on these objectives before testing their feasibility and efficacy.

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“…Dysphagia is any difficulty during bolus transport from the oral cavity to the stomach in the swallowing process ( 1 ). It is one of the most common complications that affecting 37–78% stroke survivors ( 2 , 3 ) and is strongly associated with a high risk of aspiration pneumonia, malnutrition, and increased mortality ( 4 – 6 ).…”

Section: Introductionmentioning

confidence: 99%

Effects of chin tuck against resistance exercise on post-stroke dysphagia rehabilitation: A systematic review and meta-analysis

Liu¹,

Wang²,

Tian³

et al. 2023

Front. Neurol.

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BackgroundChin tuck against resistance (CTAR) exercise was introduced to substitute for the commonly used Shaker exercise for dysphagia rehabilitation. The effects of CTAR exercise in stroke survivors needs to be validated.ObjectiveTo investigate the effects of Chin tuck against resistance (CTAR) exercise on the swallowing function and psychological condition in stroke survivors compared to no exercise intervention and the Shaker exercise.Materials and methodsThe Cochrane Library, PubMed, Web of Science, EMBASE, CINAHL and four Chinese databases were searched for randomized controlled trails (RCTs) and quasi-RCTs from inception to February 2022.ResultsAfter screened and assessed the methodological quality of the studies, nine studies with 548 stroke survivors were included in the systematic review. 8 studies were included in the meta-analysis using RevMan 5.4 software. The mean difference (MD) or standardized mean difference (SMD) with 95% confidence intervals (CIs) were calculated. The results revealed that CTAR exercise is effective in improving swallowing safety (MD, −1.43; 95% CI, −1.81 to −1.06; P < 0.0001) and oral intake ability (SMD, −1.82; 95% CI, −3.28 to −0.35; P = 0.01) compared with no exercise intervention, CTAR exercise is superior to Shaker exercise in improving swallowing safety (MD, −0.49; 95% CI, −0.83 to −0.16; P = 0.004). The psychological condition in CTAR group is significant better than the control group (MD, −5.72; 95% CI, −7.39 to −4.05; P < 0.00001) and Shaker group (MD, −2.20; 95% CI, −3.77 to −0.64; P = 0.006).ConclusionsOur findings support CTAR exercise as a superior therapeutic exercise for post-stroke dysphagia rehabilitation than Shaker exercise. More high-qualities RCTs from larger multicenter are needed to analysis the effects of CTAR exercise in patients with different type and phase of stroke and explore the optimal training dose.

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Best Practice Recommendations for Stroke Patients with Dysphagia: A Delphi-Based Consensus Study of Experts in Turkey-Part II: Rehabilitation

Cited by 20 publications

References 131 publications

Effect of Cold Fluid Compensatory Swallowing Combined with Balloon Dilation on the Treatment of Poststroke Cricopharyngeal Achalasia: A Pilot Randomized Controlled Trial

Effect of Cold Fluid Compensatory Swallowing Combined with Balloon Dilation on the Treatment of Poststroke Cricopharyngeal Achalasia: A Pilot Randomized Controlled Trial

Consensus on the Objectives of an Educational Intervention for Patients with Oropharyngeal Dysphagia and Their Informal Caregivers: A Delphi Study

Effects of chin tuck against resistance exercise on post-stroke dysphagia rehabilitation: A systematic review and meta-analysis

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