Usefulness of Ice Massage in Triggering the Swallow Reflex

Liu

Journal of Stroke and Cerebrovascular Diseases

et al. 2014

Dysphagia after stroke is associated with mortality and increased pulmonary complications. Swallowing therapies may decrease pulmonary complications and improve patients' quality of life after stroke. This study used clinical swallowing assessments and videofluoroscopy (VFS) to assess the functional recovery of acute stroke patients with dysphagia after different swallowing therapies. We enrolled 29 acute stroke patients with dysphagia and randomly divided them into 3 therapy groups: traditional swallowing (TS), oropharyngeal neuromuscular electrical stimulation (NMES), and combined NMES/TS. All patients were assessed using the clinical functional oral intake scale (FOIS), 8-point penetration-aspiration scale (PAS), and functional dysphagia scale (FDS) of VFS before and after treatment. There were no differences in the clinical parameters and swallowing results of the FOIS and VFS before swallowing treatment among the 3 groups (P > .05). TS therapy and combined therapy both had significant swallowing improvement after therapy according to the FOIS and 8-point PAS (P < .05). When comparing the results of the VFS among the 3 groups, we found significant improvements in patients eating cookies and thick liquid after combined NMES/TS therapy (P < .05). In acute stroke patients with dysphagia, combined NMES/TS therapy is the most effective swallowing therapy in taking solid diets and thick liquids.

Section: Introductionmentioning

confidence: 99%

Functional Outcome in Acute Stroke Patients with Oropharyngeal Dysphagia after Swallowing Therapy

Liu

Journal of Stroke and Cerebrovascular Diseases

et al. 2014

NMC Case Report Journal

“…Initially, the patient’s dysphagia was thought to be due to pseudobulbar palsy secondary to the thalamic hemorrhage, and the patient was treated with swallowing rehabilitation. This was comprised of improvement in the oral environment and indirect swallowing exercises (such as ice massage) 14) administered by a speech and language pathologist. The patient, however, continued to have FILS Level 2 severe dysphagia 1 month after onset (Fig.…”

Section: Case Reportmentioning

confidence: 99%

Prolonged Dysphagia due to a Combination of Cerebral Hemorrhage and Diffuse Idiopathic Skeletal Hyperostosis: A Case Report

Moriwaki

Hase

Fujioka

et al. 2016

A 79-year-old man was diagnosed with left thalamic hemorrhage. On admission, the Functional Independence Measure (FIM) motor score was 13 points, and the Food Intake Level Scale (FILS) was Level 2, with the patient needing enteral nutrition. Six months after stroke onset, the FIM motor score had improved to 38 points and the dysphagia to FILS Level 7. The patient was able to ingest easy-to-swallow food orally three times a day, but only after postural adjustment with rotation of the head. Seven months after stroke onset, the FIM motor score had reached 45 points but without further improvement in swallowing function. Videofluoroscopic swallowing evaluation (VF) revealed that the persistence of dysphagia was due to osteophytes on the cervical vertebrae caused by diffuse idiopathic skeletal hyperostosis. On surgical removal of the osteophytes, swallowing function improved to FILS Level 9; the patient was able to ingest normal food in a seated position without postural adjustment. One year after stroke onset, the patient was discharged with an FIM motor score of 59 points and FILS Level 9. At the 2-year follow-up, there was minimal recurrence of the osteophytes, and both motor and swallowing functions were maintained at the same level as at discharge. This case suggests that dysphagia in elderly patients may be due to multiple disorders, and that surgical intervention may occasionally be effective.

Curr Phys Med Rehabil Rep

“…Three studies evaluated the use of sensory stimulation before swallowing or during swallowing. In an acute pilot study, 24 patients with dysphagia post-stroke were treated using ice massage to trigger swallowing and the latency for triggering swallowing on trials with and without ice massage was measured 19 . In the 14 patients with a swallow on every trial, the effect size of the reduction in swallowing latency was moderate.…”

Section: Indirect Therapy Studiesmentioning

confidence: 99%

Relative Efficacy of Swallowing Versus Non-swallowing Tasks in Dysphagia Rehabilitation: Current Evidence and Future Directions

Drulia

Ludlow

2013

Clinical trials published in 2012 and the first six months of 2013 were reviewed. These involved either traditional dysphagia therapy, indirect methods not involving dysphagia therapy or a combination of direct and indirect methods. Of 27 studies, 7 were RCTs, 5 were controlled clinical trials and the remainder were uncontrolled case series. Sixteen studies combined an indirect treatment with traditional dysphagia therapy; only one study examined one technique for direct swallowing therapy. Effect sizes were computed and contrasted for each trial. Traditional dysphagia therapy had small to moderate effect sizes (between 0.3 and 0.6) while spontaneous recovery in acute stroke had effect sizes of 1.2. Placebo effects on patient ratings of degree of improvement on swallowing were estimated as small to moderate. To improve effect sizes, adaptive research designs are needed to develop the optimal methods and dosages of therapy before future clinical trials.