Effects of Cervical Bracing on Elderly Patients With Dysphagia.

IF 2.3 3区 医学 Q1 AUDIOLOGY & SPEECH-LANGUAGE PATHOLOGY
Jodi Hernandez, Glen Leverson, Susan L Thibeault
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引用次数: 0

Abstract

Purpose: This study aimed to determine if cervical bracing with a PMT collar increases risk of airway invasion and pharyngeal residue in elderly patients with dysphagia. Additionally, it aimed to identify patient preference for cervical bracing during deglutition.

Method: Twenty-one patients underwent a videofluoroscopic swallow study. Thin liquid, nectar thick liquid, pudding, and cracker were administered with cervical collar on and off with order of condition randomized. The Penetration-Aspiration Scale (PAS) was used to grade swallows, with McNemar's test of symmetry used to determine whether the categorical PAS score was similar between conditions. Pharyngeal residue was measured following swallows. Patients were asked which condition they preferred, and which was more comfortable with "no difference" being a selection.

Results: No significant difference in PAS categorization score was measured for any consistency (p = .317-.919). Significantly more pyriform sinus residue was measured in the collar off condition (p = .003), albeit amounts were within normative range, with no difference measured in vallecula residue between conditions (p = .939). Forty-five percent of participants preferred to swallow with the collar off, while 55% indicated no preference. Forty-one percent of participants indicated increased comfort with collar off, while 59% indicated no difference in comfort. No participant preferred swallowing or indicated increased comfort with the collar on.

Conclusions: Presence of a cervical collar in elderly patients with dysphagia did not result in a significant difference in airway invasion or total pharyngeal residue. There was significantly more residue in the pyriform sinuses when cervical bracing was removed. The majority of patients did not indicate a difference in preference or comfort between collar on/off conditions.

颈椎支架对吞咽困难老年患者的影响
目的:本研究旨在确定使用 PMT 颈圈进行颈部支撑是否会增加老年吞咽困难患者气道受侵和咽部残留物的风险。此外,研究还旨在确定患者在脱口时对颈部支撑的偏好:21名患者接受了视频荧光屏吞咽研究。方法:21 名患者接受了视频荧光屏吞咽研究,稀薄液体、花蜜浓稠液体、布丁和饼干分别在颈托开启和关闭的情况下吞咽,条件顺序随机。采用渗透-吐气量表(PAS)对吞咽进行分级,并通过麦克尼玛对称性检验来确定不同条件下的 PAS 分类得分是否相似。吞咽后测量咽残留物。患者被问及他们更喜欢哪种情况,哪种情况更舒适,"无差别 "可作为一种选择:结果:在任何一致性条件下,PAS 分类得分均无明显差异(p = .317-.919)。在关闭衣领的条件下,测得的梨状窦残留物明显较多(p = .003),尽管数量在正常范围内,但在不同条件下测得的瓣膜残留物没有差异(p = .939)。45%的受试者喜欢关闭衣领吞咽,55%的受试者表示不喜欢。41%的受试者表示关闭衣领后会更舒适,59%的受试者表示舒适度没有差别。没有人表示喜欢戴颈圈吞咽或戴颈圈会更舒适:结论:有吞咽困难的老年患者佩戴颈圈不会导致气道入侵或咽部残留物总量的显著差异。去除颈托后,梨状窦中的残留物明显增多。大多数患者并没有表示在戴/不戴颈圈的情况下在喜好或舒适度方面存在差异。
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来源期刊
American Journal of Speech-Language Pathology
American Journal of Speech-Language Pathology AUDIOLOGY & SPEECH-LANGUAGE PATHOLOGY-REHABILITATION
CiteScore
4.30
自引率
11.50%
发文量
353
审稿时长
>12 weeks
期刊介绍: Mission: AJSLP publishes peer-reviewed research and other scholarly articles on all aspects of clinical practice in speech-language pathology. The journal is an international outlet for clinical research pertaining to screening, detection, diagnosis, management, and outcomes of communication and swallowing disorders across the lifespan as well as the etiologies and characteristics of these disorders. Because of its clinical orientation, the journal disseminates research findings applicable to diverse aspects of clinical practice in speech-language pathology. AJSLP seeks to advance evidence-based practice by disseminating the results of new studies as well as providing a forum for critical reviews and meta-analyses of previously published work. Scope: The broad field of speech-language pathology, including aphasia; apraxia of speech and childhood apraxia of speech; aural rehabilitation; augmentative and alternative communication; cognitive impairment; craniofacial disorders; dysarthria; fluency disorders; language disorders in children; speech sound disorders; swallowing, dysphagia, and feeding disorders; and voice disorders.
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