The impact of physical therapy intervention of dysphagia on preventing pneumonia in acute stroke patients: A randomized controlled trial.

IF 1.5 Q3 REHABILITATION

Physiotherapy Research International Pub Date : 2024-07-01 DOI:10.1002/pri.2108

Moshera Darwish, Mohammed S El-Tamawy, Aya Mahmoud, Ahmed S Ali, Heba A Khalifa

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Abstract

Background and objectives: Dysphagia is a common complication following stroke. It corresponds to the development of pneumonia, which is always associated with bad prognosis, longer hospital stays and increased mortality. The aim of the study was to assess the impact of physical therapy intervention of dysphagia on preventing pneumonia in acute stroke patients.

Methods: A single-blind randomized controlled trial was carried out on 70 ischemic stroke patients with oropharyngeal dysphagia, age ranged from 49 to 65 years. They were randomly assigned to two groups (control and study) of equal number. Patients in the control group received oral care and nasogastric tube feeding, while patients in the study group received the same program in addition to the designed physical therapy program (exercises and neuromuscular electrical stimulation). The intervention program was applied for 40 min/session, 1 session/day, and 5 days/week for 4 weeks. Gugging swallowing screen (GUSS), and stroke associated pneumonia (SAP) control and prevention criteria were used to assess dysphagia and incidence of pneumonia at baseline, after two and 4 weeks of intervention for both groups.

Results: Before treatment, all patients were susceptible to pneumonia after two and 4 weeks of intervention; there were a significant increase in GUSS score in both groups with more improvement in favor of the study group (p < 0.05) and a statistically significant increase in incidence of SAP after 2 weeks of intervention only in the control group (p < 0.05). The results also showed a significant negative correlation between GUSS score and SAP (r = - 0.3662, p = 0.0018) IMPLICATIONS FOR PHYSIOTHERAPY PRACTICE: adding physical therapy (exercise therapy and neuromuscular electrical stimulation) to oral care and nasogastric tube feeding is effective in improving oropharyngeal dysphagia and decreasing the incidence of aspiration pneumonia in acute ischemic stroke patients.

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吞咽困难理疗干预对预防急性中风患者肺炎的影响：随机对照试验

背景和目的：吞咽困难是中风后常见的并发症。它与肺炎的发生相对应，而肺炎总是与不良预后、住院时间延长和死亡率增加相关。本研究旨在评估吞咽困难理疗干预对预防急性中风患者肺炎的影响：对 70 名患有口咽吞咽困难的缺血性中风患者进行了单盲随机对照试验。他们被随机分配到人数相等的两组（对照组和研究组）。对照组患者接受口腔护理和鼻胃管喂养，而研究组患者除了接受同样的方案外，还接受了设计好的物理治疗方案（运动和神经肌肉电刺激）。干预计划每节课 40 分钟，每天 1 节课，每周 5 天，持续 4 周。采用吞咽筛查（Gugging swallowing screen，GUSS）和中风相关肺炎（SAP）控制和预防标准来评估两组患者在基线、干预两周后和四周后的吞咽困难和肺炎发病率：治疗前，所有患者在干预两周和四周后均易患肺炎；两组患者的 GUSS 评分均有显著提高，研究组的改善幅度更大（P＜0.05）。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Physiotherapy Research International REHABILITATION-

CiteScore

3.30

自引率

5.90%

发文量

期刊介绍： Physiotherapy Research International is an international peer reviewed journal dedicated to the exchange of knowledge that is directly relevant to specialist areas of physiotherapy theory, practice, and research. Our aim is to promote a high level of scholarship and build on the current evidence base to inform the advancement of the physiotherapy profession. We publish original research on a wide range of topics e.g. Primary research testing new physiotherapy treatments; methodological research; measurement and outcome research and qualitative research of interest to researchers, clinicians and educators. Further, we aim to publish high quality papers that represent the range of cultures and settings where physiotherapy services are delivered. We attract a wide readership from physiotherapists and others working in diverse clinical and academic settings. We aim to promote an international debate amongst the profession about current best evidence based practice. Papers are directed primarily towards the physiotherapy profession, but can be relevant to a wide range of professional groups. The growth of interdisciplinary research is also key to our aims and scope, and we encourage relevant submissions from other professional groups. The journal actively encourages submissions which utilise a breadth of different methodologies and research designs to facilitate addressing key questions related to the physiotherapy practice. PRI seeks to encourage good quality topical debates on a range of relevant issues and promote critical reflection on decision making and implementation of physiotherapy interventions.