Dysphagia最新文献_第4页

Motor Imagery Practice to Improve Respiratory and Cough Function.

IF 2.2 3区医学

Dysphagia Pub Date : 2025-02-26 DOI: 10.1007/s00455-025-10818-2

Cara Donohue

{"title":"Motor Imagery Practice to Improve Respiratory and Cough Function.","authors":"Cara Donohue","doi":"10.1007/s00455-025-10818-2","DOIUrl":"https://doi.org/10.1007/s00455-025-10818-2","url":null,"abstract":"Motor imagery practice (MP), or visualizing performing a task without executing it, is an effective intervention for the limbs and tongue. However, MP of expiratory muscle strength training (EMST) and voluntary cough (VC) has not been explored. We examined the feasibility and impact of MP of VC and EMST on pulmonary and cough function in twenty community-dwelling adults. Participants underwent two baseline research evaluations of maximum expiratory and inspiratory pressure (MEP, MIP), forced vital capacity (FVC), voluntary peak expiratory flow rate (PEF), and cough spirometry. After the second research evaluation, participants underwent five weeks of MP of VC or EMST (alternating assignment, 25 repetitions, 70% training load, daily) at home with weekly telehealth sessions. Participants underwent post-treatment research evaluations of MEP, MIP, FVC, PEF, cough spirometry, and the Exercise Therapy Burden Questionnaire (ETBQ). Treatment adherence and telehealth attendance were tracked. Descriptives and Wilcoxon signed rank tests were performed. MP adherence was 95% and telehealth attendance was 91%. Median (IQR) ETBQ scores were 8 (1, 15), indicating minimal burden. Across both MP groups, increases in PEF from a handheld device (+ 13.7, 95% CI: 1.8, 25.6, p = 0.03) and from cough spirometry (+ 0.71, 95% CI: 0.05, 1.4, p = 0.04) were observed. Increases in PEF from cough spirometry (+ 1.00, 95% CI: 0.12, 1.9, p = 0.04) were observed for the MP VC group. Preliminary data demonstrate MP of VC and EMST is feasible and improves voluntary cough in community-dwelling adults. Future research is needed in larger sample sizes and patient populations with pulmonary, cough, and swallowing impairments.","PeriodicalId":11508,"journal":{"name":"Dysphagia","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143499842","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Effect of Elevation Training Mask on Swallowing Function in Individuals with Parkinson's Disease.

IF 2.2 3区医学

Dysphagia Pub Date : 2025-02-25 DOI: 10.1007/s00455-025-10815-5

Yuval Nachalon, Dina Shpunt, Anat Zait, Yael Oestreicher-Kedem, Liav Hayat, Yarden Ashkenazi, Nogah Nativ-Zeltzer, Peter C Belafsky, Gadi Maayan Eshed, Tanya Gurevich, Yael Manor

{"title":"Effect of Elevation Training Mask on Swallowing Function in Individuals with Parkinson's Disease.","authors":"Yuval Nachalon, Dina Shpunt, Anat Zait, Yael Oestreicher-Kedem, Liav Hayat, Yarden Ashkenazi, Nogah Nativ-Zeltzer, Peter C Belafsky, Gadi Maayan Eshed, Tanya Gurevich, Yael Manor","doi":"10.1007/s00455-025-10815-5","DOIUrl":"https://doi.org/10.1007/s00455-025-10815-5","url":null,"abstract":"To evaluate the impact of the elevation training mask (ETM) on swallowing safety and swallowing efficiency in patients with Parkinson's disease (PWP) when used as a respiratory muscle strengthening tool. Study Design. Prospective cohort study. Setting. Tertiary university-affiliated medical center. Thirteen PWP underwent Fiberoptic Endoscopic Evaluation of Swallowing and spirometry assessments both before and after a 4-week ETM use, which included incrementally increasing resistance each week. Measurements taken included EAT-10, swallowing disturbances questionnaire (SDQ), Penetration Aspiration Score (PAS), Yale Pharyngeal Residue Severity Rating Scale, and Peak Expiratory Flow (PEF). Disease severity was assessed using the Unified Parkinson's Disease Rating Scale (UPDRS). Eleven out of 13 male participants (median age 70 years, UPDRS 33, disease duration 8.5 years) completed the 4-week protocol (84.6% completion rate). Vallecular residue significantly decreased for solids (median from 3.0 [IQR: 2.0-3.0] to 2.0 [IQR: 1.0-2.0], p = 0.028) and semi-solids (from 3.0 [IQR: 2.0-4.0] to 2.0 [IQR: 1.0-3.0], p = 0.025), with a non-significant improvement for liquids (from 2.0 [IQR: 2.0-2.0] to 2.0 [IQR: 1.0-2.0], p = 0.19). Patient-reported outcomes (EAT-10, SDQ, VHI-10, RSI) and PEF showed non-significant trends toward improvement. A 4-week use of ETM, serving as a form of respiratory muscle strengthening, demonstrated specific improvements in vallecular residue for semi-solid and solid consistencies in PWP with dysphagia. While other swallowing and respiratory measures showed positive trends, these changes did not reach statistical significance. Further research with a larger cohort is needed to evaluate ETM's role in swallowing rehabilitation.","PeriodicalId":11508,"journal":{"name":"Dysphagia","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143499837","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Artificial Intelligence in Videofluoroscopy Swallow Study Analysis: A Comprehensive Review.

IF 2.2 3区医学

Dysphagia Pub Date : 2025-02-17 DOI: 10.1007/s00455-025-10812-8

G Sanjeevi, Uma Gopalakrishnan, Rahul Krishnan Pathinarupothi, K Subramania Iyer

{"title":"Artificial Intelligence in Videofluoroscopy Swallow Study Analysis: A Comprehensive Review.","authors":"G Sanjeevi, Uma Gopalakrishnan, Rahul Krishnan Pathinarupothi, K Subramania Iyer","doi":"10.1007/s00455-025-10812-8","DOIUrl":"https://doi.org/10.1007/s00455-025-10812-8","url":null,"abstract":"Videofluoroscopic Swallowing Study (VFSS) is considered the gold standard for diagnosing swallowing disorders, or dysphagia. However, the interpretation of VFSS is susceptible to human bias and subjectivity, resulting in significant inter- and intra-patient variability. In this context, artificial intelligence (AI) has emerged as a potentially valuable tool for physicians. This study reviews state-of-the-art research utilizing AI to analyze VFSS for the assessment of swallowing disorders and to support clinical decision-making. Our comprehensive analysis highlights substantial progress in areas such as pharyngeal phase detection, segmentation and identification of the bolus and hyoid bone, and penetration-aspiration detection. Despite these advancements, an end-to-end automated AI tool for VFSS analysis has yet to be developed. However, there is considerable potential for AI applications in areas like exploring the clinical relevance of segmented or tracked components and expanding the scope to include more upper aerodigestive components in the analysis. Additionally, we discuss the limitations of current research, including the lack of publicly available datasets, the need to address the generalizability of AI models, the integration of cutting-edge AI techniques, and the clinical implications for speech-language pathologists.","PeriodicalId":11508,"journal":{"name":"Dysphagia","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143440286","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Predictive Power of Pharyngolaryngeal Secretion Accumulations for Penetration and Aspiration in Head and Neck Cancer Patients.

IF 2.2 3区医学

Dysphagia Pub Date : 2025-02-13 DOI: 10.1007/s00455-024-10801-3

J Hötzel, E Zaretsky, A Goeze, C Hey

{"title":"Predictive Power of Pharyngolaryngeal Secretion Accumulations for Penetration and Aspiration in Head and Neck Cancer Patients.","authors":"J Hötzel, E Zaretsky, A Goeze, C Hey","doi":"10.1007/s00455-024-10801-3","DOIUrl":"https://doi.org/10.1007/s00455-024-10801-3","url":null,"abstract":"Pharyngolaryngeal secretions, penetration, and aspiration belong to the cardinal symptoms of swallowing disorders in head and neck cancer patients. In order to provide safe swallowing diagnostics, it is of interest whether pharyngolaryngeal secretion accumulations can be used as a predictor for penetration and aspiration of food and liquids. This study analyzed the predictive power of pharyngolaryngeal secretion accumulations for the penetration and aspiration in head and neck cancer patients. Between 2016 - 2024, 403 head and neck cancer patients underwent swallowing diagnostics via Fiberoptic Endoscopic Evaluation of Swallowing (FEES). Pharyngolaryngeal secretions were graded with the secretion severity rating scale (SSRS) by Murray et al., penetration and aspiration with the penetration-aspiration scale (PAS) by Rosenbek et al. Both scales were cross-tabulated and correlated with each other. Possible influencing factors on PAS were analyzed by Spearman's correlations and Kruskal-Wallis-H-tests: patients' age, tumor stage and site, type of the oncological therapy, and time of examination. A linear regression and a Categorical Principal Components Analysis were utilized for the same purpose. Higher SSRS and PAS values tended to co-occur. In univariate calculations, the tumor stage and time of examination showed significant correlations with PAS. In multivariate analyses, the tumor stage, patients' age, but above all the SSRS were shown to be significant influencing factors on PAS. Pharyngolaryngeal secretion accumulations can be used for the prediction of aspiration of food and liquids and thus for the improvement of safety of the swallowing diagnostics via FEES.","PeriodicalId":11508,"journal":{"name":"Dysphagia","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143406403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Acoustic and Perceptual Profiles of Swallowing Sounds in Preterm Neonates: A Cross-Sectional Study Cohort.

IF 2.2 3区医学

Dysphagia Pub Date : 2025-02-11 DOI: 10.1007/s00455-025-10807-5

Thuy T Frakking, Seiji Humphries, Anne B Chang, Belinda Schwerin, Majorie M Palmer, Michael David, Annelise Kyriakou, Stephen So

{"title":"Acoustic and Perceptual Profiles of Swallowing Sounds in Preterm Neonates: A Cross-Sectional Study Cohort.","authors":"Thuy T Frakking, Seiji Humphries, Anne B Chang, Belinda Schwerin, Majorie M Palmer, Michael David, Annelise Kyriakou, Stephen So","doi":"10.1007/s00455-025-10807-5","DOIUrl":"https://doi.org/10.1007/s00455-025-10807-5","url":null,"abstract":"Cervical auscultation, commonly used by speech-language pathologists in some countries as an adjuvant to the clinical feeding evaluation, requires data on acoustic and perceptual profiles of swallowing sounds. Whilst these exists in adults and children, none currently exist for preterm neonates. Our study aims to establish the acoustic and perceptual parameters of swallowing sounds in preterm neonates. Swallowing sounds were recorded on a digital microphone during oral feeding observations. Acoustic parameters of duration, peak frequency, peak power and peak intensity were determined. Perceptual parameters heard pre, during and post-swallows were rated as 'present', 'absent', or 'cannot be determined'. Eighty preterm neonates (43 males; mean age = 33.4 weeks [SD 2.6]) from three Australian special care nurseries demonstrated mean swallow durations of < 1 s. The peak amplitude correlated with the number of medical co-morbidities (r = 0.24; 95%CI 0.03-0.45). Most preterm neonates have coordinated swallows that are loud, quick and completed in < 1 s. The perceptual parameters of a bolus transit sound was consistently present in all preterm neonates. One in five pre-term neonates have an uncoordinated swallow where wheeze, stridor or wet breath sounds were present post-swallow. Our study provides clinicians with acoustic and perceptual parameters to guide use of cervical auscultation in special care nurseries. Future studies should consider simultaneous instrumental assessment to ensure validity when using cervical auscultation to support diagnostic decision-making on swallowing coordination.","PeriodicalId":11508,"journal":{"name":"Dysphagia","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143398785","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Recovery of Swallowing Function and Prognostic Factors Associated with Exacerbation of Post-stroke Dysphagia.

IF 2.2 3区医学

Dysphagia Pub Date : 2025-02-07 DOI: 10.1007/s00455-025-10804-8

Seung Jun Lee, So Young Lee, Min Kyun Sohn, Jongmin Lee, Deog Young Kim, Yong-Il Shin, Gyung-Jae Oh, Yang-Soo Lee, Min Cheol Joo, Min-Keun Song, Junhee Han, Jeonghoon Ahn, Young-Hoon Lee, Yun-Hee Kim, Won Hyuk Chang

{"title":"Recovery of Swallowing Function and Prognostic Factors Associated with Exacerbation of Post-stroke Dysphagia.","authors":"Seung Jun Lee, So Young Lee, Min Kyun Sohn, Jongmin Lee, Deog Young Kim, Yong-Il Shin, Gyung-Jae Oh, Yang-Soo Lee, Min Cheol Joo, Min-Keun Song, Junhee Han, Jeonghoon Ahn, Young-Hoon Lee, Yun-Hee Kim, Won Hyuk Chang","doi":"10.1007/s00455-025-10804-8","DOIUrl":"https://doi.org/10.1007/s00455-025-10804-8","url":null,"abstract":"Post-stroke dysphagia is a common and debilitating complication affecting millions of people worldwide, often leading to malnutrition, pneumonia, and reduced quality of life. This study, an interim analysis of the Korean Study Cohort for Functional and Rehabilitation, aimed to identify long-term changes and predictive factors associated with post-stroke dysphagia at 3 years after stroke. A total of 4735 patients with acute first-ever stroke, including both ischemic and hemorrhagic subgroups, were followed, and dysphagia was assessed using the ASHA-NOMS scale. All the patients were then followed up for up to 36 months. The results showed significant improvements in dysphagia up to 12 months after stroke in the total and hemorrhagic stroke group, and the decline in swallowing function after 24 months in the total stroke and ischemic stroke groups was a novel finding. The hemorrhagic stroke group showed worsening dysphagia after 30 months. It is unclear whether patients who experienced worsening of swallowing function had other conditions, including new strokes, that might have contributed to this decline. Male gender, age at stroke, K-FAST at 7 days, ASHA-NOMS scale, mRS score at 3 months, and early comprehensive rehabilitation were identified as predictors of a decrease in the ASHA-NOMS score after 24 months. Additionally, the K-MBI score at 3 months post-stroke was found to be a significant factor influencing long-term improvements in swallowing function. These findings suggest that patients should be closely monitored for dysphagia beyond 24 months after stroke onset, as swallowing function may decline over time. During follow-up, it is essential to carefully consider the multiple factors associated with this decline.","PeriodicalId":11508,"journal":{"name":"Dysphagia","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143364042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Development and Psychometric Evaluation of the Swallowing Satisfaction Scale (SSS).

IF 2.2 3区医学

Dysphagia Pub Date : 2025-02-06 DOI: 10.1007/s00455-025-10802-w

Ali Yousefzadeh, Mozhgan Asadi, Banafshe Mansuri, Maryam Mokhlesin, Ronald Callaway Scherer, Keyhan Poorali, Seyed Abolfazl Tohidast

{"title":"Development and Psychometric Evaluation of the Swallowing Satisfaction Scale (SSS).","authors":"Ali Yousefzadeh, Mozhgan Asadi, Banafshe Mansuri, Maryam Mokhlesin, Ronald Callaway Scherer, Keyhan Poorali, Seyed Abolfazl Tohidast","doi":"10.1007/s00455-025-10802-w","DOIUrl":"https://doi.org/10.1007/s00455-025-10802-w","url":null,"abstract":"The purpose of the current study was to develop a new scale to assess a level of satisfaction associated directly with swallowing ability. First, by interviewing 10 adults with dysphagia, 10 experts, as well as reviewing literature, the initial version of the swallowing satisfaction scale (SSS) was developed. The content validity of the SSS was evaluated using two qualitative and quantitative methods and expert opinions. The qualitative method was also used to determine face validity through interviews with 10 adults with dysphagia. Finally, the reliability of the scale was assessed by determining the values of internal consistency and test-retest reliability. Interviews with patients with swallowing disorders and experts in the field of dysphagia, as well as a literature review, led to the development of an initial version of the SSS with 36 items. After determining content and face validity, the number of items in the scale was reduced to 24. The calculation of Cronbach's alpha coefficient with participation of 53 patients with dysphagia showed the appropriate internal consistency of the SSS (0.968). Moreover, the ICC coefficient of the scale score in the test-retest phase was 0.983 and the ICC of each scale item was between 0.87 and 0.98. In this study, a suitable tool was developed to evaluate the level of satisfaction associated directly with swallowing ability in individuals with dysphagia, and its psychometric properties were investigated. The SSS is a valid and reliable tool with 24 items that can be used by therapists and researchers for clinical or research purposes.","PeriodicalId":11508,"journal":{"name":"Dysphagia","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143255093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Association Between Phase Angle and Tongue Pressure in Older Inpatients with Connective Tissue Diseases.

IF 2.2 3区医学

Dysphagia Pub Date : 2025-02-05 DOI: 10.1007/s00455-025-10806-6

Toshiyuki Moriyama, Mizuki Tokunaga, Ryoko Hori, Akiko Hachisuka, Hideaki Itoh, Mitsuhiro Ochi, Yasuyuki Matsushima, Satoru Saeki

{"title":"Association Between Phase Angle and Tongue Pressure in Older Inpatients with Connective Tissue Diseases.","authors":"Toshiyuki Moriyama, Mizuki Tokunaga, Ryoko Hori, Akiko Hachisuka, Hideaki Itoh, Mitsuhiro Ochi, Yasuyuki Matsushima, Satoru Saeki","doi":"10.1007/s00455-025-10806-6","DOIUrl":"https://doi.org/10.1007/s00455-025-10806-6","url":null,"abstract":"To investigate the association between tongue pressure (TP) and phase angle (PhA) in patients with connective tissue diseases (CTDs) aged 65 years or older. This retrospective cross-sectional study was conducted on 189 patients with CTDs who underwent hospital rehabilitation. TP was measured using a tongue pressure measuring device, and PhA was calculated from the bioimpedance analysis readings. Statistical analyses included multivariate linear regression with TP and receiver operating characteristic curves to determine PhA cutoff values indicative of low TP, defined as < 24.3 kPa for men and < 23.7 kPa for women. A total of 189 patients with CTDs (mean age 75 years; 49 men and 140 women; mean PhA 4.0°; mean TP 27.7 kPa) were included in the analysis. Fifty-five patients had low TP. Patients with low TP had lower PhA values than those with normal TP (mean PhA values 3.5° versus 4.3°). After adjusting for confounding factors, PhA (β = 0.387, p < 0.001) was significantly associated with TP. Cutoff values for PhA predicting low TP were identified as 3.9° for men and 3.5° for women. PhA is associated with TP, independent of other factors, in older inpatients with CTDs. The identified PhA cutoff values could enable the early detection of declining TP.","PeriodicalId":11508,"journal":{"name":"Dysphagia","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143187737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Barriers and Facilitators to implementation of the Free Water Protocol in the Acute Stroke Unit Setting: A Mixed Methods Systematic Review. 在急性卒中单元实施免费饮水方案的障碍和促进因素：混合方法系统回顾

IF 2.2 3区医学

Dysphagia Pub Date : 2025-02-05 DOI: 10.1007/s00455-025-10805-7

Sabrina A Eltringham, Nicola Martindale, Elizabeth Lightbody, Sue Pownall, Andrew Booth, Craig J Smith

{"title":"Barriers and Facilitators to implementation of the Free Water Protocol in the Acute Stroke Unit Setting: A Mixed Methods Systematic Review.","authors":"Sabrina A Eltringham, Nicola Martindale, Elizabeth Lightbody, Sue Pownall, Andrew Booth, Craig J Smith","doi":"10.1007/s00455-025-10805-7","DOIUrl":"https://doi.org/10.1007/s00455-025-10805-7","url":null,"abstract":"Free water protocols (FWP) give patients at risk of aspiration the option to drink water between meals. Evidence is lacking about their use in acute stroke care. This systematic review evaluated the literature about barriers and facilitators to FWP implementation in acute stroke unit settings. Electronic databases and grey literature sources were systematically searched, eligible studies were critically appraised, and data extracted and mapped onto the Consolidated Framework for Implementation Research (CFIR). The results are presented in a narrative synthesis. Five studies were identified for inclusion: Two qualitative studies, 1 mixed method study, 1 randomised controlled trial and 1 pilot cohort study. Barriers and facilitators to implementation were identified across the 5 CFIR domains. Key barriers were a lack of evidence base and a standard protocol, trying to adapt and deliver a protocol designed for a different setting, complexity of patient selection and FWP design, culture of risk aversion, nursing staff availability and skills to deliver the FWP, and a greater use of agency nurses and transient workforce. Key facilitators were the existence of national guidance for research into its use, implementation of oral care protocols prior to FWP implementation, the unique characteristics of the acute stroke setting, leadership and modelling by senior clinicians, interdisciplinary working and accountability for roles and responsibilities for each discipline, regular communication and ongoing education, and involving patients in decision making and implementation. The findings of this review will guide the data collection of a feasibility study of the FWP in acute stroke.","PeriodicalId":11508,"journal":{"name":"Dysphagia","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143188065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Effects of Thickening Agents on the Mucociliary Transport Function: Comparison by the Type of Thickening Agents and the Viscosity of Thickened Water. 增稠剂对黏膜纤毛运输功能的影响：增稠剂类型与增稠水粘度的比较

IF 2.2 3区医学

Dysphagia Pub Date : 2025-02-01 Epub Date: 2024-05-22 DOI: 10.1007/s00455-024-10704-3

Erika Matsumura, Kanji Nohara, Hikari Fukatsu, Nobukazu Tanaka, Nami Fujii, Takayoshi Sakai

{"title":"Effects of Thickening Agents on the Mucociliary Transport Function: Comparison by the Type of Thickening Agents and the Viscosity of Thickened Water.","authors":"Erika Matsumura, Kanji Nohara, Hikari Fukatsu, Nobukazu Tanaka, Nami Fujii, Takayoshi Sakai","doi":"10.1007/s00455-024-10704-3","DOIUrl":"10.1007/s00455-024-10704-3","url":null,"abstract":"Thickening agents effectively prevent liquid aspiration, but their impact on the ease of discharging aspirated liquids from the trachea remains unclear due to alterations in the physical properties of liquids. This study clarifies the effects of thickening agents, comprising various raw materials, on mucociliary transport function, focusing on the viscosities of thickened waters. The subjects were 23 healthy adults. Five types of saccharin solution were prepared: a solution without a thickening agent, a starch-based nectar-like solution, a starch-based honey-like solution, a xanthan-gum-based nectar-like solution, and a xanthan-gum-based honey-like solution. Using these five types of saccharin solutions randomly, each subject underwent five trials of the saccharine dye test to evaluate the mucociliary transport function of the respiratory tract. The saccharin time was defined as the time from the placement of the saccharin solution on the nasal vestibule of the subject to when the subject reported that they became aware of the sweetness. The saccharin transit times for all samples of thickened water were longer compared to those of water without a thickening agent (p < 0.01). A comparison between thickened water samples with different viscosities showed that the saccharin transit time was longer when thickened water samples with high viscosity were prepared using the same thickening agent (p < 0.01). This suggests that while thickening reduces aspiration, the use of thickening agents may increase the difficulty in discharging aspirated fluids from the trachea.","PeriodicalId":11508,"journal":{"name":"Dysphagia","volume":" ","pages":"70-76"},"PeriodicalIF":2.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11762424/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141079685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0