Category: Neurodegenerative Disease (e.g. MS, Parkinson's disease); Geriatric Rehabilitation
To investigate the effect of swallowing rehabilitation on dysphagia in patients with Parkinsonian disorders.
Design : A retrospective study.
Setting : A tertiary hospital.
Participants (or Animals, Specimens, Cadavers) :
Medical records of 254 dysphagic patients with Parkinsonian disorders were reviewed. Among them, 222 patients were excluded by 1) no follow up VFSS data between 60 and 120 days, 2) received less than two sessions of swallowing rehabilitation, and 3) any other neurological problems affecting dysphagia. Finally, 32 patients were included in this study.
Any conventional swallowing rehabilitation.
Main Outcome Measure(s) :
Patients were evaluated using Penetration-Aspiration Scale (PAS), Videofluoroscopic Dysphagia Scale (VDS) measured from the VFSS, American Speech–Language–Hearing Association’s National Outcome Measurement System (ASHA NOMS) swallowing scale, and Swallowing Disturbance Questionnaire (SDQ). We reviewed those outcomes before and after treatment from patients’ medical records.
Patients received 8.97 ± 5.46 swallowing rehabilitation sessions for 82.98 ± 15.46 days. There was a significant decrease in PAS score from 8 (IQR 5.25-8.00) to 5 (IQR 2.00-7.75) (P = .003). The VDS score was significantly decreased from 49.67 ± 15.10 to 43.58 ± 17.45 (P = .008). Especially when classified as swallowing stage, pharyngeal phase score in VDS significantly changed from 37.97 ± 12.31 to 32.23 ± 14.41 (P = .002) after treatment but not in oral phase (P = .750). Among the VDS items, only pharyngeal transit time was significantly decreased (P = .011). There were no significant changes in ASHA NOMS and SDQ score (P = .224 and P = .806, respectively).
Conclusions : The swallowing rehabilitation may improve objective swallowing function, especially in the pharyngeal phase, in patients with Parkinsonian disorders. Our findings are preliminary and require further prospective study.
Seo Jung Yun– Researcher, Seoul National University Hospital, Jongro-gu, Seoul-t'ukpyolsi
Han Gil Seo– Clinical Assistant Professor, Seoul National University Hospital
Min-Gu Kang– Fellow, Seoul National University Hospital, Jongno-gu, Seoul-t'ukpyolsi
Heejae Kim– Fellow, Seoul National University Hospital, Jongno-gu, Seoul-t'ukpyolsi
Byung-Mo Oh– Fellow, Seoul National University Hospital, Jongno-gu, Seoul-t'ukpyolsi