Document Detail


Rehabilitation of swallowing by exercise in tube-fed patients with pharyngeal dysphagia secondary to abnormal UES opening.
MedLine Citation:
PMID:  11984518     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND & AIMS: We evaluated the effect of a novel rehabilitative exercise on restoration of deglutition in a group of patients with deglutitive failure caused by abnormal upper esophageal sphincter (UES) opening manifested by postswallow residue and aspiration necessitating percutaneous tube feeding. METHODS: We studied a total of 27 patients by videofluoroscopy and functional assessment of swallowing scores before and after 6 weeks of a head-raising exercise program. Seven of 27 patients, assigned randomly, participated in a sham exercise before entering the tested exercise program. Eleven of 27 were randomized to the real exercise program. RESULTS: Although there was no change in swallow function and biomechanics after the sham exercise, following 6 weeks of real exercise, all 11 patients exhibited a significant improvement in their UES opening, anterior laryngeal excursion (P < 0.01), as well as resolution of postdeglutitive aspiration and were able to resume oral feeding. Similar results were found when the 7 patients in the sham group were crossed over to the real exercise group. Comparison of before and after exercise values for anteroposterior UES opening (P < 0.01) and laryngeal anterior excursion (P < 0.05), as well as functional outcome assessment of swallowing (P < 0.05) in the entire group of 27 patients also showed significant improvement. Etiology and duration of dysphagia did not affect the outcome. CONCLUSIONS: The proposed suprahyoid muscle strengthening exercise program is effective in restoring oral feeding in some patients with deglutitive failure because of abnormal UES opening.
Authors:
Reza Shaker; Caryn Easterling; Mark Kern; Terilynn Nitschke; Benson Massey; Stephanie Daniels; Barbara Grande; Marta Kazandjian; Karen Dikeman
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Gastroenterology     Volume:  122     ISSN:  0016-5085     ISO Abbreviation:  Gastroenterology     Publication Date:  2002 May 
Date Detail:
Created Date:  2002-05-01     Completed Date:  2002-05-23     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0374630     Medline TA:  Gastroenterology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1314-21     Citation Subset:  AIM; IM    
Affiliation:
MCW Dysphagia Institute, Division of Gastroenterology and Hepatology, Digestive Disease Center, Medical College of Wisconsin and Zablocki VA Medical Center, Milwaukee, Wisconsin 53226, USA. rshaker@mcw.edu
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Biomechanics
Cross-Over Studies
Deglutition*
Deglutition Disorders / rehabilitation*
Enteral Nutrition*
Esophagogastric Junction / physiopathology*
Exercise*
Female
Humans
Male
Observer Variation
Pharyngeal Diseases / rehabilitation*
Reproducibility of Results
Grant Support
ID/Acronym/Agency:
R01 DC00669/DC/NIDCD NIH HHS

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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