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Effects of Motor and Sensory Stimulation in Stroke Patients with Long-Lasting Dysphagia

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Abstract

Dysphagia is a common poststroke symptom with negative effects on recovery and rehabilitation. However, the orofacial regulation therapy, developed by Castillo Morales, comprising body regulation and orofacial regulation in combination with a palatal plate application has shown promising results in stroke patients. This therapy is based not only on muscle exercises but also on an improvement of the entire sensory-motor reflex arc involved in normal deglutition, and on the knowledge that the function of face and oropharynx at deglutition is closely interrelated with the entire body posture as well as with appropriate breathing. The treatment concept is relatively unknown to caregivers, partly due to lack of scientific evaluation of treatment results. The present investigation aimed to assess the effect of motor and sensory stimulation in stroke patients with dysphagia persisting for more than six months. Seven patients were evaluated with respect to orofacial and pharyngeal motility and sensory function before and two weeks after a five-week treatment period. The evaluation comprised a swallowing capacity test, a meal observation test, clinical examination of oral motor and sensory function, a velopharyngeal closure test, and videofluoroscopy. In addition, the symptoms were scored by the patients. An overall single-blind estimation showed objective and self-assessed swallowing improvement in all seven patients. Kappa coefficients are calculated on all reliability data, both inter- and intrarater reliabilities. Sensory and motor stimulation seems to be a promising therapy in stroke patients with long-lasting and persistent oropharyngeal dysphagia.

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References

  1. RC Castillo Morales JJ Brondo B Haberstock (1991) Darstellung der funktion der verschiadenenen elemente des orofaxialen komplexes Die orofaziale Regulationstherapie EditionNumber1 Richard Pflaum Verlag GmbH & Co. München 21–188

    Google Scholar 

  2. GJ Limbrock H Fischer–Brandies C Avalle (1991) ArticleTitleCastillo Morales’ orofacial therapy: treatment of 67 children with Down syndrome Dev Med Child Neurol. 33 296–303 Occurrence Handle1:STN:280:By6B2Mjktl0%3D Occurrence Handle1828445

    CAS  PubMed  Google Scholar 

  3. PK Anokhin (1964) Systemogenesis as a general regulator of brain development WA Himwich HE Himwich (Eds) The Developing Brain Elsevier New York 54–86

    Google Scholar 

  4. JK Chusid (1985) Correlative Neuroanatomy & Functional Neurology LANGE Medical Publication Los Altos, CA

    Google Scholar 

  5. L Heimer (1983) The Human Brain & Spinal Cord New York Spring Verlag

    Google Scholar 

  6. KM Nathadwarawala J Nicklin CM Wiles (1992) ArticleTitleA timed test of swallowing capacity for neurological patients J Neurol Neurosurg Psychiatry 55 822–825 Occurrence Handle1:STN:280:ByyD3MbjtlQ%3D Occurrence Handle1402974

    CAS  PubMed  Google Scholar 

  7. JA Logemann (1998) Evaluation and Treatment of Swallowing Disorder EditionNumber2 Pro-ed Austin, TX 91–95

    Google Scholar 

  8. JR Landis GG Koch (1977) ArticleTitleThe measurement of observer agreement for categorical data Biometrics 33 IssueID1 159–174 Occurrence Handle1:STN:280:CSiC3srhvFI%3D Occurrence Handle843571

    CAS  PubMed  Google Scholar 

  9. L Hartelius P Svensson A Bubach (1993) ArticleTitleClinical assessment of dysarthria: Performance on a dysarthria test by normal adult subjects, and by individuals with Parkinson’s disease or with multiple sclerosis Scand J Logop Phoniatr 18 131–141

    Google Scholar 

  10. W Hardcastle (1976) Physiology of Speech Production Academic Press London

    Google Scholar 

  11. KH Calhoun B Gibson L Hartley J Minton JA Hokanson (1992) ArticleTitleAge-related changes in oral sensation Laryngoscope 102 109–116 Occurrence Handle1:STN:280:By2C2cbit1M%3D Occurrence Handle1738279

    CAS  PubMed  Google Scholar 

  12. R Netsell TA Hixon (1978) ArticleTitleNon-invasive method for clinically estimating subglottal air pressure J Speech Hear Disord 43 326–330 Occurrence Handle1:STN:280:CSaD3cbhsVA%3D Occurrence Handle692098

    CAS  PubMed  Google Scholar 

  13. TR Han NJ Paik JW Park (2001) ArticleTitleQuantifying swallowing function after stroke: A functional dysphagia scale based on videofluoroscopic studies Arch Phys Med Rehabil 82 677–682 Occurrence Handle10.1053/apmr.2001.21939 Occurrence Handle1:STN:280:DC%2BD3M3ltVKgtw%3D%3D Occurrence Handle11346847

    Article  CAS  PubMed  Google Scholar 

  14. RE Perkins PL Blanton N Biggs (1977) ArticleTitleElectromyographic analysis of the “buccinator mechanism” in human beings J Dent Res 56 783–794 Occurrence Handle1:STN:280:CSeD3cngtFE%3D Occurrence Handle269159

    CAS  PubMed  Google Scholar 

  15. H Hoyer GJ Limbrock (1990) ArticleTitleOrofacial regulation therapy in children with Down syndrome, using the methods and appliances of Castillo Morales ASDC J Dent Child 57 442–444 Occurrence Handle1:STN:280:By6D2sbjtlQ%3D Occurrence Handle2147926

    CAS  PubMed  Google Scholar 

  16. B Gustavsson L Tibbling (1991) ArticleTitleDysphagia, an unrecognized handicap Dysphagia 6 193–199 Occurrence Handle1838076

    PubMed  Google Scholar 

  17. DH Barer (1989) ArticleTitleThe natural history and functional consequences of dysphagia after hemispheric stroke J Neurol Neurosurg Psychiatry 52 236–241 Occurrence Handle1:STN:280:BiaC1MbgtVw%3D Occurrence Handle2564884

    CAS  PubMed  Google Scholar 

  18. H Nilsson O Ekberg R Olsson B Hindfelt (1998) ArticleTitleDysphagia in stroke: a prospective study of quantitative aspects of swallowing in dysphagic patients Dysphagia 13 IssueID1 32–38 Occurrence Handle1:STN:280:DyaK1c%2FlsVWksg%3D%3D Occurrence Handle9391228

    CAS  PubMed  Google Scholar 

  19. C Gordon R Langton Hewer D Wade (1987) ArticleTitleDysphagia in acute stroke Br Med J (Clin Res Ed) 295 411–414 Occurrence Handle1:STN:280:BieD3c7ksFE%3D

    CAS  Google Scholar 

  20. S Hamdy Q Aziz JC Rothwell M Power KD Singh D Nicholson RC Tallis DG Thompson (1998) ArticleTitleRecovery of swallowing after dysphagic stroke relates to functional reorganisation in the intact motor cortex Gastroenterology 115 1104–1112 Occurrence Handle1:STN:280:DyaK1M%2FhsVWqtQ%3D%3D Occurrence Handle9797365

    CAS  PubMed  Google Scholar 

  21. H Cohen (1993) Neuroscience for Rehabilitation Lippincott Philadalphia, JB

    Google Scholar 

  22. S Hamdy Q Aziz JC Rothwell R Crone D Hughes RC Tallis DG Thompson (1997) ArticleTitleExplaining oropharyngeal dysphagia after unilateral hemispheric stroke Lancet 350 IssueID9079 686–692 Occurrence Handle10.1016/S0140-6736(97)02068-0 Occurrence Handle1:STN:280:ByiH3sjjs10%3D Occurrence Handle9291902

    Article  CAS  PubMed  Google Scholar 

  23. S Davis (1999) ArticleTitleDysphagia in acute strokes Nurs Stand 13 IssueID30 49–54

    Google Scholar 

  24. RM Miller MW Chang (1999) ArticleTitleAdvances in the management of dysphagia caused by stroke Phys Med Rehabil Clin North Am 10 IssueID4 925–941 Occurrence Handle1:STN:280:DC%2BD3c%2FktFSisw%3D%3D

    CAS  Google Scholar 

  25. JA Logemann (1999) ArticleTitleBehavioral management for oropharyngeal dysphagia Folia Phoniatr Logop 51 IssueID4–5 199–212 Occurrence Handle10.1159/000021497 Occurrence Handle1:STN:280:DyaK1MzotVShsQ%3D%3D Occurrence Handle10450026

    Article  CAS  PubMed  Google Scholar 

  26. LC Lin SC Wang SH Chen TG Wang MY Chen SC Wu (2003) ArticleTitleEfficacy of swallowing training for residents following stroke Adv Nurs 44 IssueID5 469–478 Occurrence Handle10.1046/j.0309-2402.2003.02830.x Occurrence Handle14651695

    Article  PubMed  Google Scholar 

  27. C Ertekin I Aydogdu (2003) ArticleTitleNeurophysiology of swallowing Clin Neurophysiol 114 IssueID12 2226–2244 Occurrence Handle10.1016/S1388-2457(03)00237-2 Occurrence Handle14652082

    Article  PubMed  Google Scholar 

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Acknowledgments

This study was supported by a grant from the Board of Rehabilitation and Technical Aids for the Disabled and The Centre for Research & Development in the County Council of Gävleborg, Sweden. Many thanks go to Lita Tibbling Grahn, M.D., Ph.D, for invaluable help with the manuscript and interpretation of data, and to Reimond Dempwolf for help with editing the illustrations.

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Authors and Affiliations

  1. Speech and Swallowing Centre, ENT Department, Hudiksvall Hospital, Hudiksvall, Sweden

    Mary Hägg DDS

  2. Centre of Research & Development, Uppsala University/County Council of, Gävleborg, Sweden

    Mary Hägg DDS

  3. Department of Radiology, Hudiksvall Hospital, Hudiksvall, Sweden

    Bengt Larsson MD

Authors
  1. Mary Hägg DDS
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  2. Bengt Larsson MD
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Correspondence to Mary Hägg DDS.

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Hägg, M., Larsson, B. Effects of Motor and Sensory Stimulation in Stroke Patients with Long-Lasting Dysphagia. Dysphagia 19, 219–230 (2004). https://doi.org/10.1007/s00455-004-0016-3

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