Article

For patients with dysphagia due to stroke, in addition to
compensatory strategies, exercises are used to help improve motor function.
Biofeedback is used in neuromuscular training and is promising for swallowing
training. OBJECTIVE: To evaluate the functional value of game-based biofeedback
in swallowing therapy for patients with poststroke dysphagia. DESIGN: A case-control study. SETTING:
Academic tertiary hospital.
PARTICIPANTS: Subjects
with poststroke dysphagia (n = 20) were individually matched to 2 separate
groups, a game-based biofeedback group (n = 10) or a control group (n = 10), for
age, gender, duration of dysphagia, and dysphagia grades. INTERVENTIONS: Each
participant underwent 1-hour sessions 3 times per week for a total of 16
treatment sessions. Each session included a 30-minute session of traditional
swallow treatment and a 30-minute session of laryngeal elevation exercises. In
the experimental group, laryngeal elevation exercises were combined with
additional game-based biofeedback. MAIN OUTCOME MEASURES: Outcomes assessed
before and after interventions included hyoid bone displacement, Functional Oral
Intake Scale (FOIS) scores, and nasogastric (NG) tube removal rate. RESULTS:
Intergroup analyses showed larger differences in hyoid bone displacement and FOIS
scores (before and after treatment) in the experimental group than in the control
group, with statistical significance (P = .007 and P = .014, respectively).
Intergroup analyses showed that the hyoid bone displacement change and FOIS
scores before and after treatment exhibited statistically significant improvement
only in the experimental group (P = .002 and P = .004, respectively). In all, 8
of 10 patients (80%) in the experimental group and 2 of 10 patients (20%) in the
control group discontinued NG tube insertion after therapy. Participation in the
experimental group was associated with an increased probability of tube removal
(odds ratio = 6.00; 95% confidence interval = 1.08-33.27, P = .009). CONCLUSIONS:
Laryngeal elevation training combined with game-based biofeedback augments the
change in hyoid bone displacement and FOIS scores, and increases the NG tube
removal rate in patients with poststroke dysphagia.
CI - Copyright (c) 2016 American Academy of Physical Medicine and Rehabilitation.
Published by Elsevier Inc. All rights reserved.

Langue : ANGLAIS