Correlation of Swallowing Function With Bilateral Diaphragmatic Movement in Hemiplegic Stroke Patients
10.5535/arm.2019.43.2.156
- Author:
Ra Yu YUN
1
;
Ho Eun PARK
;
Ji Won HONG
;
Yong Beom SHIN
;
Jin A YOON
Author Information
1. Department of Rehabilitation Medicine, Pusan National University School of Medicine and Biomedical Research Institute, Pusan National University Hospital, Busan, Korea. yjk5289@naver.com
- Publication Type:Original Article
- Keywords:
Deglutition disorders;
Diaphragm;
Fluoroscopy;
Respiration;
Stroke
- MeSH:
Deglutition Disorders;
Deglutition;
Diaphragm;
Fluoroscopy;
Humans;
Linear Models;
Longitudinal Studies;
Pyriform Sinus;
Respiration;
Stroke
- From:Annals of Rehabilitation Medicine
2019;43(2):156-162
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: To investigate difference in bilateral diaphragm movement of patients with tracheal aspiration according to post stroke residue severity and determine correlations of Penetration-Aspiration Scale (PAS), residue scale, and bilateral diaphragm movement. METHODS: A total of 47 patients diagnosed with hemiplegic stroke were enrolled in this study. PAS, severity of valleculae, and pyriform sinus retention during videofluoroscopic swallowing study (VFSS) were assessed. Bilateral fluoroscopic diaphragm movements during spontaneous breathing and forced breathing were measured. RESULTS: Patients with tracheal aspiration (PAS≥6) had significantly (p=0.035) lower ipsilateral diaphragm movement during spontaneous breathing. Post-swallow residue severity showed statistically significant (p=0.028) difference in patients with ipsilateral diaphragm movement during forced breathing. In linear regression analysis, PAS showed weak correlations with ipsilateral spontaneous diaphragm movement (r=0.397, p=0.006), ipsilateral forced diaphragm movement (r=0.384, p=0.008), and contralateral forced diaphragm movement (r=0.323, p=0.027). Weak correlation was also observed between post swallow residue severity and ipsilateral diaphragm movement during spontaneous breathing (r=0.331, p=0.023) and forced breathing (r=0.343, p=0.018). CONCLUSION: We confirmed the relationship between swallowing function and bilateral diaphragm movement in this study. The severity of dysphagia after hemiplegic stroke was correlated with bilateral diaphragm movement. Further longitudinal studies are needed to assess the effect of breathing exercise on post-stroke dysphagia.
