Characteristics of the swallowing of cortical stroke survivors with dysphagia and cognitive impairment
10.3760/cma.j.issn.0254-1424.2020.01.005
- VernacularTitle: 大脑皮质卒中后吞咽困难合并认知障碍患者的吞咽造影特征分析
- Author:
Huixiang WU
1
;
Guifang WAN
1
;
Chunqing XIE
1
;
Zheming HUANG
2
;
Huayu CHEN
1
;
Zulin DOU
1
;
Weihong QIU
1
Author Information
1. Department of Rehabilitation Medicine, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China
2. ENT Department, Guangdong Provincial People′s Hospital, Guangzhou 510080, China
- Publication Type:Clinical Trail
- Keywords:
Stroke;
Cognitive impairment;
Dysphagia;
Videofluoroscopy;
Swallowing
- From:
Chinese Journal of Physical Medicine and Rehabilitation
2020;42(1):18-23
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To identify the pathophysiological characteristics of cortical stroke survivors′ swallowing.
Methods:Sixty cortical stroke survivors with dysphagia and cognitive impairment were enrolled into the observation group, while another 16 with dysphagia but without cognitive impairment formed the unimpaired control group and 16 healthy counterparts were selected for a normal control group. Each subject was recorded videofluoroscopically while swallowing 5ml of a liquid of medium consistency. The occurrence of refusing to eat, mouth opening difficulty, incomplete oral closure, residue in the oral cavity, residue in the pharyngeal cavity, leakage and aspiration were observed. Each subject′s swallowing time and kinematic parameters were analyzed from the fluoroscopic videos.
Results:The incidence of refusing to eat (37.5%) and/or incomplete mouth closure (68.75%) were significantly higher in the observation group than in the other two groups. The incidence of difficulty in opening the mouth (37.5%), residue in the oral cavity (81.25%), residue in the pharyngeal cavity (56.25%), leakage (56.25%) and aspiration (50%) of the observation group were significantly higher in the observation group than among the normal controls, but were not significantly different from those incidences among the group without cognitive impairment. The average oral transit time and soft palate elevation time of the observation group were significantly longer than those of the other two groups. The observation group′s average hyoid movement time was significantly longer than that of the normal control group, but not significantly different from that of the group without cognitive impairment. There were no significant differences among the groups in average upper esophageal sphincter opening time, larynx closure time or the kinematic parameters.
Conclusions:Stroke survivors with dysphagia and cognitive impairment present dysphagia characteristic of oral phase swallowing difficulties.
