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Rehabilitation Practice and Science

Translated Title

巴金森病吞嚥困難的新近發展與吞嚥復健治療建議

Abstract

Dysphagia is common in Parkinson disease (PD). Dysphagia may affect quality of life in the early stage of PD and can cause dehydration, malnutrition, or even result in pneumonia and mortality in the late stage. Accordingly, management of dysphagia is a crucial issue in PD. Clinicians and researchers should spend more effort developing sensitive evaluation tools and effective intervention strategies for dysphagia in PD. In the early stage of disease, the Swallowing Disturbance Questionnaire, Münich Dysphagia Test for Parkinson’s Disease questionnaire, or noninvasive tools involving surface electromyography or sensors should be used to detect subtle or mild dysphagia. In the late stage, a video fluoroscopic swallowing study or fiberoptic endoscopic examination are recommended for detecting penetration, aspiration, and bolus residuals. PD is a degenerative disease. The symptoms of dysphagia may get worse and be related to disease severity. Therefore, early detection with early diagnosis to enable an early intervention may slow the progress of dysphagia in PD. Traditional swallowing rehabilitation programs for patients with stroke were previously applied directly to patients with PD. The causes of PD-related dysphagia are heterogeneous, and more systems are affected than in stroke. Accordingly, more experts should form the transdisciplinary care team for PD swallowing rehabilitation than in stroke. Active therapeutic programs exist that have been proven to benefit PD dysphagia; they include oral motor exercises, laryngeal exercises, Lee Silverman voice treatment, expiratory muscle strength training, signing, home programs of swallowing training, and home programs of oro-motor exercises. In patients with PD and severe dysphagia who receive tube feeding, oral hygiene remains a critical part of daily care and may decrease the development of aspiration pneumonia. Through education of patients with PD, their caregivers, and medical teams, early intervention for PD-related dysphagia can be accomplished with early detection. Such efforts may help slow the progress of swallowing dysfunction and prevent complications in PD. However, regular follow-ups at 3-month intervals are suggested for the evaluation of swallowing function in PD. When comorbidity with acute swallowing function declines, intense active swallowing rehabilitation programs should be employed.

Language

Traditional Chinese

First Page

1

Last Page

10

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