Arquivo da tag: Assessment

A Swallowing Clinical Assessment Score (SCAS) to evaluate outpatients with Parkinson’s disease

Fernanda Loureiro, Ana Caline Nóbrega, Marília Sampaio, Natalie Argolo, André Dalbem,
Ailton Melo, Irenio Gomes

Aims: This study proposes a standardized Swallowing Clinical Assessment Score (SCAS)
in PD.
Methods: 174 idiopathic PD patients and 22 controls were evaluated in a transversal study.
The SCAS comprised of twelve items that identify the occurrence of specific alterations in
the oral and pharyngeal phases. Each alteration was given a weight in accordance to its
relevance in compromising the act of swallowing.
Results: The SCAS follows a theoretical scoring system ranging from 0 to 354 points,
where zero corresponds to the ability to swallow without alteration. Scores ≤2 points
indicate normal swallowing; functional swallowing ranges from ≥2 and ≤15 points;
mildly altered ranges from ≥15 and ≤35 points; moderately altered ranges from ≥35
and ≤60 points. Scores in excess of 60 points indicate severe alteration.
Conclusions: The SCAS proposed here is only part of the global assessment of dysphagia.
Its main applications are: to screen swallowing difficulties in PD, even with no complaints,
thus facilitating early diagnosis; to monitor the development of alterations in swallowing
in an objective manner; and to assess the effectiveness of strategies for swallowing
rehabilitation.

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Assessment of electrical stimulation in the treatment of the dysphagia caused by stroke

Soares, Thaís Miranda Curvelo; Conceição, Tatiana Maíta Alves; Cardoso, Fabrício; Beresford, Heron
Acta fisiátrica; 16(4)dez. 2009.
Neurogenic dysphagia encompasses the disturbances in swallowing that occur because of a neurological disease, with the symptoms and complications stemming from the sensorial-motor impairment of the muscles involved in the swallowing process. This type of dysphagia is particularly debilitating. It can cause death or increased health care costs due to tracheal aspiration. This pathology is common and it presents a potentially fatal complication for stroke, happening in approximately 50% of these patients. Among the possible treatments, tactile-thermal stimulation and biofeedback are frequently successful, varying from 0% to 83%. Studies register a high success rate for this treatment with patients that have suffered strokes, which doesn’t usually include the most severe dysphagia. The use of the electrical stimulation in treating dysphagia was first reported in 1996 by Freed et al and, later, by Park et al. The objective of the electrical stimulation was to find an afferent branch for the swallowing reflex in stroke patients with dysphagia associated with delayed initiation of swallowing. Since this was a little-explored alternative treatment, the objective of that study was to perform a bibliographical review concerning the use of electrical stimulation in the treatment of dysphagia in patients that had suffered strokes. Conclusion: Dysphagia caused by stroke is directly associated with an increase in life-threatening medical complications and requires the attention of health professionals. Electrical stimulation is an important therapy for dysphagia and its effectiveness in this pathology must be explored.