Functional Dysphagia Therapy and PEG Treatment in a Clinical Geriatric Setting
- 26 January 2010
- journal article
- research article
- Published by Springer Science and Business Media LLC in Dysphagia
- Vol. 26 (2), 108-116
- https://doi.org/10.1007/s00455-009-9270-8
Abstract
Functional dysphagia therapy (FDT) is a noninvasive procedure that can accompany percutaneous endoscopic gastrostomy (PEG) treatment and supports transitioning from tube to oral feeding. In this retrospective study, we investigated the outcome of FDT with or without PEG feeding. Patients with dysphagia were divided into two groups: those with PEG feeding (N = 117) and those with exclusively oral feeding (N = 105). Both groups received functional training (oral motor skills/sensation, compensatory swallowing techniques) from speech-language therapists. Functional oral intake, weight, Barthel index, and speech and language abilities were evaluated pre- and post-training. The non-PEG group showed a significant post-treatment improvement in functional oral intake, with diet improvement from pasty consistency to firm meals in most cases. However, even severely disordered patients (with PEG feeding) showed a significant increase in functional oral intake, still requiring PEG feeding post-treatment but able to take some food orally. The sooner a PEG was placed, the more functional oral intake improved. Significantly more complications and higher mortality occurred in the PEG group compared to the group with exclusively oral feeding. Dysphagia treatment in the elderly requires a multiprofessional setting, differentiated assessment, and functional training of oral motor skills and sensation and swallowing techniques.Keywords
This publication has 24 references indexed in Scilit:
- Treatment of Oral and Pharyngeal DysphagiaPhysical Medicine and Rehabilitation Clinics of North America, 2008
- Strength-Training Exercise in Dysphagia Rehabilitation: Principles, Procedures, and Directions for Future ResearchDysphagia, 2007
- Effects of Sensorimotor Exercise on Swallowing Outcomes Relative to Age and Age-Related DiseaseSeminars in Speech and Language, 2006
- Functional Benefits of Dysphagia Therapy Using Adjunctive sEMG BiofeedbackDysphagia, 2004
- Percutaneous Endoscopic Gastrostomy (PEG) for Enteral Nutrition in Patients with StrokeScandinavian Journal of Gastroenterology, 2003
- Tolerance of Early Diet Textures as Indicators of Recovery from Dysphagia After StrokeDysphagia, 2002
- Behavioral Management for Oropharyngeal DysphagiaFolia Phoniatrica et Logopaedica, 1999
- Use of tube feeding to prevent aspiration pneumoniaThe Lancet, 1996
- Dysphagia in acute stroke.BMJ, 1987
- “Mini-mental state”: A practical method for grading the cognitive state of patients for the clinicianJournal of Psychiatric Research, 1975