title: A Comparative Study Between Two Sensory Stimulation Strategies After Two Weeks Treatment on Older Patients with Oropharyngeal Dysphagia.
abstract: Oropharyngeal dysphagia (OD) is a prevalent geriatric syndrome. Treatment is based on compensatory strategies to avoid complications. New treatments based on sensory stimulation to promote the recovery of the swallowing function have proved effective in acute studies but prolonged treatment needs further research. Our aim was to evaluate and compare the effect of two, longer-term sensory treatment strategies on older patients with OD. 38 older patients (≥70 years) were studied with videofluoroscopy (pre/posttreatment) and randomized into two 10-day treatment groups: Group A-transient receptor potential vanilloid 1 (TRPV1) agonist (capsaicin 1 × 10(-5) M) and Group B-transcutaneous sensory electrical stimulation (TSES) (Intelect VitalStim, biphasic pulses, 300 μs, 80 Hz). Patients were analyzed for treatment response. Patients were old (80.47 ± 5.2 years), with comorbidities (3.11 ± 1.59 Charlson Index), polymedication (8.92 ± 3.31 drugs/patient), and mild functional impairment (86.84 ± 17.84 Barthel Index), and 28.9 % were at risk of malnutrition (MNA-sf). Overall, all patients had videofluoroscopic signs of impaired safety of swallow (ISS) with delayed oropharyngeal swallow response (OSR). After sensory stimulation, prevalence of ISS decreased to 68.42 % in both groups (P = 0.019). There were 68.42 % responders in Group A (TRPV1) and 42.11 % in Group B (TSES). Group A responders showed an improvement in the penetration-aspiration scale (PAS, 5.23 ± 2.04 to 3 ± 1.47; P = 0.002), and the same was true for those of Group B (4.63 ± 1.41 to 2.13 ± 0.64; P = 0.007). 10-day sensory stimulation with either therapy improved safety of swallow and OSR in older patients with OD, reducing the severity of OD in a significant subgroup of these patients.
authors: Centro de Investigación Biomédica en Red de enfermedades hepáticas y digestivas (CIBERehd), Instituto de Salud Carlos III, Barcelona, Spain. oortega@csdm.cat.
authors: Omar
authors: 0000-0001-6178-3748
authors: O
authors: Ortega
authors: Centro de Investigación Biomédica en Red de enfermedades hepáticas y digestivas (CIBERehd), Instituto de Salud Carlos III, Barcelona, Spain.
authors: Laia
authors: L
authors: Rofes
authors: Unitat d'Exploracions Funcionals Digestives, Laboratori de Fisiologia Digestiva CIBERehd CSdM-UAB, Hospital de Mataró, Barcelona, Spain.
authors: Alberto
authors: A
authors: Martin
authors: Unitat d'Exploracions Funcionals Digestives, Laboratori de Fisiologia Digestiva CIBERehd CSdM-UAB, Hospital de Mataró, Barcelona, Spain.
authors: Viridiana
authors: V
authors: Arreola
authors: Unitat d'Exploracions Funcionals Digestives, Laboratori de Fisiologia Digestiva CIBERehd CSdM-UAB, Hospital de Mataró, Barcelona, Spain.
authors: Irene
authors: I
authors: López
authors: Centro de Investigación Biomédica en Red de enfermedades hepáticas y digestivas (CIBERehd), Instituto de Salud Carlos III, Barcelona, Spain.|Unitat d'Exploracions Funcionals Digestives, Laboratori de Fisiologia Digestiva CIBERehd CSdM-UAB, Hospital de Mataró, Barcelona, Spain.|Fundació Institut d'Investigació Germans Trias i Pujol, Badalona, Spain.
authors: Pere
authors: P
authors: Clavé
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002211:Capsaicin / Q000008:administration & dosage*; D003679:Deglutition / Q000502:physiology; D003680:Deglutition Disorders / Q000503:physiopathology / Q000628:therapy*; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D008297:Male; D018689:Sensory System Agents / Q000008:administration & dosage*; D004561:Transcutaneous Electric Nerve Stimulation / Q000379:methods*; D016896:Treatment Outcome
chemical_list: D018689:Sensory System Agents; D002211:Capsaicin
keywords: Deglutition; Deglutition disorders; Electric stimulation therapy; Older patients; Swallowing disorders; TRPV1 agonist; Therapeutics