Abstract:
PURPOSE:Duchenne muscular dystrophy (DMD) is a rapidly progressive neuromuscular disorder causing weakness of the skeletal, respiratory, cardiac and oropharyngeal muscles with up to one third of young men reporting difficulty swallowing (dysphagia). Recent studies on dysphagia in DMD clarify the pathophysiology of swallowing disorders and offer new tools for its assessment but little guidance is available for its management. This paper aims to provide a step-by-step algorithm to facilitate clinical decisions regarding dysphagia management in this patient population. METHODS:This algorithm is based on 30 years of clinical experience with DMD in a specialised Centre for Neuromuscular Disorders (Inkendaal Rehabilitation Hospital, Belgium) and is supported by literature where available. RESULTS:Dysphagia can worsen the condition of ageing patients with DMD. Apart from the difficulties of chewing and oral fragmentation of the food bolus, dysphagia is rather a consequence of an impairment in the pharyngeal phase of swallowing. By contrast with central neurologic disorders, dysphagia in DMD accompanies solid rather than liquid intake. Symptoms of dysphagia may not be clinically evident; however laryngeal food penetration, accumulation of food residue in the pharynx and/or true laryngeal food aspiration may occur. The prevalence of these issues in DMD is likely underestimated. CONCLUSIONS:There is little guidance available for clinicians to manage dysphagia and improve feeding for young men with DMD. This report aims to provide a clinical algorithm to facilitate the diagnosis of dysphagia, to identify the symptoms and to propose practical recommendations to treat dysphagia in the adult DMD population. Implications for Rehabilitation Little guidance is available for the management of dysphagia in Duchenne dystrophy. Food can penetrate the vestibule, accumulate as residue or cause aspiration. We propose recommendations and an algorithm to guide management of dysphagia. Penetration/residue accumulation: prohibit solid food and promote intake of fluids. Aspiration: if cough augmentation techniques are ineffective, consider tracheostomy.
journal_name
Disabil Rehabiljournal_title
Disability and rehabilitationauthors
Toussaint M,Davidson Z,Bouvoie V,Evenepoel N,Haan J,Soudon Pdoi
10.3109/09638288.2015.1111434subject
Has Abstractpub_date
2016-10-01 00:00:00pages
2052-62issue
20eissn
0963-8288issn
1464-5165journal_volume
38pub_type
杂志文章abstract:INTRODUCTION:The World Health Organisation Disability Assessment Schedule II (WHODAS II) is an instrument developed by the World Health Organisation in order to assess behavioural limitations and restrictions to participation experienced by an individual, independently from a medical diagnosis. The conceptual frame of ...
journal_title:Disability and rehabilitation
pub_type: 杂志文章
doi:10.1080/09638280802240498
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journal_title:Disability and rehabilitation
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abstract::Purpose: The aim of this article is to conceptualise the phenomenon of therapy-related parental stress in parents of children with a physical disability. Methods: Three models related to parental stress were reviewed, i.e., general parental stress, burden of caregiving in parents of children with physical disabilities...
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journal_title:Disability and rehabilitation
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journal_title:Disability and rehabilitation
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journal_title:Disability and rehabilitation
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journal_title:Disability and rehabilitation
pub_type: 杂志文章
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journal_title:Disability and rehabilitation
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journal_title:Disability and rehabilitation
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doi:10.1080/09638280410001684578
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journal_title:Disability and rehabilitation
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journal_title:Disability and rehabilitation
pub_type: 杂志文章,评审
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journal_title:Disability and rehabilitation
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journal_title:Disability and rehabilitation
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journal_title:Disability and rehabilitation
pub_type: 杂志文章
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journal_title:Disability and rehabilitation
pub_type: 杂志文章
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journal_title:Disability and rehabilitation
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journal_title:Disability and rehabilitation
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journal_title:Disability and rehabilitation
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journal_title:Disability and rehabilitation
pub_type: 杂志文章,多中心研究
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