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Year: 2013  Vol. 17   Num. Suppl. 1  - Print:
OROPHARYNGEAL DYSPHAGIA IN CHRONIC OBSTRUCTIVE PULMONARY DISEASE: FINDINGS FROM SPEECH THERAPIST EVALUATION
Author(s):
Danielle Martins Otto, Bruno Francisco de Fraga, Sheila Tamanini de Almeida
Abstract:

OBJECTIVE: To report the findings of clinical assessment in hospitalized patients with chronic obstructive pulmonary disease (COPD), and to describe the main signs and symptoms indicative of oropharyngeal dysphagia (OPD). METHOD: The participants were 15 patients with suspected OPD who presented with respiratory compromise because of COPD, which is characterized by chronic airflow obstruction associated with pulmonary inflammation (caused initially by smoking) and by altered coordination between swallowing and breathing. RESULTS: Of the 15 patients, 8 (53%) were women with a mean age of 63.1 years. The main signs and symptoms were cough, dyspnea, hyper secretion, and lack of coordination between swallowing and breathing because of respiratory changes. Six (40%) patients initially were on total restriction of oral feeding (PO) and received nasoenteric tube feeding. Their FOIS was classified as level 1. After a swallowing evaluation, 6 (40%) patients were determined to have moderate OPD and 4 (26.6%), mild OPD. After an average of 16.8 days in voice rehabilitation, the progression in the FOIS scale was to level 5 in 5 (33.3%) patients, to level 6 in 2 (13.3%) patients, and to level 7 in 2 (13.3%) patients. Patients at levels 5, 6, and 7 did not use an oral probe. A progression can also be observed in the degree of OPD: at hospital discharge, 7 (46.6%) patients had mild OPD and 3 (20%) patients had normal swallowing. CONCLUSION: The clinical assessment showed that patients with COPD may have OPD at different levels. Speech therapy contributed to the rehabilitation of swallowing in these patients, and to a reduction in the severity of OPD initially presented by them.

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