Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 5 de 5
Filtrar
1.
Dysphagia ; 37(5): 1207-1216, 2022 10.
Artigo em Inglês | MEDLINE | ID: mdl-34767083

RESUMO

BACKGROUND AND PURPOSE: Post-stroke dysphagia affects almost half of the survivors and severely influences quality of life, thus becoming swallowing rehabilitation of paramount importance. However, there is little adequate evidence on which the best rehabilitative strategy can be. Surface electromyography (sEMG) allows for recording swallowing muscles' activity and provides real time visual feedback, as a biofeedback adjunctive technique to improve treatment outcome. This study aimed to analyze the effectiveness of biofeedback rehabilitation of swallowing through sEMG compared to standard techniques, in post-stroke dysphagia. METHODS: A pilot-randomized controlled trial included 17 patients diagnosed with post-stroke dysphagia. Nine underwent sEMG-biofeedback rehabilitation; seven controls were submitted to control treatment, one dropout. The primary outcome was the functional oral intake scale (FOIS), secondary outcomes was pharyngeal clearance and safe swallowing, assessed through fiberoptic endoscopic evaluation of swallowing (FEES). RESULTS: FOIS improved in all patients, regardless of treatment. sEMG-biofeedback rehabilitation led to improvements of the pharyngeal clearance and swallowing safety. The rehabilitative effects appeared stable at 2-months follow-up. CONCLUSIONS: The application of biofeedback based on sEMG in post-stroke dysphagia patients resulted in an effective rehabilitative technique, in particular for pharyngeal clearance improvements and safe swallowing, thus reducing the risk of aspiration and malnutrition.


Assuntos
Transtornos de Deglutição , Acidente Vascular Cerebral , Biorretroalimentação Psicológica/métodos , Deglutição , Transtornos de Deglutição/etiologia , Transtornos de Deglutição/terapia , Humanos , Qualidade de Vida , Acidente Vascular Cerebral/complicações , Resultado do Tratamento
2.
Torture ; 33(2): 173-176, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37589074

RESUMO

The goal of the volume Migration and Torture in Today's World, curated by Fabio Perocco, is to show the existence of a link between torture and current migration policies.


Assuntos
Tortura , Humanos , Existencialismo , Política Pública
3.
Acta Otorhinolaryngol Ital ; 43(1): 12-19, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-36860145

RESUMO

Objective: In the dysphagic patient, pharyngeal residues (PR) are associated with aspiration and poor quality of life. The assessment of PR using validated scales during flexible endoscopic evaluation of swallowing (FEES) is crucial for rehabilitation. This study aims to validate and test the reliability of the Italian version of the Yale Pharyngeal Residue Severity Rating Scale (IT-YPRSRS). The effects of training and experience in FEES on the scale were also determined. Methods: The original YPRSRS was translated into Italian according to standardised guidelines. Thirty FEES images were selected after consensus and proposed to 22 naive raters who were asked to assess the severity of PR in each image. Raters were divided into two subgroups by years of experience at FEES, and randomly by training. Construct validity, inter-rater, and intra-rater reliability were assessed by kappa statistics. Results: IT-YPRSRS showed substantial to almost perfect agreement (kappa > 0.75) in validity and reliability for both the overall sample (660 ratings), and valleculae/pyriform sinus sites (330 ratings each). No significant differences emerged between groups considering years of experience, and variable differences were observed by training. Conclusions: The IT-YPRSRS demonstrated excellent validity and reliability in identifying location and severity of PR.


Assuntos
Qualidade de Vida , Traduções , Humanos , Reprodutibilidade dos Testes , Deglutição , Grupo Social
4.
Brain Res Bull ; 158: 77-83, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32119965

RESUMO

INTRODUCTION: Non-linguistic properties of speech are widely heterogeneous and require complex neurological integration. The association between white matter integrity and the severity of dysarthria was investigated in a group of patients diagnosed with amyotrophic lateral sclerosis (ALS). METHODS: Thirty-six patients diagnosed with amyotrophic lateral sclerosis completed a magnetic resonance imaging protocol inclusive of diffusion-weighted images. A clinical assessment of pneumo-phono-articulatory abilities was conducted for each patient, and a composite score of residual speech capacity was calculated. Tract-Based Spatial Statistics was carried out to model the potential association between residual speech capacity and microstructural properties of white matter (fractional anisotropy, mean and radial diffusivity). RESULTS: A significant negative association was found between residual speech capacity and mean diffusivity in a large white matter cluster located in frontal, parietal and right temporal regions. These subcortical areas were characterised by pathological microstructural disruption, as revealed by post hoc analyses. CONCLUSIONS: Non-linguistic aspects of speech are associated with microstructural integrity of frontal, parietal and right temporal white matter in amyotrophic lateral sclerosis. Such mapping is consistent with the centres responsible of volitional control of speech and sensory feedback during non-linguistic speech production.


Assuntos
Esclerose Lateral Amiotrófica/diagnóstico por imagem , Disartria/diagnóstico por imagem , Lobo Frontal/diagnóstico por imagem , Lobo Parietal/diagnóstico por imagem , Substância Branca/diagnóstico por imagem , Adulto , Idoso , Esclerose Lateral Amiotrófica/complicações , Esclerose Lateral Amiotrófica/fisiopatologia , Disartria/etiologia , Disartria/fisiopatologia , Feminino , Seguimentos , Lobo Frontal/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Lobo Parietal/fisiopatologia , Substância Branca/fisiopatologia
5.
Artigo em Inglês | MEDLINE | ID: mdl-26121168

RESUMO

Our objective was to investigate the volumetric correlates of speech in amyotrophic lateral sclerosis (ALS). Twenty-three ALS patients had a structural 3D MRI scan, neuropsychological, linguistic and speech assessments. Twenty-three healthy adults of comparable age, education, white-matter hyperintensity load and intracranial volumes were also recruited. Between-group differences in grey matter and white matter (WM) were examined to characterize ALS patients accurately. The association between residual speech and volumetric maps was studied in these patients. Results demonstrated that ALS patients showed a pattern of WM reduction, which was located in peri-cortical motor/premotor fibres bilaterally, and in a large volume extending from the pons/midbrain to the cerebellum. A speech composite score was computed, and this was positively associated with premotor/supplementary-motor WM bilaterally, and right cerebellar WM. Since premotor associations were found in volumes where ALS patients showed WM reduction, this region is believed to be directly involved in speech execution in this group. Since cerebellar associations were instead found in volumes free from shrinkage, this region is interpreted as playing a modulatory role, compensating for the impact of ALS pathology.


Assuntos
Esclerose Lateral Amiotrófica/patologia , Encéfalo/patologia , Disartria/patologia , Idoso , Esclerose Lateral Amiotrófica/complicações , Esclerose Lateral Amiotrófica/fisiopatologia , Encéfalo/fisiopatologia , Estudos de Casos e Controles , Cerebelo/patologia , Cerebelo/fisiopatologia , Disartria/etiologia , Disartria/fisiopatologia , Feminino , Substância Cinzenta/patologia , Substância Cinzenta/fisiopatologia , Humanos , Imageamento Tridimensional , Imageamento por Ressonância Magnética , Masculino , Mesencéfalo/patologia , Mesencéfalo/fisiopatologia , Pessoa de Meia-Idade , Córtex Motor/patologia , Córtex Motor/fisiopatologia , Tamanho do Órgão , Ponte/patologia , Ponte/fisiopatologia , Medida da Produção da Fala , Substância Branca/patologia , Substância Branca/fisiopatologia
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA