Manuscript Title:

EFFECT OF THREE COMBINED SWALLOWING MANEUVERS ON SELECTED OUTCOMES AMONG PATIENTS WITH STROKE

Author:

HADEER SALAH ELDIN ABD ELSAMEA, BASSAMAT OMAR AHMED, HANAN AHMED AL SEBAEE, MOHAMMAD EDREES MOHAMMAD

DOI Number:

DOI:10.5281/zenodo.12799369

Published : 2024-07-23

About the author(s)

1. HADEER SALAH ELDIN ABD ELSAMEA - Assistant Lecturer, Medical Surgical Nursing, Faculty of Nursing – Cairo University – Egypt.
2. BASSAMAT OMAR AHMED - Professor, Medical Surgical Nursing Department, Faculty of Nursing – Cairo University – Egypt.
3. HANAN AHMED AL SEBAEE - Professor, Medical Surgical Nursing Department, Faculty of Nursing – Cairo University – Egypt.
4. MOHAMMAD EDREES MOHAMMAD - Assistant Professor, Neurology, Faculty of Medicine – Cairo-Egypt.

Full Text : PDF

Abstract

Stroke is a serious life-threatening medical condition associated with dysphagia and risk for aspiration pneumonia as well as odynophagia. Unfortunately, there is no known pharmacological treatment for dysphagia, nevertheless, studies showed that combined swallowing techniques may help in neurological problems; therefore, the aim of this study is to evaluate the effect of three combined swallowing maneuvers (Mendelsohn, Effortful and Supraglottic) on severity of dysphagia with risk of aspiration pneumonia and odynophagia among patients with stroke. Methods: Quasi-experimental pretest-posttest nonequivalent control group design was applied on a purposive homogeneous sample of 60 adult male and female patients with a confirmed diagnosis of right hemispheric stroke for the first time was collected over six consecutive months. The first 30 recruited patients constituted the control group who received the routine hospital care only, while, the subsequent 30 patients formed the study group which was exposed to the three combined swallowing maneuvers in addition to the standard medical treatment for two weeks. Outcomes were assessed two times during intervention period; once every one week using Gugging Swallowing Screen (GUSS) and Pain Numeric Rating Scale (PNRS). Results: The results showed at preintervention time that there are no statistically significant differences between the two study groups with regard to all study variables that were to be measured. On the other hand, the total post severity of dysphagia with risk of aspiration pneumonia mean scores among the participants in the study group who practiced the combined swallowing maneuvers were higher than the total post severity of dysphagia with risk of aspiration pneumonia mean scores of the control group with a mean difference score of 2.867 (t = - 4.596 & P = 0.000) along the two weeks. Regarding odynophagia, the total post severity of odynophagia mean scores among the participants in the study group were statistically lower than the total post severity of odynophagia mean scores of the comparison group with a mean difference score of 1.767 (t = 3.695 & P = 0.000) along the two weeks. Conclusion: Combining Mendelsohn, Effortful and Supraglottic swallowing maneuvers had a significant positive effect on reducing severity of dysphagia with risk for aspiration pneumonia and odynophagia among patients with stroke, hence, it is recommended to be integrated with standardized hospital routine care for those group of patients.


Keywords

Stroke, Cerebrovascular, Dysphagia, Risk of Aspiration Pneumonia, Odynophagia, Swallowing Exercises, Mendelsohn Maneuver, Effortful Swallowing, Supraglottic Swallowing.