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Vorstellung verschiedener Therapiekonzepte

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Dysphagie

Part of the book series: Praxiswissen Logopädie ((PRAXISWISSEN))

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Zusammenfassung

In diesem Kapitel werden die Prinzipien wichtiger Therapiekonzepte der Dysphagiologie vorgestellt. Der 1. Abschnitt widmet sich der funktionellen Dysphagietherapie (FDT). Dabei handelt es sich um funktions- und problemorientierte Verfahren der Restitution, Kompensation und Adaption, deren Wirksamkeit im Sinne der „evidence-based medicine“ nachgewiesen wurde oder aufgrund der Pathophysiologie wahrscheinlich ist. Es folgt ein Abschnitt zum Behandlungsansatz nach Castillo Morales; dieses neurophysiologisch orientierte Therapiekonzept wurde für Kinder und Erwachsene mit kommunikativen, sensomotorischen und orofazialen Störungen entwickelt. Der 3. Abschnitt behandelt die Fazio-Orale-Trakt-Therapie (F.O.T.T.); dieses auf dem Bobath-Konzept basierende Verfahren fokussiert neurogene Störungen mimischer und oraler Bewegungen, des Schluckens, der Atmung, der Stimme und des Sprechens bei Menschen mit erworbenen Hirnschädigungen. Der darauffolgende Abschnitt über propriozeptive neuromuskuläre Fazilitation (PNF) behandelt schwerpunktmäßig das schlucktherapeutische Hauptelement des PNF-Konzeptes, das sog. Kopf-Hals-Muster, welches durch Aktivierung der Halsmuskulatur verschiedene schluckrelevante Bewegungen anbahnt bzw. erleichtert. Der letzte Abschnitt widmet sich neuen bzw. experimentellen Verfahren, die in Zukunft bei bestimmten Indikationen die „traditionelle“ Schlucktherapie zunehmend ergänzen werden; im Einzelnen werden dabei pharyngeale Elektrostimulation, neuromuskuläre Stimulation des Halsbereichs, repetitive transkranielle Magnetstimulation und transkranielle Gleichstromstimulation behandelt.

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Literatur

  • Barritt AW, Smithard DG (2009) Role of cerebral cortex plasticity in the recovery of swallowing function following dysphagic Stroke. Dysphagia 24: 83–90

    Article  Google Scholar 

  • Bath PM, Scutt P, Love J, Clavé P, Cohen D, Dziewas R, Iversen HK, Ledl C, Ragab S, Soda H, Warusevitane A, Woisard V, Hamdy S; Swallowing Treatment Using Pharyngeal Electrical Stimulation (STEPS) Trial Investigators (2016) Pharyngeal electrical stimulation for treatment of dysphagia in subacute stroke: a randomized controlled trial. Stroke 47: 1562–1570

    Google Scholar 

  • Blumenfeld L, Hahn Y, Lepage A, Leonard R, Belafsky PC (2006) Transcutaneous electrical stimulation versus traditional dysphagia therapy: a nonconcurrent cohort study. Otolaryngol Head Neck Surg 135: 754–757

    Article  Google Scholar 

  • Bülow M, Speyer R, Baijens L, Woisard V, Ekberg O (2008) Neuromuscular electrical stimulation (NMES) in stroke patients with oral and pharyngeal dysfunction. Dysphagia 23: 302–309

    Article  Google Scholar 

  • Burnett TA, Mann EA, Stoklosa JB, Ludlow CL (2005) Self-triggered functional electrical stimulation during swallowing. J Neurophysiol 94: 4011–4018

    Article  Google Scholar 

  • Castillo Morales R (1998) Die orofaziale Regulationstherapie. Pflaum, München

    Google Scholar 

  • Chen YW, Chang KH, Chen HC, Liang WM, Wang YH, Lin YN (2016) The effects of surface neuromuscular electrical stimulation on post-stroke dysphagia: a systemic review and meta-analysis. Clin Rehabil 30: 24–35

    Article  Google Scholar 

  • Cugy E, Leroi AM, Kerouac-Laplante J, Dehail P, Joseph PA, Gerardin E, Marie JP, Verin É (2016) Effect of submental sensitive transcutaneous electrical stimulation on virtual lesions of the oropharyngeal cortex. Ann Phys Rehabil Med 59: 94–99

    Article  Google Scholar 

  • Dziewas R, Mistry S, Hamdy S, Minnerup J, Van Der Tweel I, Schäbitz W, Bath PM; PHAST-TRAC Investigators (2017) Design and implementation of Pharyngeal electrical Stimulation for early de-cannulation in TRACheotomized (PHAST-TRAC) stroke patients with neurogenic dysphagia: a prospective randomized single-blinded interventional study. Int J Stroke 12: 430–437

    Article  Google Scholar 

  • Frank U, Mäder M, Sticher H (2006) Dysphagic patients with tracheotomies: a multidisciplinary treatment and decannulation management. Dysphagia 22: 20–29

    Article  Google Scholar 

  • Fraser C, Power M, Hamdy S, Rothwell JC, Hobday D, Hollander I, Tyrell P, Hobson A, Williams S, Thompson D (2002) Driving plasticity in human adult motor cortex is associated with improved motor function after brain injury. Neuron 34: 831–840

    Article  CAS  Google Scholar 

  • Freed ML, Freed L, Chatburn RL, Christian M (2001) Electrical stimulation for swallowing disorders caused by stroke. Respir Care 46: 466–474

    CAS  PubMed  Google Scholar 

  • Gallas S, Marie JP, Leroi AM, Verin E (2010) Sensory transcutaneous electrical stimulation improves post-stroke dysphagic patients. Dysphagia 25: 291–297

    Article  Google Scholar 

  • Gow D, Rothwell J, Hobson A, Thompson D, Hamdy S (2004) Induction of long-term plasticity in human swallowing motor cortex following repetitive cortical stimulation. Clin Neurophysiol 115: 1044–1051

    Article  Google Scholar 

  • Hägg M, Larsson B (2004) Effects of motor and sensory stimulation in stroke patients with long-lasting dysphagia. Dysphagia 19: 219–230

    Article  Google Scholar 

  • Hamdy S, Rothwell JC, Aziz Q, Singh KD, Thompson DG (1998) Long-term reorganization of human motor cortex driven by short-term sensory stimulation. Nat Neurosci 1: 64–68

    Article  CAS  Google Scholar 

  • Humbert IA, Poletto CJ, Saxon KG, Kearney PR, Crujido L, Wright-Harp W, Payne J, Jeffries N, Sonies BC, Ludlow CL (2006) The effect of surface electrical stimulation on hyolaryngeal movement in normal individuals at rest and during swallowing. J Appl Physiol 101: 1657–1663

    Article  Google Scholar 

  • Khedr EM, Abo-Elfetoh N (2010) Therapeutic role of rTMS on recovery of dysphagia in patients with lateral medullary syndrome and brainstem infarction. J Neurol Neurosurg Psychiatry 81: 495–499

    Article  Google Scholar 

  • Khedr EM, Abo-Elfetoh N, Rothwell JC (2009) Treatment of post-stroke dysphagia with repetitive transcranial magnetic stimulation. Acta Neurol Scand 119: 155–161

    Article  CAS  Google Scholar 

  • Kiger M, Brown CS, Watkins L (2006) Dysphagia management: an analysis of patient outcomes using VitalStim therapy compared to traditional swallow therapy. Dysphagia 21: 243–253

    Article  Google Scholar 

  • Korbmacher HM, Limbrock JG, Kahl-Nieke B (2006) Long-term evaluation of orofacial function in children with Down syndrome after treatment with a stimulating plate according to Castillo Morales. J Clin Pediatr Dent 30: 325–328

    Article  CAS  Google Scholar 

  • Kumar S, Wagner CW, Frayne C, Zhu L, Selim M, Feng W, Schlaug G (2011) Noninvasive brain stimulation may improve stroke-related dysphagia: a pilot study. Stroke 42: 1035–1040

    Article  Google Scholar 

  • Langmore SE, Pisegna JM (2015) Efficacy of exercises to rehabilitate dysphagia: a critique of the literature. Int J Speech Lang Pathol 17: 222–229

    Article  Google Scholar 

  • Leelamanit V, Limsakul C, Geater A (2002) Synchronized electrical stimulation in treating pharyngeal dysphagia. Laryngoscope 112: 2204–2210

    Article  Google Scholar 

  • Limbrock GJ, Castillo-Morales R, Hoyer H, Stöver B, Onufer CN (1993) The Castillo-Morales approach to orofacial pathology in Down syndrome. Int J Orofacial Myology 19: 30–37

    CAS  PubMed  Google Scholar 

  • Ludlow CL, Humbert I, Saxon K, Poletto C, Sonies B, Crujido L (2007) Effects of surface electrical stimulation both at rest and during swallowing in chronic pharyngeal dysphagia. Dysphagia 22: 1–10

    Article  Google Scholar 

  • Michou E, Raginis-Zborowska A, Watanabe M, Lodhi T, Hamdy S (2016) Repetitive transcranial magnetic stimulation: a novel approach for treating oropharyngeal dysphagia. Curr Gastroenterol Rep 18: 10

    Article  Google Scholar 

  • Mistry S, Verin E, Singh S, Jefferson S, Rothwell JC, Thompson DG, Hamdy S (2007) Unilateral suppression of pharyngeal motor cortex to repetitive transcranial magnetic stimulation reveals functional asymmetry in the hemispheric projections to human swallowing. J Physiol 585: 525–538

    Article  CAS  Google Scholar 

  • Nusser-Müller-Busch R (2008) Die Entwicklung von Konsensus-Empfehlungen zur Facio-OralenTrakt-Therapie (F.O.T.T.). Neurol Rehabil 14: 275–281

    Google Scholar 

  • Nusser-Müller-Busch R (Hrsg) (2015) Die Therapie des Facio-Oralen Trakts. Springer, Berlin

    Book  Google Scholar 

  • Park CL, O’Neill PA, Martin DF (1997) A pilot exploratory study of oral electrical stimulation on swallow function following stroke: an innovative technique. Dysphagia 12: 161–166

    Article  CAS  Google Scholar 

  • Pisegna JM, Kaneoka A, Pearson WG Jr, Kumar S, Langmore SE (2016) Effects of non-invasive brain stimulation on post-stroke dysphagia: A systematic review and meta-analysis of randomized controlled trials. Clin Neurophysiol 127: 956–968

    Google Scholar 

  • Power M, Fraser C, Hobson A, Rothwell JC, Mistry S, Nicholson DA, Thompson DG, Hamdy S (2004) Changes in pharyngeal corticobulbar excitability and swallowing behavior after oral stimulation. Am J Physiol Gastrointest Liver Physiol 286: G45–G50

    Article  CAS  Google Scholar 

  • Power M, Fraser CH, Hobson A, Singh S, Tyrrell P, Nicholson DA, Turnbull I, Thompson DG, Hamdy S (2006) Evaluating oral stimulation as a treatment for dysphagie after stroke. Dysphagia 21: 49–55

    Article  Google Scholar 

  • Shaw GY, Sechtem PR, Searl J, Keller K, Rawi TA, Dowdy E (2007) Transcutaneous neuromuscular electrical stimulation (VitalStim) curative therapy for severe dysphagia: myth or reality? Ann Otol Rhinol Laryngol 116: 36–44

    Article  Google Scholar 

  • Steele CM, Thrasher AT, Popovic MR (2007) Electric stimulation approaches to the restoration and rehabilitation of swallowing: a review. Neurol Res 29: 9–15

    Article  Google Scholar 

  • Suiter DM, Leder SB, Ruark JL (2006) Effects of neuromuscular electrical stimulation on submental muscle activity. Dysphagia 21: 56–60

    Article  Google Scholar 

  • Suntrup S, Marian T, Schröder JB, Suttrup I, Muhle P, Oelenberg S, Hamacher C, Minnerup J, Warnecke T, Dziewas R (2015) Electrical pharyngeal stimulation for dysphagia treatment in tracheotomized stroke patients: a randomized controlled trial. Intensive Care Med 41: 1629–1637

    Article  CAS  Google Scholar 

  • Türk Ch, Söhlemann S, Rummel H (2012) Das Castillo Morales-Konzept. Thieme, Stuttgart

    Google Scholar 

  • Vasant DH, Michou E, Mistry S, Rothwell JC, Hamdy S (2015) High-frequency focal repetitive cerebellar stimulation induces prolonged increases in human pharyngeal motor cortex excitability. J Physiol 593: 4963–4977

    Article  CAS  Google Scholar 

  • Verin E, Maltete D, Ouahchi Y, Marie JP, Hannequin D, Massardier EG, Leroi AM (2011) Submental sensitive transcutaneous electrical stimulation (SSTES) at home in neurogenic oropharyngeal dysphagia: a pilot study. Ann Phys Rehabil Med 54: 366–375

    Article  CAS  Google Scholar 

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Prosiegel, M., Weber, S. (2018). Vorstellung verschiedener Therapiekonzepte. In: Dysphagie. Praxiswissen Logopädie. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-56132-4_9

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  • DOI: https://doi.org/10.1007/978-3-662-56132-4_9

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  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-662-56131-7

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