Internationale Zeitschrift für Physikalische Medizin und Rehabilitation
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The Efficacy of Intervention for the Prevention of Aspiration Pneumonitis in Recipients of Non-oral Nutrition

Misako Higashijima, Aya Tanaka, Joji Higashi, Tomoya Sakai and Hiroyasu Shiozu

Objective: We provided continuous training targeting the oral cavity and neck region to elderly, bedridden recipients of non-oral nutrition in addition to conventional physical interventions, with the aim of investigating changes in feeding and swallowing function.
Method: Bedridden (and caregiver’s extensive care-requiring), non-tracheotomized patients with a conscious level of 1 or 2 on the Japan Coma Scale (three inclusion criteria) were eligible. We enrolled 13 patients (5 men, 8 women; mean age: 85.2 ± 6.4 years) meeting the three criteria specified in the Setting, who had been receiving nutrition nasogastrically, via a gastrostomy tube, or by central venous hyperalimentation.
Intervention was provided three times weekly, as additional interventions to conventional physical function training. The interventions were 1) neck stretching, 2) facilitation of swallowing response, 3) stimulation of the oral cavity, and 4) positioning into an anti-gravity posture (in a position with the back elevated 60° from the bed).
Comparative assessments covered 1) intraoral saliva volume, 2) swallowing response time, 3) neck muscle hardness, 4) lip opening width, and 5) aspiration pneumonitis status at the initiation of training and the completion of training three months later.
Results: All assessments showed significant changes in a beneficial direction post-training relative to pretraining. Additionally, no participant experienced recurrent aspiration pneumonitis.
Conclusion: Selection of suitable training for the target function site, and continuous implementation of that training, are important for achieving efficacy.