Caracterização do risco de disfagia em paciente com doença de Parkinson
Data
2021
Autores
Costa, Edneia Maurer [UNIFESP]
Orientadores
Bommarito, Silvana [Unifesp]
Tipo
Trabalho de conclusão de curso de graduação
Título da Revista
ISSN da Revista
Título de Volume
Resumo
Introdução: Depois da Doença de Alzheimer (DA), a Doença de Parkinson (DP) é a doença neurodegenerativa mais comum, acometendo homens e mulheres, independentemente de suas etnias e ocupações. A disfagia costuma afetar 80% dos pacientes com DP podendo levar a óbito. Objetivo: Caracterizar o risco de disfagia do paciente com Doença de Parkinson, segundo a escala Hoehn & Yahr. Metodologia: Estudo clínico e prospectivo CEP n: 0661/2017. A amostra foi composta por 150 indivíduos divididos (grupo experimental – GE com faixa etária entre 56 e 82 anos e um grupo controle – GC com 80 indivíduos com faixa etária entre 63 e 97 anos). O GE apresentava diagnóstico de DP Idiopática com medicação estável, sem atendimento prévio no serviço de Fonoaudiologia e o GC indivíduos que não apresentavam queixas relacionadas à deglutição ou diagnóstico prévio de disfagia. Toda a amostra respondeu o protocolo Mini Exame de Estado Mental – MEEM e o EAT-10 e o GE ainda foi avaliado, por uma fisioterapeuta, segundo a Escala Modificada de incapacidade Hoehn e Yahr, Shenkman et al 2001; Horta, 1996 para indicar o grau de deficiência da incapacidade clínica. Resultados: Do total de 70 pacientes com Doença de Parkinson, 22, ou seja, 31,45% obtiveram no protocolo EAT-10, escore igual ou maior que 3. Dentre esses, os pacientes encontram-se todos os estágios da escala de, exceto o estágio 01. Houve, correlação estatisticamente significante entre o total do EAT-10 e a escolaridade em anos (rho=-0,27, p-valor=0,025) e MEEM (rho=-0,26, p-valor=0,030); a questão 10 e hipertensão arterial sistêmica (HAS) (rho=0,25, p-valor=0,043); questão 09 e escolaridade em anos (rho=-0,24, p-valor=0,045), estágio da DP (rho=0,33, p-valor=0,006) e MEEM (rho=-0,28, p-valor=0,022). Na questão 04 encontrou-se correlação estatisticamente significante entre escolaridade em anos (rho=-0,26, p-valor=0,029), diabetes mellitus (DM) (rho=0,26, p-valor=0,035) e MEEM (rho=-0,32, p-valor=0,007). Na questão 02 identificou-se correlação estatisticamente significante entre essa questão do EAT 10 e o estágio da DP (rho=0,30, p-valor=0,013). Conclusão: A disfagia se mostrou presente a partir do estágio 1,5 da Doença de Parkinson. Houve relação direta da autopercepção da disfagia com a maior pontuação na escala Hoehn & Yahr na DP, estando os maiores valores alcançados no total do EAT-10 associados a baixa escolaridade e, menores resultados do MEEM. As comorbidades hipertensão e diabetes mellitus apresentaram relação direta nas respostas a respeito "engolir me deixa estressado" e "preciso fazer força para engolir" respectivamente.
Introduction: After Alzheimer's Disease (AD), Parkinson's Disease (PD) is the most common neurodegenerative disease, affecting men and women, regardless of their ethnicity and occupation. Dysphagia usually affects 80% of patients with PD and can lead to death. Objective: To characterize the risk of dysphagia in patients with Parkinson's Disease, according to the Hoehn & Yahr scale. Methodology: Clinical and prospective study CEP n: 0661/2017. The sample consisted of 150 individuals divided (experimental group – EG aged between 56 and 82 years and a control group – CG with 80 individuals aged between 63 and 97 years). The EG had a diagnosis of Idiopathic PD with stable medication, without prior assistance in the Speech Therapy service, and the CG individuals who did not present complaints related to swallowing or a previous diagnosis of dysphagia. The entire sample responded to the Mini Mental State Examination – MMSE and EAT-10 protocol, and the EG was also assessed by a physical therapist, according to the Modified Disability Scale Hoehn and Yahr, Shenkman et al 2001; Horta, 1996 to indicate the degree of impairment of clinical incapacity. Results: Of the total of 70 patients with Parkinson's Disease, 22, that is, 31.45% obtained a score equal to or greater than 3 in the EAT-10 protocol. except stage 01. There was a statistically significant correlation between the total EAT-10 and education in years (rho=-0.27, p-value=0.025) and MMSE (rho=-0.26, p-value= 0.030); question 10 and systemic arterial hypertension (SAH) (rho=0.25, p-value=0.043); question 09 and education in years (rho=-0.24, p-value=0.045), PD stage (rho=0.33, p-value=0.006) and MMSE (rho=-0.28, p-value =0.022). In question 04, a statistically significant correlation was found between education in years (rho=-0.26, p-value=0.029), diabetes mellitus (DM) (rho=0.26, p-value=0.035) and MMSE (rho =-0.32, p-value=0.007). In question 02, a statistically significant correlation was identified between this EAT 10 question and the stage of PD (rho=0.30, p-value=0.013). Conclusion: Dysphagia was present from stage 1.5 of Parkinson's Disease. There was a direct relationship between self-perception of dysphagia and higher scores on the Hoehn & Yahr scale on PD, with the highest values achieved in the total EAT-10 being associated with low education and lower MMSE results. The comorbidities of hypertension and diabetes mellitus showed a direct relationship in the responses regarding "swallowing makes me stressed" and "I need to force myself to swallow", respectively.
Introduction: After Alzheimer's Disease (AD), Parkinson's Disease (PD) is the most common neurodegenerative disease, affecting men and women, regardless of their ethnicity and occupation. Dysphagia usually affects 80% of patients with PD and can lead to death. Objective: To characterize the risk of dysphagia in patients with Parkinson's Disease, according to the Hoehn & Yahr scale. Methodology: Clinical and prospective study CEP n: 0661/2017. The sample consisted of 150 individuals divided (experimental group – EG aged between 56 and 82 years and a control group – CG with 80 individuals aged between 63 and 97 years). The EG had a diagnosis of Idiopathic PD with stable medication, without prior assistance in the Speech Therapy service, and the CG individuals who did not present complaints related to swallowing or a previous diagnosis of dysphagia. The entire sample responded to the Mini Mental State Examination – MMSE and EAT-10 protocol, and the EG was also assessed by a physical therapist, according to the Modified Disability Scale Hoehn and Yahr, Shenkman et al 2001; Horta, 1996 to indicate the degree of impairment of clinical incapacity. Results: Of the total of 70 patients with Parkinson's Disease, 22, that is, 31.45% obtained a score equal to or greater than 3 in the EAT-10 protocol. except stage 01. There was a statistically significant correlation between the total EAT-10 and education in years (rho=-0.27, p-value=0.025) and MMSE (rho=-0.26, p-value= 0.030); question 10 and systemic arterial hypertension (SAH) (rho=0.25, p-value=0.043); question 09 and education in years (rho=-0.24, p-value=0.045), PD stage (rho=0.33, p-value=0.006) and MMSE (rho=-0.28, p-value =0.022). In question 04, a statistically significant correlation was found between education in years (rho=-0.26, p-value=0.029), diabetes mellitus (DM) (rho=0.26, p-value=0.035) and MMSE (rho =-0.32, p-value=0.007). In question 02, a statistically significant correlation was identified between this EAT 10 question and the stage of PD (rho=0.30, p-value=0.013). Conclusion: Dysphagia was present from stage 1.5 of Parkinson's Disease. There was a direct relationship between self-perception of dysphagia and higher scores on the Hoehn & Yahr scale on PD, with the highest values achieved in the total EAT-10 being associated with low education and lower MMSE results. The comorbidities of hypertension and diabetes mellitus showed a direct relationship in the responses regarding "swallowing makes me stressed" and "I need to force myself to swallow", respectively.
Descrição
Citação
MAURER, Edneia. Caracterização do Risco de Disfagia em Paciente com Doença de Parkinson. 2021. 68 f. Trabalho de Conclusão de Curso (Bacharelado em Fonoaudiologia) – Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (UNIFESP). São Paulo, 2021.