Deglutição de parkinsonianos pré e pós riboflavina: queixa, aspectos funcionais e impacto na vida diária
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Data
2009-01-28
Autores
Silvério, Carolina Castelli [UNIFESP]
Orientadores
Gonçalves, Maria Inês Rebelo [UNIFESP]
Tipo
Dissertação de mestrado
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Objetivo: verificar a relação entre queixa, aspectos funcionais da deglutição e impacto na qualidade de vida referente à voz e à deglutição, em pacientes portadores da doença de Parkinson, submetidos à administração de riboflavina, no período de um ano. Métodos: participaram do estudo 16 pacientes portadores da Doença de Parkinson, com média de idade de 67,25 anos, média do nível de severidade da doença de II para III e média de tempo de diagnóstico da doença de Parkinson de 3,5 anos. As avaliações videofluoroscópicas da deglutição foram realizadas antes e após um ano da administração de riboflavina e restrição de carne vermelha e de aves. Foram realizadas a análise qualitativa da deglutição, a verificação da presença de queixa com relação à deglutição e aplicação de dois protocolos de qualidade de vida sendo relacionados um com o impacto da alteração vocal, e outro com o impacto da alteração na deglutição. A análise quantitativa compreendeu a realização de medidas de deslocamento do osso hióide, de abertura do esfíncter esofágico superior e de constrição da faringe. Resultados: foram observadas redução da queixa e discreta piora na qualidade de vida relacionada à voz e à deglutição, maior freqüência de ocorrência de deglutição normal, no momento pós-riboflavina. Não foram observadas diferenças significativas entre as medidas quantitativas. Conclusões: Conclui-se neste estudo que: houve melhora, apesar de não significativa, da queixa relacionada à deglutição; não ocorreram pioras significativas na dinâmica da deglutição, com exceção do deslocamento da cartilagem cricóidea na consistência de líquido fino após um ano de estudo; não houve piora com relação ao impacto na qualidade de vida, tanto relacionado à deglutição, quanto ao aspecto vocal; os pacientes que não apresentavam queixas de deglutição no momento pré apresentaram melhora na dinâmica da deglutição, com exceção da constrição da faringe; os pacientes com queixa de deglutição no momento pré apresentaram melhora nos índices de qualidade de vida e na auto-avaliação vocal segundo o QVV, no momento pós.
Objective: to verify the relation between clinical complaint, swallowing functional aspects and the impact on quality of life related to voice and swallowing in patients with Parkinson´s disease submitted to treatment with riboflavin during one year period. Method: sixteen patients with Parkinson´s disease participated in the study; mean age was 67.25 years old, mean degree of disease severity was II to III and mean time of disease diagnosis was 3.5 years. Videofluoroscopic evaluations were performed before and after one year of treatment with riboflavin and restriction diet of read meat and chicken. It were analyzed: qualitative analysis of swallowing, presence of complaints related to swallowing, application of questionnaires related to the impact of voice and swallowing alterations and quantitative analyses of swallowing, which included computerized measurements of hyoid bone and cricoid cartilage displacement, opening of the superior esophageal sphincter and pharyngeal constriction. Results: it were observed: decrease of complaints and slight worsening in quality of life impact regarding voice and swallowing and more frequent normal swallowing post riboflavin; there were no significant changes regarding quantitative measurements. Conclusions: there was a non significant improvement regarding swallowing complaints; it were not observed significant impairments of the swallowing dynamics, except for cricoid cartilage displacement during thin liquid ingestion at the end of the treatment; there was no impairment of quality of life regarding swallowing or voice; patients without swallowing complaints at the beginning of the treatment showed improvement in swallowing dynamics, except for pharyngeal constriction; patients with swallowing complaints at the beginning of the treatment showed improvement regarding quality of life and vocal selfevaluation after treatment.
Objective: to verify the relation between clinical complaint, swallowing functional aspects and the impact on quality of life related to voice and swallowing in patients with Parkinson´s disease submitted to treatment with riboflavin during one year period. Method: sixteen patients with Parkinson´s disease participated in the study; mean age was 67.25 years old, mean degree of disease severity was II to III and mean time of disease diagnosis was 3.5 years. Videofluoroscopic evaluations were performed before and after one year of treatment with riboflavin and restriction diet of read meat and chicken. It were analyzed: qualitative analysis of swallowing, presence of complaints related to swallowing, application of questionnaires related to the impact of voice and swallowing alterations and quantitative analyses of swallowing, which included computerized measurements of hyoid bone and cricoid cartilage displacement, opening of the superior esophageal sphincter and pharyngeal constriction. Results: it were observed: decrease of complaints and slight worsening in quality of life impact regarding voice and swallowing and more frequent normal swallowing post riboflavin; there were no significant changes regarding quantitative measurements. Conclusions: there was a non significant improvement regarding swallowing complaints; it were not observed significant impairments of the swallowing dynamics, except for cricoid cartilage displacement during thin liquid ingestion at the end of the treatment; there was no impairment of quality of life regarding swallowing or voice; patients without swallowing complaints at the beginning of the treatment showed improvement in swallowing dynamics, except for pharyngeal constriction; patients with swallowing complaints at the beginning of the treatment showed improvement regarding quality of life and vocal selfevaluation after treatment.
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Citação
SILVÉRIO, Carolina Castelli. Deglutição de parkinsonianos pré e pós riboflavina: queixa, aspectos funcionais e impacto na vida diária. 2009. Dissertação (Mestrado) - Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), São Paulo, 2009.