Northwestern Dysphagia Patient Check Sheet 101 :

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1 88/4/24 : 88/0/5 : (MS) :.. Northwestern Dysphagia Patient Check Sheet 0 : 4. «-» (EDSS )... :.. :.. : mpoorjavad@yahoo.com ( ) 4.. : Associated Factors with Swallowing Disorders in Patients with Multiple Sclerosis Marziyeh Poorjavad MSc *, Fatemeh Derakhshandeh MSc **, Masoud Etemadifar MD ***, Bahram Soleymani PhD **** Abstract Background: Swallowing disorders are commonly observed in more than one-third of patients with multiple sclerosis (MS). However, dysphagia in multiple sclerosis usually receives limited attention. The purpose of this study was to identify associated factors with different kinds of swallowing disorders in these patients. Methods: Swallowing function of 0 consecutive multiple sclerosis patients evaluated by the Northwestern Dysphagia Patient Check Sheet and Clinical Oropharyngeal Examination, clinically. Northwestern Dysphagia Patient Check Sheet could have identified patients with pharyngeal stage disorders, aspiration, oral stage disorders, and/or pharyngeal delay. Then possible associations between these disorders and age, age at onset of disease, disease duration and neurological disability were studied. Findings: Oral stage disorders related to disease duration (P = 0.00) and neurological disability as measured by EDSS scores (P < 0.00). Moreover, the prevalence of pharyngeal delay rose with increasing disease duration, significantly (P = 0.004). But the significant associations were not observed between swallowing disorders and age, and age at onset of disease. Conclusion: The findings of this study emphasized the importance of assessment and management of swallowing function in multiple sclerosis patients, especially in patients with a high EDSS score and long disease duration. Keywords: Multiple Sclerosis, Swallowing Disorders, Dysphagia. * Speech Therapist, School of Rehabilitation Sciences, Isfahan University of Medical Sciences, Isfahan, Iran. ** Faculty Member Department, of Speech Therapy, School of Rehabilitation Sciences, Isfahan University of Medical Sciences, Isfahan, Iran. *** Professor, Department of Neurology, Al-zahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran. **** Assistant Professor of Biostatistics, School of Medical, Najafabad Branch, Islamic Azad University, Isfahan, Iran. Corresponding Author: Marziyeh Poorjavad MSc, mpoorjavad@yahoo.com 389 /04 / 40

2 MS. (7) MS.(8) MS. (9).(8 0-).(8-9 -3) MS (0) Calcagno MS 34/3. (3) Wiles Thomas (4) Svensson Hartelius (5) Bergamaschi MS (). 3/ MS.(8-2).(8 2) (2 0) MS. MS.(-2)......(3). (4). ) (.(4) (MS). (5).(6) /04 /

3 MS. Northwestern» (8) Dysphagia Patient Check Sheet. (9) «- Northwestern Dysphagia Patient Check Logemann (8) Sheet (8) (9) «-» Daniels (9).(0).. MS.. EDSS. (6) (EDSS) () MS ( ) 0 MS.(7) EDSS 2 6 Anarthria /04 / 42

4 MS 0/ ( 80/2) 8 34 ± 9/3. ( 9/8) 5/9 ± 5 27/9 ± 8/5. 6 2/26 ± /2... Mann-Whitney EDSS.(P < 0/00) Northwestern Dysphagia 4 Patient Check Sheet. (8) Logemann (EDSS ). MS Mann-Whitney. t. Northwestern» Dysphagia Patient Check Sheet «-. P value. z 0/52 -/4 2/2 2/ /52-0/64 2/ < 0/0-3/5 2/ 4/ / -/6 2/2 4/ /04 /

5 MS.2 t 0/22 -/3 -/2 5/2 4/3 5/6 6/ /62-0/97-0/50 5/ 2/8 5/9 6/ /00-7/2-3/3 4/7 5/2 5/6 2/ /004-4/2-2/9 4/8 0 5/8 20/ ( ). (EDSS ) MS... ( ). MS. (0) Calcagno (5) Bergamaschi t..(2 ) (P < 0/05).(P < 0/05)». «.(P < 0/05) MS 389 /04 / 44

6 MS. MS.... MS. MS..... MS Calcagno. (22) Abraham (0). ) MS ( MS MS. References. Provencio-Arambula MH, Provencio D, Hegde MN. Assessment of dysphagia in adults: recources and protocols in English and Spanish. San Diego: Plural Publishing; p Logemann JA. Evaluation and treatment of swallowing disorders. 2 nd Sub ed. Texas: Pro-Ed; Murry T, Carrau RL. Clinical management of swallowing disorders. 2 nd ed. San Diego: Plural Publishing; Perlman AL, Schulze K. Deglutition and it s disorder. San Diego: Singular Publishing Group; 7. p Hazrati M, Zahmatkeshan N, Dejbakhsh T, Nikseresht AR, Zeyghami B. The effect of rehabilitation process on the quality of life in multiple sclerosis patients. Armaghan-e-Danesh 2005; 0(3): [Persian]. 6. Etemadifar M, Ashtari F. Diagnosis and Treatment of Multiple Sclerosis. Isfahan: Chaharbagh Publication; p. 9. [Persian]. 7. Cichero J, Murdoch B. Dysphagia: foundation, theory and practice. New York: Kohn Wiley and Sons Ltd; p /04 /

7 MS 8. Marchese-Ragona R, Restivo D, Marioni G, Ottaviano G, Masiero S, Staffieri A. Evaluation of swallowing disorders in multiple sclerosis. Neurol Sci 2006; 27(Suppl 4): s335-s Restivo DA, Marchese-Ragona R, Patti F. Management of swallowing disorders in multiple sclerosis. Neurol Sci 2006; 27(Suppl 4): s Calcagno P, Ruoppolo G, Grasso MG, De Vincentiis M, Paolucci S. Dysphagia in multiple sclerosis - prevalence and prognostic factors. Acta Neurol Scand 2002; 05(): Poorjavad M, Derakhshandeh F, Etemadifar M, Soleymani B, Minagar A, Maghzi AH. Oropharyngeal dysphagia in multiple sclerosis. Multiple Sclerosis [Persian]. 2. Abraham SS, Yun PT. Laryngopharyngeal dysmotility in multiple sclerosis. Dysphagia 2002; 7(): Thomas FJ, Wiles CM. Dysphagia and nutritional status in multiple sclerosis. J Neurol 9; 246(8): Hartelius L, Svensson P. Speech and swallowing symptoms associated with Parkinson's disease and multiple sclerosis: a survey. Folia Phoniatr Logop 4; 46(): Bergamaschi R, Crivelli P, Rezzani C, Patti F, Solaro C, Rossi P, et al. The DYMUS questionnaire for the assessment of dysphagia in multiple sclerosis. J Neurol Sci 2008; 269(-2): Kurtzke JF. Rating neurologic impairment in multiple sclerosis: an expanded disability status scale (EDSS). Neurology 983; 33(): Kesselring J. Multiple sclerosis. Cambridge: Cambridge University Press; 7. p Logemann JA, Veis S, Colangelo L. A screening procedure for oropharyngeal dysphagia. Dysphagia 9; 4(): Daniels SK, McAdam CP, Brailey K, Foundas AL. Clinical assessment of swallowing and prediction of dysphagia severity. American Journal of Speech-Language Pathology 7; 6(4): De Pauw A, Dejaeger E, D'hooghe B, Carton H. Dysphagia in multiple sclerosis. Clin Neurol Neurosurg 2002; 04(4): Wiesner W, Wetzel SG, Kappos L, Hoshi MM, Witte U, Radue EW, et al. Swallowing abnormalities in multiple sclerosis: correlation between videofluoroscopy and subjective symptoms. Eur Radiol 2002; 2(4): Abraham S, Scheinberg LC, Smith CR, LaRocca NG. Neurologic impairment and disability status in outpatients with multiple sclerosis reporting dysphagia symptomatology. Neurorehabilitation and Neural Repair 7; (): /04 / 46

Swallowing Disorders and Their Management in Patients with Multiple Sclerosis

National Multiple Sclerosis Society 733 Third Avenue New York, NY 10017-3288 Clinical Bulletin Information for Health Professionals Swallowing Disorders and Their Management in Patients with Multiple Sclerosis