Dados do Trabalho

Título

EVALUATION OF DYSPHAGIA, SARCOPENIA AND PULMONARY FUNCTION IN PATIENTS WITH RARE NEUROMUSCULAR DISEASES

Resumo

Neuromuscular diseases (NMDs) affect the Central Nervous System (CNS) and the Peripheral Nervous System (PNS). They can be chronic, progressive and degenerative. Dysphagia is characterized by changes in one or more phases of swallowing biomechanics, preventing adequate safe, efficient and comfortable oral intake. It can cause important functional damage to the individual, such as pneumonias, malnutrition, dehydration and mortality. Another frequent manifestation is sarcopenia, which is defined as the natural and progressive loss of muscle mass and strength, whether peripheral or respiratory.
The objective of this study is to evaluate these manifestations in a group of patients from an outpatient clinic for rare neuromuscular diseases, followed by a multidisciplinary team, using the "Eating Assessment Tool - EAT-10, in the classification of the risk of dysphagia.
Methods: The following instruments were applied: sociodemographic and clinical data; Eating Assessment Tool (EAT-10) scale; Speech and voice assessment; Assessment of strength and resistance of lips and tongue measured by Iowa Oral Performance Instrument (IOPI); Nutritional assessment, including calf circumference and handgrip strength measurement; Maximum inspiratory and expiratory pressure and peak expiratory flow values.
Results: Seventy-two patients were analyzed, 38.88% men and 61.11% women. Fifty – nine patients with ALS, twenty-three with SMA. According to EAT-10, it was classified patients into risk or not risk for dysphagia. In the risk group, age was 62.0 ± 15.39 years. BMI, calf circumference and hand grip were respectively 25.10 ± 11 Kg/m2, 36.0 ± 3.3 cm and 9.8 ± 10.22 kpa. The PImax and the PEmax were 40.00 ± 29.62 cmH20 and 31.00 ± 31.82 cmH20. Peak flow value and the maximum time of sustained phonation (TMF) were 160.0 ± 103.3 L/min and 6.46 ± 9.66 s. The maximum peak of tongue tip and dorsum were, respectively, 17.50 ± 13.56 kPa and 17.00 ± 12.20 kPa. Finally, the endurance strength result was 9.00 ± 7.19 s. Values ​​from the group without risk of dysphagia were higher, but no significant differences when the groups were compared.
Conclusion: The importance of a multidisciplinary team in the follow-up of patients with neuromuscular diseases in order to promote comprehensive care is highlighted. This study presented partial results, requiring an expanded analysis to better assess the outcomes of rare conditions that affect the quality of life of these individuals.

Palavras Chave

Dysphagia; sarcopenia; pulmonary function; rare neuromuscular disease