Top

Neurological Sciences

Published in:

09-03-2022 | Dysphagia | Original Article

Relationship between dysphagia severity and head and neck proprioception in patients with neurological disorders

Authors: Mahmut Sevim, Numan Demir, Aynur Ayşe Karaduman, Selen Serel-Arslan

Published in: Neurological Sciences | Issue 7/2022

Abstract

Purpose

The aim of this study was to examine the relationship between dysphagia severity and head and neck proprioception in patients with neurological diseases.

Methods

Twenty-six patients with neurological diseases who received the modified barium swallowing study (MBSS) were included. Dysphagia severity was assessed with the penetration aspiration scale (PAS). Patients were divided into two groups according to their PAS scores as “with dysphagia” (n = 15) and “without dysphagia” (n = 11). Active range of motion (AROM) and muscle strength were measured. Proprioception measurement of the cervical region was performed with a laser marker placed on the head of the patients, and the deviation from the middle target was noted in centimeters.

Results

There was no difference between groups in terms of gender, age, height, weight, diagnosis, AROM, and the muscle strength of the cervical region (p > 0.05). A moderate, positive correlation was found between dysphagia severity and the results of proprioception in terms of neck flexion, extension, and left rotation (r = 0.48, p = 0.01; r = 0.58, p = 0.002; r = 0.42, p = 0.02, respectively). There was a statistically significant difference in proprioception measurements of neck flexion, extension, and left rotation between groups (p < 0.05).

Conclusion

In conclusion, patients’ decreased head and neck proprioception is related to severe dysphagia. Therefore, a holistic approach should be followed for swallowing function, and head and neck proprioception should be considered in dysphagia management.

Daniels SK, Brailey K, Foundas AL (1999) Lingual discoordination and dysphagia following acute stroke: analyses of lesion localization. Dysphagia 14(2):85–92. https://doi.org/10.1007/PL00009592CrossRefPubMed

Robbins J (1999) Old swallowing and dysphagia: thoughts on intervention and prevention. Nutr Clin Pract 14:21–26. https://doi.org/10.1177/0884533699014005S05CrossRef

Hägg M, Larsson B (2004) Effects of motor and sensory stimulation in stroke patients with long-lasting dysphagia. Dysphagia 19(4):219–230. https://doi.org/10.1007/s00455-004-0016-3CrossRefPubMed

Logemann JA (1998) Swallowing physiology and pathophysiology. Otolaryngol Clin North Am 21(4):613–623CrossRef

Mekata K, Takigawa T, Matsubayashi J et al (2013) Cervical spine motion during swallowing. Eur Spine J 22(11):2558–3256. https://doi.org/10.1007/s00586-013-2975-2CrossRefPubMedPubMedCentral

Larnert G, Ekberg O (1995) Positioning improves the oral and pharyngeal swallowing function in children with cerebral palsy. Acta Paediatr 84(6):689–693. https://doi.org/10.1111/j.1651-2227.1995.tb13730.xCrossRefPubMed

Röijezon U, Clark NC, Treleaven J (2015) Proprioception in musculoskeletal rehabilitation. Part 1: basic science and principles of assessment and clinical interventions. Man Ther 20(3):368–377. https://doi.org/10.1016/j.math.2015.01.008CrossRefPubMed

Milner TE, Hinder MR, Franklin DW (2007) How is somatosensory information used to adapt to changes in the mechanical environment? Prog Brain Res 165:363–372. https://doi.org/10.1016/s0079-6123(06)65022-xCrossRefPubMed

Riemann BL, Lephart SM (2002) The sensorimotor system, part I: the physiologic basis of functional joint stability. J Athl Train 37(1):71. http://www.ncbi.nlm.nih.gov/pmc/articles/pmc164311/PubMedPubMedCentral

10.

Liu JX, Thornell LE, Pedrosa-Domellöf F (2003) Muscle spindles in the deep muscles of the human neck: a morphological and immunocytochemical study. J Histochem Cytochem 51(2):175–186. https://doi.org/10.1177/002215540305100206CrossRefPubMed

11.

Bisch EM, Logemann JA, Rademaker AW et al (1994) Pharyngeal effects of bolus volume, viscosity, and temperature in patients with dysphagia resulting from neurologic impairment and in normal subjects. J Speech Res 37(5):1041–1049. https://doi.org/10.1044/jshr.3705.1041CrossRef

12.

Kılınç HE, Arslan SS, Demir N et al (2002) The effects of different exercise trainings on suprahyoid muscle activation, tongue pressure force and dysphagia limit in healthy subjects. Dysphagia 35(4):717–724. https://doi.org/10.1007/s00455-019-10079-wCrossRef

13.

Shaker R, Kern M, Bardan E et al (1997) Augmentation of deglutitive upper esophageal sphincter opening in the elderly by exercise. Am J Physiol Gastrointest Liver Physiol 272(6):G1518–G1522. https://doi.org/10.1152/ajpgi.1997.272.6.g1518CrossRef

14.

Connell LA, Lincoln NB, Radford KA (2008) Somatosensory impairment after stroke: frequency of different deficits and their recovery. Clin Rehabil 22(8):758–767. https://doi.org/10.1177/0269215508090674CrossRefPubMed

15.

Dick JP, Guiloff RJ, Stewart A et al (1984) Mini-mental state examination in neurological patients. J Neurol Neurosurg Psychiatry 47(5):496–499. https://doi.org/10.1136/jnnp.47.5.496CrossRefPubMedPubMedCentral

16.

Treleaven J (2008) Sensorimotor disturbances in neck disorders affecting postural stability, head and eye movement control. J Man Ther 13(1):2–11. https://doi.org/10.1016/j.math.2007.06.003CrossRef

17.

Folstein MF, Folstein SE, McHugh PR (1975) “Mini-mental state”: a practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 12(3):189–198. https://doi.org/10.1016/0022-3956(75)90026-6CrossRefPubMed

18.

Lee JW, Randall DR, Evangelista LM et al (2017) Subjective assessment of videofluoroscopic swallow studies. Otolaryngol Head Neck Surg 156(5):901–905. https://doi.org/10.1177/0194599817691276CrossRefPubMed

19.

Martin-Harris B, Jones B (2008) The videofluorographic swallowing study. Phys Med Rehabil Clin N Am 19(4):769–785. https://doi.org/10.1016/j.pmr.2008.06.004CrossRefPubMedPubMedCentral

20.

Logemann JA (1998) Instrumental techniques for the study of swallowing. Austin/Texas, pp 169–185

21.

Rosenbek JC, Robbins JA, Roecker EB et al (1996) A penetration-aspiration scale. Dysphagia 11(2):93–98. https://doi.org/10.1007/bf00417897CrossRefPubMed

22.

Karaduman AA, Serel S, Ünlüer Ö et al (2012) The penetration aspiration scale: an interrater reliability study. Fizyoter Rehabil 23(3):151–155

23.

Bohannon RW (1986) Test-retest reliability of hand-held dynamometry during a single session of strength assessment. Phys Ther 66(2):206–209. https://doi.org/10.1093/ptj/66.2.206CrossRefPubMed

24.

Lovett RW, Martin EG (1916) Certain aspects of infantile paralysis: with a description of a method of muscle testing. J Am Med Assoc 66(10):729–733. https://doi.org/10.1001/jama.1916.02580360031009CrossRef

25.

Revel M, Andre-Deshays C, Minguet M (1991) Cervicocephalic kinesthetic sensibility in patients with cervical pain. Arch Phys Med Rehabil 72(5):288–291. https://doi.org/10.5555/uri:pii:000399939190243CCrossRefPubMed

26.

Kristjansson E, Dall’Alba P, Jull G (2001) Cervicocephalic kinaesthesia: reliability of a new test approach. Physiother Res Int 6(4):224–235. https://doi.org/10.1002/pri.230CrossRefPubMed

27.

Mukaka MM (2012) Statistics corner: a guide to appropriate use of correlation coefficient in medical research. Malawi Med J 24:69–71. http://www.ncbi.nlm.nih.gov/pmc/articles/pmc3576830/PubMedPubMedCentral

28.

Takizawa C, Gemmell E, Kenworthy J et al (2016) A systematic review of the prevalence of oropharyngeal dysphagia in stroke, Parkinson’s disease, Alzheimer’s disease, head injury, and pneumonia. Dysphagia 31(3):434–441. https://doi.org/10.1007/s00455-016-9695-9CrossRefPubMed

29.

Leibowitz N, Levy N, Weingarten S et al (2008) Automated measurement of proprioception following stroke. Disabil rehabil 30(24):1829–1836. https://doi.org/10.1002/ana.26200CrossRefPubMed

30.

Vaughan SK, Kemp Z, Hatzipetros T et al (2015) Degeneration of proprioceptive sensory nerve endings in mice harboring amyotrophic lateral sclerosis–causing mutations. J Comp Neurol 523(17):2477–2494. https://doi.org/10.1002/cne.23848CrossRefPubMedPubMedCentral

31.

Riancho J, Paz-Fajardo L, Lopez de Munain A (2021) Clinical and preclinical evidence of somatosensory involvement in amyotrophic lateral sclerosis. Br J Pharmacol 178(6):1257–1268. https://doi.org/10.1111/bph.15202CrossRefPubMed

32.

Mochizuki Y, Mizutani T, Shimizu T et al (2011) Proportional neuronal loss between the primary motor and sensory cortex in amyotrophic lateral sclerosis. Neurosci Lett 503(1):73–75. https://doi.org/10.1016/j.neulet.2011.08.014CrossRefPubMed

33.

Rodriguez-Oroz MC, Rodriguez M, Guridi J et al (2001) The subthalamic nucleus in Parkinson’s disease: somatotopic organization and physiological characteristics. Brain 124(9):1777–1790. https://doi.org/10.1093/brain/124.9.1777CrossRefPubMed

34.

Peterson DS, Gera G, Horak FB (2017) Corpus callosum structural integrity is associated with postural control improvement in persons with multiple sclerosis who have minimal disability. Neurorehabil Neural Repair 2017(31):343–353. https://doi.org/10.1177/1545968316680487CrossRef

35.

Harding IH, Chopra S, Arrigoni F et al (2021) Brain structure and degeneration staging in Friedreich ataxia: magnetic resonance imaging volumetrics from the ENIGMA-ataxia working group. Ann Neurol 90(4):570–583. https://doi.org/10.1002/ana.26200CrossRefPubMed

36.

Leon-Sarmiento FE, Leon-Ariza JS, Prada D et al (2016) Sensory aspects in myasthenia gravis: a translational approach. J Neurol Sci 368:379–388. https://doi.org/10.1016/j.jns.2016.07.014CrossRefPubMed

37.

Lee H, Nicholson LL, Adams RD et al (2005) Proprioception and rotation range sensitization associated with subclinical neck pain. Spine 30(3):E60-67. https://doi.org/10.1097/01.brs.0000152160.28052.a2CrossRefPubMed

38.

Gosselin G, Rassoulian H, Brown I (2004) Effects of neck extensor muscles fatigue on balance. Clin Biomech (Bristol, Avon) 19(5):473–479. https://doi.org/10.1016/j.clinbiomech.2004.02.001CrossRef

39.

Treleaven J, Jull G, LowChoy N (2005) Smooth pursuit neck torsion test in whiplash- associated disorders: relationship to self-reports of neck pain and disability, dizziness and anxiety. J Rehabil Med 37(4):219–223. https://doi.org/10.1080/16501970410024299CrossRefPubMed

40.

Stanton TR, Leake HB, Chalmers KJ et al (2016) Evidence of impaired proprioception in chronic, idiopathic neck pain: systematic review and meta-analysis. Phys Ther 96(6):876–887. https://doi.org/10.2522/ptj.20150241CrossRefPubMed

41.

Dodds WJ, Man KM, Cook IJ (1988) Influence of bolus volume on swallow-induced hyoid movement in normal subjects. AJR Am J Roentgenol 150:1307–1309. https://doi.org/10.2214/ajr.150.6.1307CrossRefPubMed

42.

Ueda N, Nohara K, Kotani Y et al (2013) Effects of the bolus volume on hyoid movements in normal individuals. J Oral Rehabil 40(7):491–499. https://doi.org/10.1111/joor.12060CrossRefPubMed

43.

Aviv JE, Martin JH, Sacco RL et al (1996) Supraglottic and pharyngeal sensory abnormalities in stroke patients with dysphagia. Ann Otol Rhinol Laryngol 105(2):92–97. https://doi.org/10.1177/000348949610500202CrossRefPubMed

44.

Eriksson PO, Häggman-Henrikson B, Nordh E et al (2000) Co-ordinated mandibular and head-neck movements during rhythmic jaw activities in man. J Dent Res 79(6):1378–1384. https://doi.org/10.1177/00220345000790060501CrossRefPubMed

45.

Logemann JA (1995) Dysphagia: evaluation and treatment. Folia Phoniatr Logop 47(3):140–164. https://doi.org/10.1159/000266348CrossRefPubMed

46.

Mårnsson I, Sandberg N (1974) Effects of surface anesthesia on deglutition in man. Laryngoscope 84(3):427–437. https://doi.org/10.1288/00005537-197403000-00006CrossRef

47.

Cook IJ, Dodds WJ, Dantas RO et al (1989) Timing of videofluoroscopic, manometric events, and bolus transit during the oral and pharyngeal phases of swallowing. Dysphagia 4(1):8–15. https://doi.org/10.1007/bf02407397CrossRefPubMed

48.

Bakir C (2020) The Turkish state’s responses to existential COVID-19 crisis. Policy Soc 39(3):424–441. https://doi.org/10.1080/14494035.2020.1783786CrossRefPubMedPubMedCentral

Title: Relationship between dysphagia severity and head and neck proprioception in patients with neurological disorders
Authors: Mahmut Sevim
Numan Demir
Aynur Ayşe Karaduman
Selen Serel-Arslan
Publication date: 09-03-2022
Publisher: Springer International Publishing
Keywords: Dysphagia
Dysphagia
Dysphagia
Published in: Neurological Sciences / Issue 7/2022
Print ISSN: 1590-1874
Electronic ISSN: 1590-3478
DOI: https://doi.org/10.1007/s10072-022-05998-w

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Relationship between dysphagia severity and head and neck proprioception in patients with neurological disorders

Abstract

Purpose

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 7/2022

Ultrasonographic evaluation reveals thinning of cervical nerve roots and peripheral nerves in spinal and bulbar muscular atrophy

Seeing double: check again! Isolated unilateral pseudoabducens palsy

A new mutation in the GNAL gene in familial dystonia presenting with mental symptoms

Steroid-induced spinal epidural lipomatosis in a patient with myasthenia gravis

Inattentional blindness to DWI lesions in spontaneous intracerebral hemorrhage

Impact of GABAA receptor gene variants (rs2279020 and rs211037) on the risk of predisposition to epilepsy: a case–control study