Amyotrophic Lateral Sclerosis (ALS): dysphagia assessment and nutritional aspects management
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Abstract
Background
This research examines a number of patients with Amyotrophic Lateral Sclerosis (ALS), by evaluating the impact of specific dietary protocols in the malnutrition management.
The study aims at verifying how the correct nutritional aspects management- through diet protocols and dysphagia assessment scales - can improve the nutrition and nutritional status of patients affected by this pathology, reducing the related complications and improving their life quality.
Materials and Methods
11 patients diagnosed with ALS were examined and subjected to two different eating attitude screening tests (Eating Attitude Test 10; Northwestern Dysphagia Patient Check Sheet), which were repeated six months apart.
Results
The carried out evaluations showed an improvement (36% of the cases) in the history of recurrent pneumonia and in the frequency of feverish peaks.
As regards the behavioural variables, improvements (36% of cases) in the awareness of dysphagia and in the management of salivary secretions have been observed.
In 91% of cases there was a marked improvement in the delay of the pharyngeal reflex of swallowing.
Discussion
The results of the research, according to the scientific evidence of the sector, point out the importance of taking care of the nutritional status of patients in relation to their life expectancy and quality and highlight the value of constant monitoring of swallowing abilities to prevent associated complications (e.g. malnutrition and / or dehydration).
Conclusion
A correct mutlidisciplinary management, which includes a constant assessment of swallowing and the use of specific dietary protocols, improves the nutrition of patients with ALS, reducing the risk of complications development (e.g. malnutrition, aspiration during the meal) and improving the life quality of the patient.
Key – words
Dysphagia, Speech Therapy, Malnutrition, ALS.
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References
[2] Goutman SA. Diagnosis and clinical management of amyotrophic lateral sclerosis and other motorneuron disorders. CONTINUUM: Lifelong Learning in Neurology. 2017 Oct 1;23(5):1332-59.
[3] Couratier P, Corcia P, Lautrette G, Nicol M, Preux PM, Marin B. Epidemiology of amyotrophic lateral sclero-sis: a review of literature. Revue neurologique. 2016 Jan 1;172(1):37-45.
[4] Watts CR, Vanryckeghem M. Laryngeal dysfunction in amyotrophic lateral sclerosis: a review and case re-port. BMC Ear, Nose and Throat Disorders. 2001 Dec;1(1):1.
[5] Greenwood DI. Nutrition management of amyotrophic lateral sclerosis. Nutrition in clinical practice. 2013 Jun;28(3):392-9.
[6] Desport JC, Maillot F. Nutrition et sclérose latérale amyotrophique (SLA). Nutrition clinique et métaboli-sme. 2002 Jun 1;16(2):91-6.
[7] Lisiecka D, Kelly H, Jackson J. How do people with Motor Neurone Disease experience dysphagia? A qualita-tive investigation of personal experiences. Disability and rehabilitation. 2019 Sep 24:1-0.
[8] Kidney D, Alexander M, Corr B, O'Toole O, Hardiman O. Oropharyngeal dysphagia in amyotrophic lateral sclerosis: neurological and dysphagia specific rating scales. Amyotrophic Lateral Sclerosis and Other Motor Neuron Disorders. 2004 Sep 1;5(3):150-3.
[9] Allison KM, Yunusova Y, Campbell TF, Wang J, Berry JD, Green JR. The diagnostic utility of patient-report and speech-language pathologists’ ratings for detecting the early onset of bulbar symptoms due to ALS. Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration. 2017 Jul 3;18(5-6):358-66.
[10] Brown RH, Swash M, Pasinelli P, editors. Amyotrophic lateral sclerosis. Taylor & Francis; 1999 Oct 29.
[11] Agenzia Regionale per i Servizi Sanitari - Regione Piemonte “Percorso Diagnostico Terapeutico Assistenziale della Disfagia, 2013”.
[12] Limousin N, Blasco H, Corcia P, Gordon PH, De Toffol B, Andres C, Praline J. Malnutrition at the time of di-agnosis is associated with a shorter disease duration in ALS. Journal of the neurological sciences. 2010 Oct 15;297(1-2):36-9.
[13] Genton L, Viatte V, Janssens JP, Héritier AC, Pichard C. Nutritional state, energy intakes and energy ex-penditure of amyotrophic lateral sclerosis (ALS) patients. Clinical nutrition. 2011 Oct 1;30(5):553-9.
[14] Sathasivam S. Managing patients with amyotrophic lateral sclerosis. European journal of internal medicine. 2009 Jul 1;20(4):355-8.
[15] Holm T, Maier A, Wicks P, Lang D, Linke P, Münch C, Steinfurth L, Meyer R, Meyer T. Severe loss of appe-tite in amyotrophic lateral sclerosis patients: online self-assessment study. Interactive journal of medical research. 2013;2(1):e8.
[16] Belafsky PC, Mouadeb DA, Rees CJ, Pryor JC, Postma GN, Allen J, Leonard RJ. Validity and reliability of the Eating Assessment Tool (EAT-10). Annals Otology Rhinology & Larynology 2008; 117(12): 919-924.
[17] Logemann JA, Veis S, Colangelo L. A screening procedure for oropharyngeal dysphagia. Dysphagia. 1999 Jan 1;14(1):44-51.
[18] Schindler O. Raimondo S. Linee guida sulla gestione del paziente disfagico adulto in foniatria e logopedia. Torino: Consensus Conference, 29 gennaio 2007. Acta Phoniatrica Latina. 2007; 29:5-31.
[19] Guigoz Y, Vellas J, Garry P (1994)., Mini Nutritional Assessment: A practical assessment tool for grading the nutritional state of elderly patients., Facts Res Gerontol 4 (supp. 2):15-59
[20] Andersen PM, Borasio GD, Dengler R, Hardiman O, Kollewe K, Leigh PN, Pradat PF, Silani V, Tomik B. EFNS task force on management of amyotrophic lateral sclerosis: guidelines for diagnosing and clinical care of patients and relatives: An evidence‐based review with good practice points. European Journal of Neurology. 2005 Dec;12(12):921-38.
[21] Madeddu A., Sciacca S., Epidemiologia facile tra scuola e territorio – Elementi di Metodologia Epidemiologi-ca e Biostatistica per studenti universitari e operatori delle aziende sanitarie – Esse Editrice, Cecchina (Ro-ma) 2006.
[22] Muscaritoli M, Kushta I, Molfino A, Inghilleri M, Sabatelli M, Fanelli FR. Nutritional and metabolic support in patients with amyotrophic lateral sclerosis. Nutrition. 2012; Oct 1; 28(10):959-66.
[23] Schindler O, Ruoppolo G, Schindler A. Deglutologia. Omega; 2001.
[24] Decreto Assessoriale n. 1177/2015 Dipartimento Regionale per la Pianificazione Strategica – Servizio 8 - Assessorato della Salute – Regione Sicilia “Linee guida per la presa in carico delle persone affette da Scle-rosi Laterale Amiotrofica”.