Therapeutic approach to dysphagia in post-COVID patients in a rehabilitation unit: a descriptive longitudinal study

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• dc.contributor.author Guillén-Solà, Anna
• dc.contributor.author Ramírez, Cindry
• dc.contributor.author Nieto, Sonia
• dc.contributor.author Duarte Oller, Esther
• dc.contributor.author Tejero Sánchez, Marta
• dc.contributor.author Grillo, Christian
• dc.contributor.author Bel, Helena
• dc.contributor.author Boza, Roser
• dc.date.accessioned 2025-05-23T05:53:53Z
• dc.date.available 2025-05-23T05:53:53Z
• dc.date.issued 2024
• dc.description.abstract Background: A high rate of hospitalized patients for COVID-19 had dysphagia, frequently underdiagnosed, and not treated, inducing a prolonged dysphagia with protracted recovery. Specific treatments and protocols have not been well described yet. Aim: Given the potential benefits of respiratory muscle training (IEMT) and neuromuscular stimulation (NMES) in dysphagia treatment, this study aimed to assess the feasibility of the protocol used for treating dysphagia in patients who experienced prolonged hospitalization for COVID-19. Design: Observational, descriptive, prospective study. Setting: Department of Physical Medicine and Rehabilitation of a tertiary University hospital. Population: Fifty-eight COVID-19 patients were admitted for intensive rehabilitation (March 2020 to October 2021) were prospectively studied. Methods: Dysphagia was diagnosed using videofluoroscopy and treated with a 3-week protocol adapted from neuromuscular stimulation (NMES) in a motor threshold and inspiratory/expiratory muscle strength training (IEMST), five sets of five repetitions three times daily for 3 weeks. Feasibility was assessed with adherence, outcomes achieved, and occurrence of adverse/unexpected events. Respiratory function (peak cough flow, maximal inspiratory/expiratory pressures) and swallow function (Penetration-Aspiration Scale and Bolus Residue Scale measured by videofluoroscopy) were recorded descriptive statistics, Student's t test for numerical data, and Wilcoxon Test for ordinal variables were applied. SPPSS vs28 and STATA version 15.1 (StataCorp, College Station, TX, USA) were used for statistical analysis. P values 0.05 were considered significant. Results: Dysphagia was highly prevalent in severe COVID-19 patients (86.6%); all respiratory and swallow parameters improved after a 3-week intervention and 12 of 18 patients dependent on tube feeding resumed a normal diet (66.7%; McNemar P=0.03), and 84.09% attended a no restriction diet at discharge. Adherence to treatment was 85%. No significant adverse events were detected. Conclusions: We conclude that a structured swallowing-exercise training intervention based on IEMT and NMES is feasible and safe in prolonged hospitalization post-COVID patients. Clinical rehabilitation impact: To describe rehabilitation protocols used to treat dysphagia in post-COVID patients will help us to optimize the available techniques in each center and to induce a faster recovery avoiding potential complications.
• dc.format.mimetype application/pdf
• dc.identifier.citation Guillen-Sola A, Ramírez C, Nieto S, Duarte E, Tejero M, Grillo C, et al. Therapeutic approach to dysphagia in post-COVID patients in a rehabilitation unit: a descriptive longitudinal study. Eur J Phys Rehabil Med. 2024 Apr;60(2):373-81. DOI: 10.23736/S1973-9087.24.08234-0
• dc.identifier.doi http://dx.doi.org/10.23736/S1973-9087.24.08234-0
• dc.identifier.issn 1973-9087
• dc.identifier.uri http://hdl.handle.net/10230/70463
• dc.language.iso eng
• dc.publisher Edizione Minerva Medica
• dc.relation.ispartof Eur J Phys Rehabil Med. 2024 Apr;60(2):373-81
• dc.rights Copyright © 2024 THE AUTHORS. This is an open access article distributed under the terms of the CC BY-NC-ND 4.0 license which allows users to copy and distribute the manuscript, as long as this is not done for commercial purposes and further does not permit distribution of the manuscript if it is changed or edited in any way, and as long as the user gives appropriate credits to the original author(s) and the source (with a link to the formal publication through the relevant DOI) and provides a link to the license.
• dc.rights.accessRights info:eu-repo/semantics/openAccess
• dc.rights.uri http://creativecommons.org/licenses/by-nc-nd/4.0/
• dc.subject.keyword Deglutition disorders
• dc.subject.keyword COVID-19
• dc.subject.keyword Rehabilitation
• dc.subject.keyword Neuromuscular monitoring
• dc.subject.keyword Breathing exercises
• dc.title Therapeutic approach to dysphagia in post-COVID patients in a rehabilitation unit: a descriptive longitudinal study
• dc.type info:eu-repo/semantics/article
• dc.type.version info:eu-repo/semantics/publishedVersion