Sequential changes in peak cough flow in patients with dysphagia Yoko Fujiwara 1 , Kimitaka Hase 1 , Fumio Nagashima 1 , Naotaka Okishio 1 1Department of Physical Medicine and Rehabilitation, Kansai Medical University Hirakata Hospital Keyword: 咳嗽時最大呼気流速(PCF) , 咳嗽力 , 嚥下障害 , 誤嚥性肺炎 , 摂食嚥下リハビリテーション , peak cough flow (PCF) , cough intensity , dysphagia , aspiration pneumonia , dysphagia rehabilitation pp.264-271
Published Date 2015/12/15
DOI https://doi.org/10.11477/mf.6001200058
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 The purpose of the present study was to investigate the sequential changes in Peak Cough Flow (PCF) in patients with dysphagia undergoing intervention. We tried to determine the relationship between PCF and the severity of dysphagia, and also to look at the PCF of patients with aspiration pneumonia. We measured the PCF of 39 male inpatients with an average age of 65 (SD 12) years who received swallowing training. There was a positive correlation between Dysphagia Severity Scale (DSS) and PCF. The PCF of the patients whose DSS score improved increased significantly, while the PCF of those whose DSS score showed no improvement did not change. At the Water Aspiration Level and Food Aspiration Level, the PCF of the patients whose DSS scores improved increased as their dysphagia rehabilitation advanced and their PCF change per day was the biggest between the day when patients started training with food (direct training) and the day when their feeding tubes were removed. The results suggest that the strength of cough greatly improves when the direct swallowing training progresses to the recovery of full oral intake. The precritical PCF of the patients with aspiration pneumonia was as low as 140L/min. It is recommended for patients with the low PCF level to start direct training after the appropriate meal form is evaluated by videofluorography or videoendoscopy and the strength of cough is improved.

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