Disfaji Rehabilitasyonu
Özet
Besinlerin oral kaviteden mideye geçişinde problem varlığında disfajiden bahsedilir. Oral kavite, farenks, larenks ve özefagusun yapısal veya fonksiyonel herhangi bir patolojisinde disfaji, malnutisyon, pnömoni gibi komplikasyonlar ve kişinin toplu yemek aktivitelerine katılmasını engelleyen durum söz konusudur. Disfaji rehabilitasyonunda yutmanın iyileştirilmesi ve komplikasyonların önlenmesine odaklanılır. Yutma fizyolojisi ve ilgili yapıların anatomisine, yutma bozukluğunun patofizyolojisine, disfajiye sebep olan hastalıklara hakim olmak tedavi açısından önemlidir. Tanıda anamnez, ayrıntılı nörolojik muayeneyi içeren fizik muayene ve çeşitli görüntüleme yöntemlerinden faydalanılır. Rehabilitasyon sürecinde hasta ve aile eğitimi, yutmaya yardımcı egzersiz ve manevralardan faydalanılır. Egzersiz uygulamalarında kanıt seviyesinin artması için daha fazla randomize kontrollü çalışmaya ihtiyaç vardır.
Referanslar
Palmer JB, Pelletier CA, Matsuo K. Rehabilitation of patients with swallowing disorders in Braddom RL (ed.) Physical Medicine and Rehabilitation 4th Edition. Philadelphia: Elsevier; 2011. p 581-600.
İnanır M. Nörojenik yutma ve konuşma bozuklukları in Beyazova M, Kutsal YG (Eds.) Fiziksel Tıp ve Rehabilitasyon. 2.baskı. Ankara: Güneş Tıp Kitabevleri; 2011. p 1483- 1505.
Kamrani P, Sadiq NM. Anatomy, Head and Neck, Oral Cavity (Mouth) (Updated 2022 Aug 8). In: StatPearls (Internet). Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK545271/
Topbaş S, Nörojenik yutma bozuklukları in Oğuz H, Dursun E, Dursun N (Eds.) Tıbbi Rehabilitasyon. 2.baskı. İstanbul: Nobel Tıp Kitapevleri; 2004. p 779-795.
KM Petra. Head and neck in Elhan A (Çev. Ed.) Wolf-Heidegger’s Atlas of Human Anatomy, Berlin. Volume 2, Türkçe 1.Baskı Ankara; Güneş Kitabevi; 2001. p 51,52.
Malhi H. Dysphagia: warning signs and management. Br J Nurs. 2016 May 26-Jun 8;25(10):546-9. doi: 10.12968/bjon.2016.25.10.546. PMID: 27231737.
Labeit B, Jung A, Ahring S, et al. Relationship between post-stroke dysphagia and pharyngeal sensory impairment. Neurol Res Pract. 2023 Feb 16;5(1):7. doi: 10.1186/s42466-023-00233-z. PMID: 36793109; PMCID: PMC9933330.
Morris H. Dysphagia in the elderly-a management challenge for nurses. Br J Nurs. 2006 May 25-Jun 7;15(10):558-62. doi: 10.12968/bjon.2006.15.10.21132. PMID: 16835552.
Sitoh YY, Lee A, Phua SY, et al. Bedside assessment of swallowing: a useful screening tool for dysphagia in an acute geriatric ward. Singapore Med J. 2000 Aug;41(8):376-81. PMID: 11256344.
Takahashi, K, Groher ME, Michi K. Methodology for detecting swallowing sounds. Dysphagia 9, 54–62 (1994). https://doi.org/10.1007/BF00262760
Helliwell K, Hughes VJ, Bennion CM, et al. The use of videofluoroscopy (VFS) and fibreoptic endoscopic evaluation of swallowing (FEES) in the investigation of oropharyngeal dysphagia in stroke patients: A narrative review. Radiography (Lond). 2023 Jan 12;29(2):284-290. doi: 10.1016/j.radi.2022.12.007. Epub ahead of print. PMID: 36640583.
Krekeler BN, Davidson K, Kantarcigil C, et al. Determining Swallowing Biomechanics Underlying Modified Barium Swallow Impairment Profile Scoring Using Computational Analysis of Swallowing Mechanics. J Speech Lang Hear Res. 2022 Oct 17;65(10):3798-3808. doi: 10.1044/2022_JSLHR-22-00047. Epub 2022 Sep 8. PMID: 36075206; PMCID: PMC9927620.
Vespa E, Farina DA, Kahrilas PJ, et al. Identifying spastic variant of type II achalasia after treatment with high-resolution manometry and FLIP Panometry. Neurogastroenterol Motil. 2023 Feb 21:e14552. doi: 10.1111/nmo.14552. Epub ahead of print. PMID: 36807659.
Kunieda K, Hayashi Y, Yoshikura N, et al. The Usefulness of Swallowing Pressure Assessment in the Identification of Mild Pharyngeal Weakness of Myasthenia Gravis: A Case Report. Case Rep Neurol. 2022 Sep 30;14(3):372-376. doi: 10.1159/000526399. PMID: 36824579; PMCID: PMC9941770.
Recasens BB, Guillen-Sola A, Llorens JMM, et al. Ultrasonographic and manometric study of the tongue as biomarkers of dysphagia in patients with amyotrophic lateral sclerosis. Neurol Sci. 2023 Mar;44(3):931-939. doi: 10.1007/s10072-022-06486-x. Epub 2022 Nov 11. PMID: 36367593.
Nappi AG, Altini C, D'Alò C, et al. Ruolo dello studio scintigrafico del transito orofaringoesofageo nella valutazione della disfagia nei pazienti affetti da patologia neurologica [The role of oropharyngoesophageal scintigraphy in the assessment of dysphagia in neurological patients.]. Recenti Prog Med. 2022 Dec;113(12):739-748. Italian. doi: 10.1701/3914.38976. PMID: 36420850.
Suárez-Patiño LV, Orozco-Duque A, Pérez-Giraldo E, et al. Synchronization between videofluoroscopic swallowing study and surface electromyography in patients with neurological involvement presenting symptoms of dysphagia. Biomedica. 2022 Dec 1;42(4):650-664. English, Spanish. doi: 10.7705/biomedica.6446. PMID: 36511672; PMCID: PMC9814368.
Ertekin C, Aydoğdu I, Yüceyar N. Piecemeal deglutition and dysphagia limit in normal subjects and in patients with swallowing disorders. J Neurol Neurosurg Psychiatry. 1996 Nov;61(5):491-6. doi: 10.1136/jnnp.61.5.491. PMID: 8937344; PMCID: PMC1074047.
Halfpenny R, Stewart A, Kelly P, et al. Dysphagia rehabilitation following acquired brain injury, including cerebral palsy, across the lifespan: a scoping review protocol. Syst Rev. 2021 Dec 13;10(1):312. doi: 10.1186/s13643-021-01861-9. PMID: 34903269; PMCID: PMC8667523.
Lapa S, Neuhaus E, Harborth E, et al. Dysphagia assessment in ischemic stroke after mechanical thrombectomy: When and how? Front Neurol. 2022 Nov 23;13:1024531. doi: 10.3389/fneur.2022.1024531. PMID: 36504648; PMCID: PMC9726734.
Hamilton VK, Pitts LL, Walaszek EA, et al. Videofluoroscopic Profiles of Swallowing and Airway Protection Post-traumatic Cervical Spinal Cord Injury. Dysphagia. 2022 Dec;37(6):1599-1611. doi: 10.1007/s00455-022-10407-7. Epub 2022 Feb 25. PMID: 35212848.
Braut T, Maršić M, Ravlić I, et al. Posttraumatic Vernet syndrome without fracture: A case report and short literature review. Medicine (Baltimore). 2021 Oct 29;100(43):e27618. doi: 10.1097/MD.0000000000027618. PMID: 34713846; PMCID: PMC8556020.
Lee KD, Koo JH, Song SH, et al. Central cholinergic dysfunction could be associated with oropharyngeal dysphagia in early Parkinson's disease. J Neural Transm (Vienna). 2015 Nov;122(11):1553-61. doi: 10.1007/s00702-015-1427-z. Epub 2015 Jul 22. PMID: 26199040.
Noorani M, Bolognone RK, Graville DJ, et al. The Association Between Dysphagia Symptoms, DIGEST Scores, and Severity Ratings in Individuals with Parkinson's Disease. Dysphagia. 2023 Jan 24. doi: 10.1007/s00455-023-10555-4. Epub ahead of print. PMID: 36692654.
Kim JH, Jeon J, Lee Y, et al. Striatal Dopaminergic Loss and Dysphagia in Parkinson Disease. Clin Nucl Med. 2023 Feb 1;48(2):143-149. doi: 10.1097/RLU.0000000000004501. Epub 2022 Dec 7. PMID: 36607363; PMCID: PMC9835674.
Segura T, Medrano IH, Collazo S, et al. Symptoms timeline and outcomes in amyotrophic lateral sclerosis using artificial intelligence. Sci Rep. 2023 Jan 13;13(1):702. doi: 10.1038/s41598-023-27863-2. PMID: 36639403; PMCID: PMC9839769.
Shoesmith C. Palliative care principles in ALS. Handb Clin Neurol. 2023;191:139-155. doi: 10.1016/B978-0-12-824535-4.00007-0. PMID: 36599506.
Zhao Y, Tang H, Peng T, et al. Relationship Between Nutritional Status and Severity of Cerebral Palsy: A Multicentre Cross-Sectional Study. J Rehabil Med. 2023 Jan 12;55:jrm00367. doi: 10.2340/jrm.v55.4395. PMID: 36633287; PMCID: PMC9847369.
Xinou E, Chryssogonidis I, Kalogera-Fountzila A, et al. Longitudinal Evaluation of Swallowing with Videofluoroscopy in Patients with Locally Advanced Head and Neck Cancer After Chemoradiation. Dysphagia. 2018 Oct;33(5):691-706. doi: 10.1007/s00455-018-9889-4. Epub 2018 Mar 23. PMID: 29572573.
Rivelsrud MC, Hartelius L, Speyer R, et al. Qualifications, professional roles and service practices of nurses, occupational therapists and speech-language pathologists in the management of adults with oropharyngeal dysphagia: a Nordic survey. Logoped Phoniatr Vocol. 2023 Feb 14:1-13. doi: 10.1080/14015439.2023.2173288. Epub ahead of print. PMID: 36786502.
Balou M, Herzberg EG, Kamelhar D, et al. An intensive swallowing exercise protocol for improving swallowing physiology in older adults with radiographically confirmed dysphagia. Clin Interv Aging. 2019 Feb 11;14:283-288. doi: 10.2147/CIA.S194723. PMID: 30804667; PMCID: PMC6375531.
Price K, Isbister G, Long S, et al. Are Bubbles the Future of Dysphagia Rehabilitation: A Systematic Review Analysing Evidence on the Use of Carbonated Liquids in Dysphagia Rehabilitation. Geriatrics (Basel). 2023 Jan 1;8(1):6. doi: 10.3390/geriatrics8010006. PMID: 36648911; PMCID: PMC9844419.
Zhu J, Wang X, Chen S, et al. Improving compliance with swallowing exercise to decrease radiotherapy-related dysphagia in patients with head and neck cancer. Asia Pac J Oncol Nurs. 2022 Nov 19;10(1):100169. doi: 10.1016/j.apjon.2022.100169. PMID: 36583099; PMCID: PMC9792737.
Dotevall H, Tuomi L, Petersson K, et al. Treatment with head-lift exercise in head and neck cancer patients with dysphagia: results from a randomized, controlled trial with flexible endoscopic evaluation of swallowing (FEES). Support Care Cancer. 2022 Dec 17;31(1):56. doi: 10.1007/s00520-022-07462-z. PMID: 36526734; PMCID: PMC9758100.
Choy J, Pourkazemi F, Anderson C, et al. Dosages of swallowing exercises in stroke rehabilitation: a systematic review. Eur Arch Otorhinolaryngol. 2023 Mar;280(3):1017-1045. doi: 10.1007/s00405-022-07735-7. Epub 2022 Dec 6. PMID: 36471047; PMCID: PMC9899761.
Nanto T, Ono T, Hori K et al. The effects of tongue elevation using a weighted plastic bottle on the tongue pressure and activity of suprahyoid muscles. J Oral Rehabil. 2022 Nov;49(11):1041-1048. doi: 10.1111/joor.13365. Epub 2022 Sep 5. PMID: 36029125.
Sugaya N, Goto F, Seino Y, et al. The effect of laryngeal elevation training on swallowing function in patients with dysphagia. J Laryngol Otol. 2021 Jul;135(7):574-578. doi: 10.1017/S0022215121001481. Epub 2021 Jun 16. PMID: 34130763.
Pu D, Yao TJ. The use and effects of whole-body exercises on swallowing function: A scoping review. Int J Lang Commun Disord. 2023 Feb 9. doi: 10.1111/1460-6984.12858. Epub ahead of print. PMID: 36759960.
Liu J, Wang Q, Tian J, et al. Effects of chin tuck against resistance exercise on post-stroke dysphagia rehabilitation: A systematic review and meta-analysis. Front Neurol. 2023 Jan 9;13:1109140. doi: 10.3389/fneur.2022.1109140. PMID: 36698882; PMCID: PMC9868925.
İnanır M. Nörojenik yutma ve konuşma bozuklukları in Beyazova M, Kutsal YG (Eds.) Fiziksel Tıp ve Rehabilitasyon. 2.baskı. Ankara: Güneş Tıp Kitabevleri; 2011. p 1483- 1505.
Kamrani P, Sadiq NM. Anatomy, Head and Neck, Oral Cavity (Mouth) (Updated 2022 Aug 8). In: StatPearls (Internet). Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK545271/
Topbaş S, Nörojenik yutma bozuklukları in Oğuz H, Dursun E, Dursun N (Eds.) Tıbbi Rehabilitasyon. 2.baskı. İstanbul: Nobel Tıp Kitapevleri; 2004. p 779-795.
KM Petra. Head and neck in Elhan A (Çev. Ed.) Wolf-Heidegger’s Atlas of Human Anatomy, Berlin. Volume 2, Türkçe 1.Baskı Ankara; Güneş Kitabevi; 2001. p 51,52.
Malhi H. Dysphagia: warning signs and management. Br J Nurs. 2016 May 26-Jun 8;25(10):546-9. doi: 10.12968/bjon.2016.25.10.546. PMID: 27231737.
Labeit B, Jung A, Ahring S, et al. Relationship between post-stroke dysphagia and pharyngeal sensory impairment. Neurol Res Pract. 2023 Feb 16;5(1):7. doi: 10.1186/s42466-023-00233-z. PMID: 36793109; PMCID: PMC9933330.
Morris H. Dysphagia in the elderly-a management challenge for nurses. Br J Nurs. 2006 May 25-Jun 7;15(10):558-62. doi: 10.12968/bjon.2006.15.10.21132. PMID: 16835552.
Sitoh YY, Lee A, Phua SY, et al. Bedside assessment of swallowing: a useful screening tool for dysphagia in an acute geriatric ward. Singapore Med J. 2000 Aug;41(8):376-81. PMID: 11256344.
Takahashi, K, Groher ME, Michi K. Methodology for detecting swallowing sounds. Dysphagia 9, 54–62 (1994). https://doi.org/10.1007/BF00262760
Helliwell K, Hughes VJ, Bennion CM, et al. The use of videofluoroscopy (VFS) and fibreoptic endoscopic evaluation of swallowing (FEES) in the investigation of oropharyngeal dysphagia in stroke patients: A narrative review. Radiography (Lond). 2023 Jan 12;29(2):284-290. doi: 10.1016/j.radi.2022.12.007. Epub ahead of print. PMID: 36640583.
Krekeler BN, Davidson K, Kantarcigil C, et al. Determining Swallowing Biomechanics Underlying Modified Barium Swallow Impairment Profile Scoring Using Computational Analysis of Swallowing Mechanics. J Speech Lang Hear Res. 2022 Oct 17;65(10):3798-3808. doi: 10.1044/2022_JSLHR-22-00047. Epub 2022 Sep 8. PMID: 36075206; PMCID: PMC9927620.
Vespa E, Farina DA, Kahrilas PJ, et al. Identifying spastic variant of type II achalasia after treatment with high-resolution manometry and FLIP Panometry. Neurogastroenterol Motil. 2023 Feb 21:e14552. doi: 10.1111/nmo.14552. Epub ahead of print. PMID: 36807659.
Kunieda K, Hayashi Y, Yoshikura N, et al. The Usefulness of Swallowing Pressure Assessment in the Identification of Mild Pharyngeal Weakness of Myasthenia Gravis: A Case Report. Case Rep Neurol. 2022 Sep 30;14(3):372-376. doi: 10.1159/000526399. PMID: 36824579; PMCID: PMC9941770.
Recasens BB, Guillen-Sola A, Llorens JMM, et al. Ultrasonographic and manometric study of the tongue as biomarkers of dysphagia in patients with amyotrophic lateral sclerosis. Neurol Sci. 2023 Mar;44(3):931-939. doi: 10.1007/s10072-022-06486-x. Epub 2022 Nov 11. PMID: 36367593.
Nappi AG, Altini C, D'Alò C, et al. Ruolo dello studio scintigrafico del transito orofaringoesofageo nella valutazione della disfagia nei pazienti affetti da patologia neurologica [The role of oropharyngoesophageal scintigraphy in the assessment of dysphagia in neurological patients.]. Recenti Prog Med. 2022 Dec;113(12):739-748. Italian. doi: 10.1701/3914.38976. PMID: 36420850.
Suárez-Patiño LV, Orozco-Duque A, Pérez-Giraldo E, et al. Synchronization between videofluoroscopic swallowing study and surface electromyography in patients with neurological involvement presenting symptoms of dysphagia. Biomedica. 2022 Dec 1;42(4):650-664. English, Spanish. doi: 10.7705/biomedica.6446. PMID: 36511672; PMCID: PMC9814368.
Ertekin C, Aydoğdu I, Yüceyar N. Piecemeal deglutition and dysphagia limit in normal subjects and in patients with swallowing disorders. J Neurol Neurosurg Psychiatry. 1996 Nov;61(5):491-6. doi: 10.1136/jnnp.61.5.491. PMID: 8937344; PMCID: PMC1074047.
Halfpenny R, Stewart A, Kelly P, et al. Dysphagia rehabilitation following acquired brain injury, including cerebral palsy, across the lifespan: a scoping review protocol. Syst Rev. 2021 Dec 13;10(1):312. doi: 10.1186/s13643-021-01861-9. PMID: 34903269; PMCID: PMC8667523.
Lapa S, Neuhaus E, Harborth E, et al. Dysphagia assessment in ischemic stroke after mechanical thrombectomy: When and how? Front Neurol. 2022 Nov 23;13:1024531. doi: 10.3389/fneur.2022.1024531. PMID: 36504648; PMCID: PMC9726734.
Hamilton VK, Pitts LL, Walaszek EA, et al. Videofluoroscopic Profiles of Swallowing and Airway Protection Post-traumatic Cervical Spinal Cord Injury. Dysphagia. 2022 Dec;37(6):1599-1611. doi: 10.1007/s00455-022-10407-7. Epub 2022 Feb 25. PMID: 35212848.
Braut T, Maršić M, Ravlić I, et al. Posttraumatic Vernet syndrome without fracture: A case report and short literature review. Medicine (Baltimore). 2021 Oct 29;100(43):e27618. doi: 10.1097/MD.0000000000027618. PMID: 34713846; PMCID: PMC8556020.
Lee KD, Koo JH, Song SH, et al. Central cholinergic dysfunction could be associated with oropharyngeal dysphagia in early Parkinson's disease. J Neural Transm (Vienna). 2015 Nov;122(11):1553-61. doi: 10.1007/s00702-015-1427-z. Epub 2015 Jul 22. PMID: 26199040.
Noorani M, Bolognone RK, Graville DJ, et al. The Association Between Dysphagia Symptoms, DIGEST Scores, and Severity Ratings in Individuals with Parkinson's Disease. Dysphagia. 2023 Jan 24. doi: 10.1007/s00455-023-10555-4. Epub ahead of print. PMID: 36692654.
Kim JH, Jeon J, Lee Y, et al. Striatal Dopaminergic Loss and Dysphagia in Parkinson Disease. Clin Nucl Med. 2023 Feb 1;48(2):143-149. doi: 10.1097/RLU.0000000000004501. Epub 2022 Dec 7. PMID: 36607363; PMCID: PMC9835674.
Segura T, Medrano IH, Collazo S, et al. Symptoms timeline and outcomes in amyotrophic lateral sclerosis using artificial intelligence. Sci Rep. 2023 Jan 13;13(1):702. doi: 10.1038/s41598-023-27863-2. PMID: 36639403; PMCID: PMC9839769.
Shoesmith C. Palliative care principles in ALS. Handb Clin Neurol. 2023;191:139-155. doi: 10.1016/B978-0-12-824535-4.00007-0. PMID: 36599506.
Zhao Y, Tang H, Peng T, et al. Relationship Between Nutritional Status and Severity of Cerebral Palsy: A Multicentre Cross-Sectional Study. J Rehabil Med. 2023 Jan 12;55:jrm00367. doi: 10.2340/jrm.v55.4395. PMID: 36633287; PMCID: PMC9847369.
Xinou E, Chryssogonidis I, Kalogera-Fountzila A, et al. Longitudinal Evaluation of Swallowing with Videofluoroscopy in Patients with Locally Advanced Head and Neck Cancer After Chemoradiation. Dysphagia. 2018 Oct;33(5):691-706. doi: 10.1007/s00455-018-9889-4. Epub 2018 Mar 23. PMID: 29572573.
Rivelsrud MC, Hartelius L, Speyer R, et al. Qualifications, professional roles and service practices of nurses, occupational therapists and speech-language pathologists in the management of adults with oropharyngeal dysphagia: a Nordic survey. Logoped Phoniatr Vocol. 2023 Feb 14:1-13. doi: 10.1080/14015439.2023.2173288. Epub ahead of print. PMID: 36786502.
Balou M, Herzberg EG, Kamelhar D, et al. An intensive swallowing exercise protocol for improving swallowing physiology in older adults with radiographically confirmed dysphagia. Clin Interv Aging. 2019 Feb 11;14:283-288. doi: 10.2147/CIA.S194723. PMID: 30804667; PMCID: PMC6375531.
Price K, Isbister G, Long S, et al. Are Bubbles the Future of Dysphagia Rehabilitation: A Systematic Review Analysing Evidence on the Use of Carbonated Liquids in Dysphagia Rehabilitation. Geriatrics (Basel). 2023 Jan 1;8(1):6. doi: 10.3390/geriatrics8010006. PMID: 36648911; PMCID: PMC9844419.
Zhu J, Wang X, Chen S, et al. Improving compliance with swallowing exercise to decrease radiotherapy-related dysphagia in patients with head and neck cancer. Asia Pac J Oncol Nurs. 2022 Nov 19;10(1):100169. doi: 10.1016/j.apjon.2022.100169. PMID: 36583099; PMCID: PMC9792737.
Dotevall H, Tuomi L, Petersson K, et al. Treatment with head-lift exercise in head and neck cancer patients with dysphagia: results from a randomized, controlled trial with flexible endoscopic evaluation of swallowing (FEES). Support Care Cancer. 2022 Dec 17;31(1):56. doi: 10.1007/s00520-022-07462-z. PMID: 36526734; PMCID: PMC9758100.
Choy J, Pourkazemi F, Anderson C, et al. Dosages of swallowing exercises in stroke rehabilitation: a systematic review. Eur Arch Otorhinolaryngol. 2023 Mar;280(3):1017-1045. doi: 10.1007/s00405-022-07735-7. Epub 2022 Dec 6. PMID: 36471047; PMCID: PMC9899761.
Nanto T, Ono T, Hori K et al. The effects of tongue elevation using a weighted plastic bottle on the tongue pressure and activity of suprahyoid muscles. J Oral Rehabil. 2022 Nov;49(11):1041-1048. doi: 10.1111/joor.13365. Epub 2022 Sep 5. PMID: 36029125.
Sugaya N, Goto F, Seino Y, et al. The effect of laryngeal elevation training on swallowing function in patients with dysphagia. J Laryngol Otol. 2021 Jul;135(7):574-578. doi: 10.1017/S0022215121001481. Epub 2021 Jun 16. PMID: 34130763.
Pu D, Yao TJ. The use and effects of whole-body exercises on swallowing function: A scoping review. Int J Lang Commun Disord. 2023 Feb 9. doi: 10.1111/1460-6984.12858. Epub ahead of print. PMID: 36759960.
Liu J, Wang Q, Tian J, et al. Effects of chin tuck against resistance exercise on post-stroke dysphagia rehabilitation: A systematic review and meta-analysis. Front Neurol. 2023 Jan 9;13:1109140. doi: 10.3389/fneur.2022.1109140. PMID: 36698882; PMCID: PMC9868925.
Sayfalar
139-156
Yayınlanan
3 Nisan 2023
Telif Hakkı (c) 2023 Akademisyen Kitap Portalı
Lisans
LisansNasıl Atıf Yapılır
1.
Akın T. Disfaji Rehabilitasyonu. Içinde: Kelle B, editör. Fizik Tedavi ve Rehabilitasyonda Güncel Konular [Internet]. Türkiye: Akademisyen Yayınevi Kitap DOI Portalı; 2023 [a.yer 16 Temmuz 2026]. ss. 139-56. Erişim adresi: https://omp35.books.akademisyen.net/index.php/akya/catalog/book/2533/chapter/13798
