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ワカバヤシ ヒデタカ
Wakabayashi Hidetaka
若林 秀隆 所属 医学部 医学科（東京女子医科大学病院） 職種 教授・基幹分野長 |
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| 論文種別 | 症例報告 |
| 言語種別 | 英語 |
| 査読の有無 | 査読あり |
| 表題 | Home-based Combined Therapy with Rehabilitation and Aggressive Nutrition Management for a Parkinson's Disease Patient with Sarcopenic Dysphagia: A Case Report. |
| 掲載誌名 | 正式名：Progress in rehabilitation medicine 略 称：Prog Rehabil Med ISSNコード：24321354/24321354 |
| 掲載区分 | 国内 |
| 巻・号・頁 | 3,pp.20180019 |
| 著者・共著者 | Yamada Yumi, Shamoto Hiroshi, Maeda Keisuke, Wakabayashi Hidetaka |
| 担当区分 | 最終著者 |
| 発行年月 | 2018 |
| 概要 | Background:Sarcopenic dysphagia is caused by decreased muscle mass and muscle weakness in the swallowing muscles that occurs because of sarcopenia. The key to treating sarcopenic dysphagia is combined therapy with rehabilitation and aggressive nutrition management. However, to our knowledge, no studies based in a home medical care setting have yet been published.Case:A 72-year-old man with Parkinson's disease developed sarcopenia and possible sarcopenic dysphagia during hospitalization for drug adjustment. At discharge, the patient's body weight was 39.0 kg (-33.8%/4 months, body mass index: 15.3 kg/m2), the Barthel Index was 45, Functional Oral Intake Scale was level 4, and Dysphagia Severity Scale was 4. Sarcopenia was confirmed by a calf circumference of 23.8 cm, a handgrip strength of 22 kg, and a gait speed of 0.5 m/s. The patient was diagnosed with sarcopenic dysphagia, according to the consensus diagnostic criteria for sarcopenic dysphagia. After the patient was discharged, he underwent a combination of dysphagia rehabilitation, daily activity training, and aggressive nutrition management, which started from 1200 kcal/day and reached a maximum of 2800 kcal/day. Four months after discharge, the patient's swallowing function returned to normal (Functional Oral Intake Scale: 7, Dysphagia Severity Scale: 6) and his weight increased by 31% (body mass index: 20.1 kg/m2). Increases in muscle mass (calf circumference: 32 cm), muscle strength (handgrip strength: 34 kg), physical function (gait speed: 1 m/s), and activities of daily living (Barthel Index: 90) indicated recovery from sarcopenia.Discussion:Sarcopenic dysphagia may be a complication of Parkinson's disease, and home-based combined therapy with rehabilitation and aggressive nutrition management may be effective for treating this condition. |
| DOI | 10.2490/prm.20180019 |
| PMID | 32789244 |