卒中后有无吞咽困难风险的女性盆底症状与功能状态：一项横断面比较研究

文献信息

中文摘要

引言与假设： 吞咽困难与卒中后盆底功能障碍和不良功能结局相关。我们假设卒中女性的盆底症状和功能状态因吞咽困难风险不同而存在差异。
方法： 本研究纳入71名年龄18-65岁、诊断为卒中的女性。土耳其版进食评估工具-10得分≥3分者被归类为有吞咽困难风险（n=31），得分<3分者被归类为无吞咽困难风险（n=40）。评估包括盆底困扰量表-20（PFDI-20）、简易体能状况量表（SPPB）、计时起立-行走测试（TUG）、Jamar握力计、Fugl-Meyer上肢评估和改良Barthel指数。
结果： 有吞咽困难风险的卒中女性PFDI-20总分显著更高（分别为p=0.013和p<0.001）。有吞咽困难风险的参与者SPPB各分项得分较低，但无统计学显著性。此外，吞咽困难风险组的TUG测试完成时间显著更长（p=0.002）。另外，在调整产次、卒中后便秘和体能表现后，吞咽困难风险与卒中后尿失禁独立相关。
结论： 本研究通过考察卒中女性盆底症状、功能状态与吞咽困难之间的关系，填补了文献中的重要空白。盆底症状在有吞咽困难风险的个体中更为常见，且体能表现、握力、功能移动能力和日常生活活动独立性更低。鉴于卒中后吞咽困难的风险，包括评估盆底症状和体能表现的整体评估非常重要。

英文摘要

INTRODUCTION AND HYPOTHESIS: Dysphagia is associated with pelvic floor dysfunction and poor functional outcomes after stroke. We hypothesized that pelvic floor symptoms and functional status differ according to dysphagia risk in women with stroke.
METHODS: This study included 71 women aged 18-65 years with a diagnosis of a stroke. Individuals scoring 3 or higher on the Turkish Eating Assessment Tool-10 were classified as being at risk of dysphagia (n = 31), whereas individuals scoring below 3 were classified as not at risk of dysphagia (n = 40). Assessments included the Pelvic Floor Distress Inventory-20 (PFDI-20), Short Physical Performance Battery (SPPB), Timed Up and Go Test (TUG), Jamar hand dynamometer, Fugl-Meyer Upper Extremity Assessment, and the Modified Barthel Index.
RESULTS: The PFDI-20 total was significantly higher in women with stroke who were at risk of dysphagia (p = 0.013 and p < 0.001 respectively). Participants at risk of dysphagia demonstrated lower, but not statistically significantly, SPPB subtests. Additionally, TUG test completion times were significantly longer in the dysphagia risk group (p = 0.002). In addition, dysphagia risk was independently associated with post-stroke urinary incontinence after adjustment for parity, post-stroke constipation, and physical performance.
CONCLUSIONS: This study addresses an important gap in the literature by examining the relationship between pelvic floor symptoms, functional status, and dysphagia in women after stroke. Pelvic floor symptoms were more common in individuals at risk of dysphagia, and physical performance, hand-grip strength, functional mobility, and independence in activities of daily living were lower. Given the risk of dysphagia after a stroke, holistic assessment including evaluation of pelvic symptoms and physical performance is important.