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Master Thesis

Amélioration des compétences en déglutition chez des patients en état végétatif chronique et en état pauci-relationnel. Élaboration d’un protocole basé sur des stimulations olfactives et gustatives

Abstract : Severe brain traumatism patients in vegetative or minimal concioussness state (MCS) have frequently a non oral alimentation because of swallowing disorders. In this case, they also can't have swallowing reeducation which is based on an active participation and the ability to understand orders, even if oral alimentation is the beginning of relationships. In this study, we tested the hypothesis that oflfactory and gustatory stimulations could influence swallowing in MCS patients.
Method:
16 patients in MCS have followed a stimulation protocol during 21 weeks. A cross-over has been established in order to formed a control group. This protocol started with a first clinical swallowing assessment. During the nine first weeks, the first randomized group was stimulated (taste and olfaction : fruits, chocolat, the, vanilla, minth) while the second one wasn't. After the second swallowing assessment, the two groups were switched and evaluated a third time at the end of the second group stimulation.
Results:
At the end of the stimulation protocol, abilities necessary to swallow were increased : the number of salivary at rest swallowing, the meal time for patients with oral nutrition and the lingual and pharynx mobility. Lingual mobility improved for 12 patients, pharyngeal mobility in 12 and number of swallows increased in 10. The lenght of the meal did not changed in the four patients having an oral intake. There was no correlation between the Wessex Head Injury Matrix scale (scale of concioussness) and the improvement of swallowing.
Conclusion :
Swallowing improvement are hopeful in MCS patients because it is an open window on external stimulations. It could combine taste and olfactif stimulation, which are important for this kind of patients, often deprived of eating pleasure since a long time.
Document type :
Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-01840035
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Submitted on : Monday, July 16, 2018 - 12:18:47 PM
Last modification on : Monday, December 2, 2019 - 10:24:02 AM
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Margaux Béatrix. Amélioration des compétences en déglutition chez des patients en état végétatif chronique et en état pauci-relationnel. Élaboration d’un protocole basé sur des stimulations olfactives et gustatives. Sciences cognitives. 2018. ⟨dumas-01840035⟩

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