Institut Spezielle Pädagogik und Psychologie
Dauerhafte URI für die Sammlunghttps://irf.fhnw.ch/handle/11654/57
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Publikation Inhalation therapy with nebulized capsaicin in a patient with oropharyngeal dysphagia post stroke. A clinical case report(MDPI, 2022) Pekacka-Egli, Anna Maria; Herrmann, Jana; Spielmanns, Marc; Goerg, Arthur; Schulz, Katharina; Zenker, Eveline; Windisch, Wolfram; Kulnik, Stefan TinoDysphagia and aspiration risk are common sequelae of stroke, leading to increased risk of stroke-associated pneumonia. This is often aggravated by stroke-related impairment of cough, the most immediate mechanical defense mechanism against aspiration. In humans, reflex cough can be repeatedly and safely elicited by inhalation of nebulized capsaicin, a compound contained in chili peppers. Could this cough-eliciting property of capsaicin support the recovery of stroke survivors who present with dysphagia and aspiration risk? We present a clinical case report of a 73-year-old man, admitted to inpatient stroke rehabilitation following a right middle cerebral artery infarct with subsequent dysphagia and hospital-acquired pneumonia. A course of daily inhalation therapy with nebulized capsaicin was initiated, triggering reflex coughs to support secretion clearance and prevent recurrence of pneumonia. Clinical observations in each inhalation therapy session demonstrate good patient response, safety and tolerability of nebulized capsaicin in this mode of application. Repeated Fiberoptic Endoscopic Evaluation of Swallowing (FEES) assessments show concurrent improvement in the patient’s swallowing status. Inhalation therapy with nebulized capsaicin may offer a viable treatment to facilitate coughing and clearing of secretions, and to minimize aspiration and risk of aspiration-related pneumonia post stroke. Further investigation in a randomized controlled trial design is warranted.01A - Beitrag in wissenschaftlicher ZeitschriftPublikation Clinical effects of pulmonary rehabilitation in very old patients with COPD(MDPI, 2023) Spielmanns, Marc; Schulze, Sofia-Theresia; Guenes, Erhan; Pekacka-Falkowska, Katarzyna; Windisch, Wolfram; Pekacka-Egli, Anna MariaBackground: Pulmonary rehabilitation (PR) improves physical and mental performance as well as quality of life in patients with chronic obstructive pulmonary disease (COPD). However, data on outcomes in very old patients are insufficient. We analyzed whether the elderly with COPD benefit in a similar way to younger patients from participation in an inpatient PR according to the assessments usually collected. Methods: Data from 3173 patients with COPD were retrospectively analyzed. Patients were referred to PR at the Zurich RehaZentren, Switzerland, between January 2013 and December 2019. PR was performed 6 days per week with an average duration of 18.85 days. Functional Independence Measurement (FIM), Feeling Thermometer (FT), and 6-Minute Walk Test (6MWT) were recorded on admission and discharge. Results: In all age groups, the 6MWT and FT improved significantly. FIM results also showed a significant increase. The results of the different age groups showed no significant differences in percentage improvements according to the assessments that were considered. Conclusions: All patient groups with COPD, even the oldest (>85 years), benefited from PR regardless of their age and according to the assessments. Prospective studies are needed to support this hypothesis.01A - Beitrag in wissenschaftlicher ZeitschriftPublikation Schluckstörungen im Alter. Diagnostik und Therapie in der Grundversorgung(Springer Medizin, 17.11.2023) Pekacka-Egli, Anna Maria; Bujan, Magdalena; Disko, Andreas; Lutz, Dietmar; Spielmanns, Marc; Kolbm, Benjamin; Bujanm Bartosz01A - Beitrag in wissenschaftlicher ZeitschriftPublikation Pulmonary rehabilitation outcomes of post-acute COVID-19 patients during different waves of the pandemic(MDPI, 2023) Spielmanns, Marc; Schaer, Corina E.; Pekacka-Egli, Anna Maria; Spielmanns, Sabine; Ibish, Olberk; Gafina, Guzel; Stiube, Antonela; Hermann, Matthias(1) Background: Between the beginning of the coronavirus pandemic and summer 2022, we distinguished four pandemic waves, with different characteristics of the affected patients. This study investigated the impact of patient characteristics on the outcome of inpatient pulmonary rehabilitation (PR). (2) Methods: Using a prospective approach, the characteristics of post-acute COVID-19 patients of the different waves who participated in inpatient PR were compared based on their assessments and results collected as part of PR (Cumulative Illness Rating Scale (CIRS), six-minute walk test (6-MWT), Pulmonary Function Testing (PFT), and Functional Independent Measurement (FIM). (3) Results: A total of 483 patients were included in the analysis (Wave 1 n = 51, Wave 2 n = 202, Wave 3 n = 84, Wave 4 n = 146). Compared to Wave 3 + 4, patients of Wave 1 + 2 were older (69 vs. 63 years; p < 0.001), had a significantly lower CIRS (13.0 vs. 14.7 points; p = 0.004), had significant better PFT (FVC: 73 vs. 68%pred; p = 0.009; DLCOSB: 58 ± 18 vs. 50 ± 17%pred; p = 0.001), and showed significantly more comorbidities (2.0 vs. 1.6 n/pers.; p = 0.009). Wave 3 + 4 showed significantly greater improvements according to the 6-MWT (147 vs. 188 m; p < 0.001) and the FIM (5.6 vs. 21.1 points; p < 0.001). (4) Conclusions: Patients of the COVID-19 infection waves differed significantly according to their anthropometric data, incidence of comorbidities, and impact of the infection. All cohorts achieved clinically relevant and significant functional improvements during PR, with significant higher improvements in Wave 3 + 4.01A - Beitrag in wissenschaftlicher ZeitschriftPublikation Naming images in aphasia: effects of illustrative and photographic images on naming performance in people with and without aphasia(Taylor & Francis, 03.05.2022) Reymond, Claire; Widmer Beierlein, Sandra; Müller, Christine; Kuntner, Katrin Petra; Falcón García, Noelia; Grumbinaite, Indre; Hemm-Ode, Simone; Degen, Markus; Parrillo, Fabrizio; Karlin, Stefan; Park, Sung Hea; Blechschmidt, Anja; Reutimann, RicardaBackground: Picture naming is a common tool in aphasia diagnosis and therapy. However, opin-ions differ as to which type of image (e.g., photographs, drawings) is most suitable for naming tasks and whether there is a difference on naming correctness and latencies based on image type. Moreover, recent studies have mainly analysed colour photographs and black-and-white line drawings leaving out image types like graphic representations that apply image features that can facilitate naming such as colour, controlled size, or texture. Aims: To shed more light on ap-propriate image types for persons with aphasia, we created graphic representations depicting nouns and verbs and compared them to photographic stimuli in a naming task including persons with aphasia (PWA) and a control group (CG). Methods & Procedures: 33 PWA and 33 age matched persons (CG) participated in the study. Naming correctness and latencies were meas-ured in two different conditions: concepts depicted as coloured photographs vs. as graphic rep-resentations. 128 pictures of linguistically controlled German-language concepts (64 nouns, 64 verbs) had to be named. The designed graphic stimuli were developed by professional designers based on photographs. The photographs were selected from stock image databases according to a defined image concept. This image concept was based on empirical findings regarding im-age features that facilitate naming (e.g., colour, texture, shading) and was applied to the selec-tion of the photographs as well as to the creation of the graphic representations. The images were presented in pseudo-randomized sequences on a tablet and all reactions of the participants were videotaped. The data from the main study was analysed using generalized linear mixed models (GLMM) and linear mixed models (LMM).01A - Beitrag in wissenschaftlicher Zeitschrift