2020 Volume 24 Issue 1 Pages 38-46
Purpose: This study used the Japanese version of the short sensory profile (SSP-J) to clarify whether desensitization therapy alleviates tactile hypersensitivity in elderly patients. The purpose was to examine whether changes in the state of rejection and mouth opening affect oral function.
Subjects and Methods: Patients who had been admitted for diagnosis of dysphagia and had received swallowing training by a speech-language-hearing therapist (ST) were selected according to: 1) those who had difficulty in independent oral care; 2) those who had difficulty in oral care and eating with an assistant nurse due to rejection response of tactile sensitivity; and 3) those who had been diagnosed as having dementia. The patients who fulfilled all criteria were extracted. The age ranged from 65 to 82 years old according to SSP-J.
Training continued with oral care 5 times a week for 5 weeks, after desensitization therapy with ST. We evaluated sensory stimulation response by SSP-J, and oral function by the Revised Oral Assessment Guide (ROAG). In addition, the change in rejection during desensitization therapy and the change in opening retention during oral care were recorded.
Results: The subjects of this study were 20 persons. After desensitization therapy, tactile hypersensitivity in SSP-J and rejection decreased. Oral function of the patients with tactile sensitivity improved, especially for the saliva index. In 8 cases, an opening holder was not needed and finally oral care was accepted.
Discussion: Continuous desensitization therapy reduced tactile hypersensitivity in the elderly patients. The results of this study are considered to be better than those of a previous study. In desensitization therapy, it is suggested that continuing training with a certain frequency of intervention may improve the outcome compared with extending one intervention time. For patients who did not respond to desensitization, it was necessary to construct a new desensitization therapy that introduced other superficial and special sensory stimuli.
After desensitization therapy, oral care became possible because the patients could open the mouth easily. The saliva item in ROAG was improved, resulting in a wetter oral cavity.
