Browsing by Author "Nascimento, David"
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- Contributo para a caracterização das perturbações da deglutição no parkinsonismo atípico: paralisia supranuclear progressiva e atrofia de múltiplos sistemasPublication . Nascimento, David; Cardoso, Ana Rita
- Drooling rating scales in Parkinson’s disease: a systematic reviewPublication . Nascimento, David; Carmona, Jaqueline; Mestre, Tiago; Ferreira, Joaquim; Guimarães, IsabelBackground: Drooling is a clinically relevant non-motor symptom of people with Parkinson’s disease (PwP). Several drooling rating scales are available. Nevertheless, the compelling scientific evidence supporting their validity is limited. This study aims to evaluate clinical rating scales for drooling, assessing their characteristics, clinimetric properties, and clinical utility classification. Methods: A systematic review was undertaken. Two reviewers performed independent literature searches using the CENTRAL®, CINAHL®, Embase®, MEDLINE®, SciElo®, and SPEECH BITE® databases. We used consensusbased standards for the selection of health measurement instruments (COSMIN) and the International Parkinson’s disease and the Movement Disorders (MDS) criteria to evaluate the included rating scales. Results: The following six rating scales were identified: Drooling Impact Scale (DIS), Sialorrhea Scoring Scale (SSS), Drooling Severity and Frequency Scale (DSFS), Drooling Rating Scale (DRS), Sialorrhea Clinical Scale for Parkinson Disease (SCS-PD), and the Radboud Oral Motor inventory for Parkinson’s disease – Saliva (ROMPsaliva). The scales had heterogeneous characteristics: (i) not all were created/adapted for PwP; (ii) different dimensions associated with drooling are assessed; (iii) cross-cultural adaptations are limited to some languages. The clinimetric properties showed: (i) target population size limitations; (ii) incomplete reliability analysis; (iii) lack of robust validity; (iv) sensitivity to change not fully explored. Following the MDS criteria, only one tool was classified as “recommended”, the ROMP-saliva. Conclusions: This review provides information for an adequate selection of a drooling rating scale for clinical and/or research purposes. To date, ROMP-saliva is the only scale with substantial evidence of its clinimetric properties adequacy and data in PwP.
- Predictors of drooling severity in people with Parkinson’s diseasePublication . Nascimento, David; Meira, Bruna; Garcez, Luís; Abreu, Daisy; Outeiro, Tiago; Guimarães, Isabel; Ferreira, Joaquim J.Background Drooling, defned as the unintentional loss of saliva from the anterior oral cavity, remains poorly understood in terms of the underlying clinical factors in people with Parkinson’s disease (PwP). This study aims to clarify these factors by analyzing predictors and secondarily the correlates with the severity of drooling in PwP. Methods We conducted a cross-sectional study involving 42 PwP with drooling and 59 without drooling. Clinical assess ments were performed, and the primary outcome was the item 2.2 Saliva and drooling of the Movement Disorder Society Unifed Parkinson’s Disease Rating Scale. The Mann–Whitney test was used to compare the distribution diferences in clinical variables between PwP with and without drooling. The Spearman test was used to examine correlations with drooling, and ordinal logistic regression was used to examine predictors of drooling. Results PwP with drooling showed signifcantly greater impairments in axial signs, posture, facial expression, speech, swallowing, oromotor, motor and non-motor domains than PwP without drooling. Longer disease duration, higher disease severity, levodopa equivalent daily dose, axial signs, unstimulated salivary fow rate, and impairments in speech, posture, facial expression, swallowing, oromotor, motor and non-motor domains were signifcantly correlated with a higher score on the item 2.2. Male sex, poorer swallowing, oromotor and speech functions were strong predictors of higher scores on the item 2.2 Saliva and drooling. Conclusions Male PwP with swallowing disorders, oromotor and speech impairments are signifcantly more likely to have severe drooling. Targeted interventions aimed at these swallowing, oromotor, and speech impairments may ofer promising approaches to reducing drooling severity in PwP.
- Research practices of the speech- language pathologist in Portugal: needs, barriers and facilitatorsPublication . Mendes, Ana; Moreira, Miriam; Guerreiro, David; Nascimento, David; Tello Rodrigues, Inês; Aguiar, VaniaIntrodução: A necessidade e o interesse na investigação pelos Terapeutas da Fala (TFs) tem sido crescente. Objetivos: (i) caracterizar o nível de autonomia atual dos TFs em Portugal em investigação científica; (ii) caracterizar o nível de autonomia desejado dos TFs em Portugal em investigação científica; (iii) caracterizar as necessidades de formação assim como identificar as barreiras e facilitadores de práticas de investigação dos TFs em Portugal. Métodos: 86 TFs preencheram um questionário validado por um painel de peritos. A recolha de dados incidiu sobre: (i) nível de autonomia atual e desejado para a prática de investigação; (ii) barreiras e facilitadores inerentes à prática da investigação. Resultados: Os níveis de autonomia foram significativamente inferiores aos níveis desejados (p<0,001). A autonomia atual para a tarefa de criação de uma ideia de investigação foi significativamente inferior quando comparada com as tarefas de definição de metodologia (p<0,05), análise de dados (p<0,001), processamento de dados (p<0,001) e síntese de resultados (p<0,001). Não houve diferenças de autonomia entre a tarefa de comunicação em conferências e a tarefa de criação de uma ideia de investigação (p<0,05). A maioria reportou a necessidade de formação adicional para conseguir integrar a investigação na sua prática clínica. A principal barreira para a realização de investigação foi a ausência de tempo (64,5%). O principal facilitador foi o tempo disponível (27,7%). Conclusão: Os TFs possuem o desejo de maior autonomia no processo de investigação. A identificação de barreiras e facilitadores encontrados poderão permitir uma resposta mais adequada às capacidades e necessidades dos TFs.