OBJECTIVE: To investigate functional and physiological changes in swallowing performance of adults with chronic dysphagia after an exercise-based dysphagia therapy. DESIGN: Intervention study: before-after trial with 3-month follow-up evaluation. SETTING: Outpatient clinic within a tertiary care academic health science center. PARTICIPANTS: Adults (N=9) with chronic (>12 mo) dysphagia after unsuccessful prior therapies. Subjects were identified from among patients referred to an outpatient dysphagia clinic. Subjects had dysphagia secondary to prior treatment for head/neck cancer or from neurologic injury. All subjects demonstrated clinical and fluoroscopic evidence of oropharyngeal dysphagia. No subject withdrew during the course of this study. INTERVENTIONS: All subjects completed 3 weeks of an intensive, exercise-based dysphagia therapy. Therapy was conducted daily for 1h/d, with additional activities completed by subjects each night between therapy sessions. MAIN OUTCOME MEASURES: Primary outcomes were clinical and functional change in swallowing performance with maintenance at 3 months after intervention. Secondary, exploratory outcomes included physiological change in swallow performance measured by hyolaryngeal elevation, lingual-palatal and pharyngeal manometric pressure, and surface electromyographic amplitude. RESULTS: Clinical and functional swallowing performances improved significantly and were maintained at the 3-month follow-up examination. Subject perspective (visual analog scale) on functional swallowing also improved. Four of 7 subjects who were initially feeding tube dependent progressed to total oral intake after 3 weeks of intervention. Physiological indices demonstrated increased swallowing effort after intervention. CONCLUSIONS: Significant clinical and functional improvement in swallowing performance followed a time-limited (3 wk) exercise-based intervention in a sample of subjects with chronic dysphagia. Physiological changes after therapy implicate improved neuromuscular functioning within the swallow mechanism.
OBJECTIVE: To investigate functional and physiological changes in swallowing performance of adults with chronic dysphagia after an exercise-based dysphagia therapy. DESIGN: Intervention study: before-after trial with 3-month follow-up evaluation. SETTING:Outpatient clinic within a tertiary care academic health science center. PARTICIPANTS: Adults (N=9) with chronic (>12 mo) dysphagia after unsuccessful prior therapies. Subjects were identified from among patients referred to an outpatientdysphagia clinic. Subjects had dysphagia secondary to prior treatment for head/neck cancer or from neurologic injury. All subjects demonstrated clinical and fluoroscopic evidence of oropharyngeal dysphagia. No subject withdrew during the course of this study. INTERVENTIONS: All subjects completed 3 weeks of an intensive, exercise-based dysphagia therapy. Therapy was conducted daily for 1h/d, with additional activities completed by subjects each night between therapy sessions. MAIN OUTCOME MEASURES: Primary outcomes were clinical and functional change in swallowing performance with maintenance at 3 months after intervention. Secondary, exploratory outcomes included physiological change in swallow performance measured by hyolaryngeal elevation, lingual-palatal and pharyngeal manometric pressure, and surface electromyographic amplitude. RESULTS: Clinical and functional swallowing performances improved significantly and were maintained at the 3-month follow-up examination. Subject perspective (visual analog scale) on functional swallowing also improved. Four of 7 subjects who were initially feeding tube dependent progressed to total oral intake after 3 weeks of intervention. Physiological indices demonstrated increased swallowing effort after intervention. CONCLUSIONS: Significant clinical and functional improvement in swallowing performance followed a time-limited (3 wk) exercise-based intervention in a sample of subjects with chronic dysphagia. Physiological changes after therapy implicate improved neuromuscular functioning within the swallow mechanism.
Authors: Primož Strojan; Katherine A Hutcheson; Avraham Eisbruch; Jonathan J Beitler; Johannes A Langendijk; Anne W M Lee; June Corry; William M Mendenhall; Robert Smee; Alessandra Rinaldo; Alfio Ferlito Journal: Cancer Treat Rev Date: 2017-07-18 Impact factor: 12.111
Authors: Laura W J Baijens; Margaret Walshe; Leena-Maija Aaltonen; Christoph Arens; Reinie Cordier; Patrick Cras; Lise Crevier-Buchman; Chris Curtis; Wojciech Golusinski; Roganie Govender; Jesper Grau Eriksen; Kevin Hansen; Kate Heathcote; Markus M Hess; Sefik Hosal; Jens Peter Klussmann; C René Leemans; Denise MacCarthy; Beatrice Manduchi; Jean-Paul Marie; Reza Nouraei; Claire Parkes; Christina Pflug; Walmari Pilz; Julie Regan; Nathalie Rommel; Antonio Schindler; Annemie M W J Schols; Renee Speyer; Giovanni Succo; Irene Wessel; Anna C H Willemsen; Taner Yilmaz; Pere Clavé Journal: Eur Arch Otorhinolaryngol Date: 2020-12-19 Impact factor: 2.503