Maryam Tarameshlu1, Leila Ghelichi2, Amir Reza Azimi3, Noureddin Nakhostin Ansari4, Ahmad Reza Khatoonabadi5. 1. Department of Speech Therapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran. Electronic address: m.tarameshlu@gmail.com. 2. Department of Speech and Language Pathology, Rehabilitation Research Center, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran. Electronic address: lghelichi@gmail.com. 3. MS Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran. Electronic address: amirreza_azimi@yahoo.com. 4. Department of Physiotherapy, School of Rehabilitation, Tehran University of Medical Sciences, Sports Medicine Research Center, Tehran University of Medical Sciences, Neuromusculoskeletal Research Center, Iran University of Medical Sciences, Tehran, Iran. Electronic address: nakhostin@tums.ac.ir. 5. Department of Speech Therapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran. Electronic address: khatoonabadi@tums.ac.ir.
Abstract
BACKGROUND: Dysphagia is common following Multiple Sclerosis (MS) and is associated with significant morbidity and mortality. The current rehabilitation program to swallowing therapy is Traditional Dysphagia Therapy (TDT), but there is a dearth of evidence about its effectiveness in MS patients. OBJECTIVES: This study was aimed to determine the effects of the TDT on the swallowing function in MS patients with dysphagia. METHODS: A pilot double blind randomized clinical trial was carried out on 20 patients with MS. Patients were randomly divided into experimental group (TDT) comprising sensorimotor exercises and swallowing maneuvers, and Usual Care (UC) comprising diet prescription and postural changes. Patients in both groups received treatments for 6 weeks, 18 treatment sessions, 3 times per week, every other day. The Mann Assessment of Swallowing Ability (MASA) was the main outcome measure. The swallowing ability was assessed before treatment (T0), after the end of 9th session (T1), after the end of 18th session (T2), and after 6 weeks follow-up (T3). Penetration-Aspiration Scale (PAS) and Pharyngeal Residue Rating Scale (PRRS) as secondary outcome measures were applied at T0 and T2. RESULTS: Both groups had improved regarding MASA, PAS and PRRS scores over the time (P < 0.001). The improvements achieved in all outcomes were significantly greater in the TDT group than those of the UC group. The Main effect of the Time × Group interaction was significant for MASA score (P < 0.001). The large effect sizes were found for MASA score in both the TDT (d = 3.91) and the UC (d = 1.11) groups. CONCLUSIONS: This pilot randomized controlled trial showed that the TDT significantly improved the swallowing function of the MS patients with dysphagia.
RCT Entities:
BACKGROUND:Dysphagia is common following Multiple Sclerosis (MS) and is associated with significant morbidity and mortality. The current rehabilitation program to swallowing therapy is Traditional Dysphagia Therapy (TDT), but there is a dearth of evidence about its effectiveness in MSpatients. OBJECTIVES: This study was aimed to determine the effects of the TDT on the swallowing function in MSpatients with dysphagia. METHODS: A pilot double blind randomized clinical trial was carried out on 20 patients with MS. Patients were randomly divided into experimental group (TDT) comprising sensorimotor exercises and swallowing maneuvers, and Usual Care (UC) comprising diet prescription and postural changes. Patients in both groups received treatments for 6 weeks, 18 treatment sessions, 3 times per week, every other day. The Mann Assessment of Swallowing Ability (MASA) was the main outcome measure. The swallowing ability was assessed before treatment (T0), after the end of 9th session (T1), after the end of 18th session (T2), and after 6 weeks follow-up (T3). Penetration-Aspiration Scale (PAS) and Pharyngeal Residue Rating Scale (PRRS) as secondary outcome measures were applied at T0 and T2. RESULTS: Both groups had improved regarding MASA, PAS and PRRS scores over the time (P < 0.001). The improvements achieved in all outcomes were significantly greater in the TDT group than those of the UC group. The Main effect of the Time × Group interaction was significant for MASA score (P < 0.001). The large effect sizes were found for MASA score in both the TDT (d = 3.91) and the UC (d = 1.11) groups. CONCLUSIONS: This pilot randomized controlled trial showed that the TDT significantly improved the swallowing function of the MSpatients with dysphagia.