This study compares the effects of traditional logopedic dysphagia treatment with those of neuromuscular electrical stimulation (NMES) as adjunct to therapy on the quality of life in patients with Parkinson’s disease and oropharyngeal dysphagia. Eighty-eight patients were randomized over three treatment groups. Traditional logopedic dysphagia treatment and traditional logopedic dysphagia treatment combined with NMES at sensor or motor level stimulation were compared. At three times (pretreatment, post-treatment, and 3 months following treatment), two quality-of-life questionnaires (SWAL-QOL and MD Anderson Dysphagia Inventory) and a single-item Dysphagia Severity Scale were scored. The Functional Oral Intake Scale was used to assess the dietary intake. After therapy, all groups showed significant improvement on the Dysphagia Severity Scale and restricted positive effects on quality of life. Minimal group differences were found. These effects remained unchanged 3 months following treatment. No significant correlations were found between dietary intake and quality of life. Logopedic dysphagia treatment results in a restricted increased quality of life in patients with Parkinson’s disease. In this randomized controlled trial, all groups showed significant therapy effects on the Dysphagia Severity Scale and restricted improvements on the SWAL-QOL and the MDADI. However, only slight nonsignificant differences between groups were found.

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Telehealth services may be as effective as face-to-face interventions, which is encouraging given the potential benefits of telehealth in rural and remote areas with regards to healthcare access and time and cost savings.

Quality of life is an important outcome measurement in objectifying the current health status or therapy effects in patients with oropharyngeal dysphagia. In this study, the validity and reliability of the Dutch version of the Deglutition Handicap Index (DHI) and the MD Anderson Dysphagia Inventory (MDADI) have been determined for oncological patients with oropharyngeal dysphagia. At Maastricht University Medical Center, 76 consecutive patients were selected and asked to fill in three questionnaires on quality of life related to oropharyngeal dysphagia (the SWAL-QOL, the MDADI, and the DHI) as well as a simple one-item visual analog Dysphagia Severity Scale. None of the quality-of-life questionnaires showed any floor or ceiling effect. The test-retest reliability of the MDADI and the Dysphagia Severity Scale proved to be good. The test-retest reliability of the DHI could not be determined because of insufficient data, but the intraclass correlation coefficients were rather high. The internal consistency proved to be good. However, confirmatory factor analysis could not distinguish the underlying constructs as defined by the subscales per questionnaire. When assessing criterion validity, both the MDADI and the DHI showed satisfactory associations with the SWAL-QOL (reference or gold standard) after having removed the less relevant subscales of the SWAL-QOL. In conclusion, when assessing the validity and reliability of the Dutch version of the DHI or the MDADI, not all psychometric properties have been adequately met. In general, because of difficulties in the interpretation of study results when using questionnaires lacking sufficient psychometric quality, it is recommended that researchers strive to use questionnaires with the most optimal psychometric properties.

Objective: To evaluate the efficacy of the use of surface electromyographic feedback in the treatment of stroke patients with chronic dysphagia. Patients and Methods: Data of 11 consecutive patients with chronic dysphagia after stroke were analyzed. Our patients were treated for dysphagia with surface electromyography as biofeedback as adjunct to normal exercises. All patients suffered from dysphagia after stroke. The average time after onset was 31.1 months. All patients had been previously treated by speech therapists without success. Functional swallowing was estimated using the Functional Oral Intake Scale (FOIS). At the start of the treatment 8 patients were tube dependent (FOIS ≤4). Three patients were on an oral diet, but with restrictions (FOIS ≥5). Results: The patients were treated on average seven 7 times. The time between the first and last treatment session was on average 76.1 days (SD ± 44.0; range = 29–168). Before treatment the average FOIS was 2.6 (SD ±2.3) and after treatment 5.6 (SD ±1.6). The median scores improved from 1 to 6, showing a significant and clinically relevant improvement (z = –2.820: p < 0.01) in swallowing function. In 6 of initially 8 patients with percutaneous enteral gastrostomy tubes, the feeding tube could be removed after treatment. Conclusion: Our data suggest that the use of surface electromyography as biofeedback in the treatment of chronic dysphagia after stroke could be an effective adjunct to standard therapy for swallowing disorders in 11 patients.

These findings have implications for any postlaryngectomy research that uses pulmonary parameters.

The aim of this work was to translate the 44-item SWAL-QoL into Dutch (SWAL-QoL-NL) and compare the validity of this questionnaire against Euroqol in a Dutch population with dysphagia. SWAL-QoL was translated according to international guidelines. SWAL-QoL-NL and Euroqol were completed by 152 patients in seven diagnosis groups. Internal consistency and correlations were calculated. Scores for nine subscales (General burden, Food selection, Eating duration, Fear of eating, Sleep, Fatigue, Mental health, Social functioning and a symptom score) ranged between 0.80 and 0.92 (Cronbach's a). Two subscales (Eating desire and Communication scored 0.67 and 0.60, respectively, and were removed from the questionnaire. The 14-item battery on clinical symptoms showed an internal consistency of 0.80, allowing the use of a sum score on group level in clinical research. Correlation of SWALQoL-NL subscales with the Euroqol was negligible to low (Pearson's correlations range = 0.09-0.36). The 39-item SWAL-QoL-NL proved to be a reliable tool to examine the impact of dysphagia on quality of life in a Dutch population. Internal consistency allows the use of nine subscales of SWAL-QoL-NL for comparisons on a group level (0.80 \ a \ 0.92) only. Also a Symptom score can be derived from the raw data.

Purpose Speech-language pathologists are playing a crucial role in the assessment and management of patients infected with severe acute respiratory syndrome coronavirus 2. Our goal was to synthesize peer-reviewed literature and association guidelines from around the world regarding dysphagia assessment and management for this specific population. Method A review of publications available in the PubMed database and official guidelines of international groups was performed on May 23, 2020. The information was synthesized and categorized into three content areas for swallowing: clinical evaluation, instrumental assessment, and rehabilitation. Results Five publications were identified in the PubMed database. Following title, abstract, and full-text review, only three publications met inclusion criteria: two reviews and one narrative report. Additionally, 19 international guidelines were reviewed. To assess swallowing, a modified clinical evaluation was recommended and only following a risk assessment. Instrumental assessments were often considered aerosol generating, especially transnasal procedures such as endoscopy and manometry. For this reason, many associations recommended that these examinations be performed only when essential and with appropriate personal protective equipment. Guidelines recommended that intervention should focus on compensatory strategies, including bolus modification, maneuvers/postural changes, and therapeutic exercises that can be conducted with physical distancing. Respiratory training devices were not recommended during rehabilitation. Conclusions International associations have provided extensive guidance regarding the level of risk related to the management of dysphagia in this population. To date, there are no scientific papers offering disease and/or recovery profiling for patients with dysphagia and coronavirus disease 2019. As a result, research in this area is urgently needed.