Efficacy of Myofunctional Therapy Associated with Voice Therapy in the Rehabilitation of Neurogenic Oropharyngeal Dysphagia: a pilot study

Abstract

Introduction Dysphagia causes changes in the laryngeal and stomatognathic structures; however, the use of vocal exercises is poorly described. Objective To verify whether the therapy consisting of myofunctional exercises associated with vocal exercises is more effective in rehabilitating deglutition in stroke patients. Methods This is a pilot study made up of two distinct groups: a control group, which performed only myofunctional exercises, and an experimental group, which performed myofunctional and vocal exercises. The assessment used for oral intake was the functional oral intake scale (FOIS). Results The FOIS levels reveal that the pre-therapy median of the experimental group was 4, and increased to 7 after therapy, while in the control group the values were 5 and 6 respectively. Thus, the experimental group had a statistically significant difference between the pre- and post-therapy assessments ( p = 0.039), which indicates that the combination of myofunctional and vocal exercises was more effective in improving the oral intake levels than the myofunctional exercises alone ( p = 0.059). On the other hand, the control group also improved, albeit at a lower rate compared with the experimental group; hence, there was no statistically significant difference between the groups post-therapy ( p = 0.126). Conclusion This pilot study showed indications that using vocal exercises in swallowing rehabilitation in stroke patients was able to yield a greater increase in the oral intake levels. Nevertheless, further controlled blind clinical trials with larger samples are required to confirm such evidence, as this study points to the feasibility of conducting this type of research.

Efficacy of speech therapy in post-intubation patients with oropharyngeal dysphagia: a randomized controlled trial

“…It is important to highlight that the present results indicated the benefits of a daily speech therapy program for dysphagia during ICU hospitalization, once the study methods included a concept of intensive speech therapy in dysphagia, based on previous research focused on daily therapy sessions that showed an early progression of oral intake outcome (23) .…”

“…The factors that could be potential biases in the present findings would be age and severity of dysphagia. Aging influences in swallowing mechanism and can be related to oropharyngeal dysphagia regardless of their use of orotracheal intubation (23) , but differences between groups remained after adjusting for age and severity of oropharyngeal dysphagia in the post-intervention period.…”

Interventions for oropharyngeal dysphagia in acute and critical care: a systematic review and meta-analysis

“…At present, seven trials are ongoing in acute care [50][51][52][53][54][55][56], four of these in intensive care, testing swallowing exercises post-extubation [50] or sensory electrical stimulation during intubation or post-extubation [51][52][53]. Ten trials are unclassified testing interventions in stroke [57][58][59][60][61][62][63][64][65][66]. The review team were unable to obtain trial results or sufficient data from authors to confirm inclusion.…”

Diagnosis and treatments for oropharyngeal dysphagia: effects of capsaicin evaluated by newly developed ultrasonographic method

“…Swallowing intervention with exercise, such as rehabilitation and swallowing training, was also reported to improve swallowing dysfunction and ODrelated comorbidities (41,42). Generally, the methods of rehabilitation for OD in older patients include training tongue pressure to improve lip muscle function, and the Shaker exercise (1,43,44). Although these treatments are noninvasive, there are individual differences in their effects.…”