Effects of bedside self-exercise on oropharyngeal swallowing function in stroke patients with dysphagia: a pilot study

Cho, Young-Seok; Oh, Dong-Hwan; Paik, Young-Rim; Lee, Jeong-Hoon; Park, Jisu

doi:10.1589/jpts.29.1815

Cited by 18 publications

(22 citation statements)

References 9 publications

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“…One study [39] did not report final sample size, and therefore it was not possible to determine whether any participants were lost to follow-up. Finally, reporting bias was deemed to be high in three studies [37][38][39] that did not provide any information regarding the stimuli used to assess swallowing function on VFSS. The quality assessment completed using the NIH tool deemed four studies to be "poor" in quality, two as "fair", and one study as "good"(see Table 2).…”

Section: Literature Retrievalmentioning

confidence: 99%

“…Patient characteristics can be found in Table 3. Three different patient population groups were included: stroke [1,3,[37][38][39], acquired brain injury [2], and healthy participants [29]. Sample sizes varied widely across studies, ranging from six participants [2] to 29 participants [38].…”

Section: Patient Characteristicsmentioning

confidence: 99%

“…Selection bias was also found in five studies as convenience sampling was mainly used with no randomization or concealment to treatment conditions. Furthermore, small sample size was identified as a limitation in 50% [1,2,29,39] of included studies. This increases the risk of bias as it undermines the reliability of the results leading to lack of confidence that any statistically significant effect reflects a true effect at the population level.…”

Section: Risk Of Biasmentioning

confidence: 99%

“…Cho et al [39] VDS (oral phase; pharyngeal phase) Significant improvement in oral phase components (p < 0.05) Significant improvement in the pharyngeal phase components (p < 0.05) Kim et al [37] Anterior tongue strength Baseline MIP = 32.67 kPa; post-treatment MIP: 41.89 kPa Significant increases for both experimental and control; Statistically significant difference between groups (p < 0.000) Posterior tongue strength Baseline MIP = 28.06 kPa; post-treatment MIP: 39.11 kPa Significant increases for both experimental and control; Statistically significant difference between groups (p < 0.000) VDS (oral phase; pharyngeal phase)…”

Section: Studymentioning

confidence: 99%

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The Effect of Lingual Resistance Training Interventions on Adult Swallow Function: A Systematic Review

2019

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Lingual resistance training has been proposed as an intervention to improve decreased tongue pressure strength and endurance in patients with dysphagia. However, little is known about the impact of lingual resistance training on swallow physiology. This systematic review scrutinizes the available evidence regarding the effects of lingual resistance training on swallowing function in studies using Videofluoroscopic Swallowing Studies (VFSS) with adults. Seven articles met the inclusion criteria and underwent detailed review for study quality, data extraction, and planned meta-analysis. Included studies applied this intervention to a stroke and brain injury patient populations or to healthy participants, applied different training protocols, and used a number of outcome measures, making it difficult to generalize results. Lingual resistance training protocols included anterior and posterior tongue strengthening, accuracy training, and effortful press against hard palate with varying treatment durations. VFSS protocols typically included a thin barium stimulus along with one other consistency to evaluate the effects of the intervention. Swallowing measures included swallow safety, efficiency, and temporal measures. Temporal measures significantly improved in one study, while safety improvements showed mixed results across studies. Reported improvements in swallowing efficiency were limited to reductions in thin liquid barium residue in two studies. Overall, the evidence regarding the impact of lingual resistance training for dysphagia is mixed. Meta-analysis was not possible due to differences in methods and outcome measurements across studies. Reporting all aspects of training and details regarding VFSS protocols is crucial for the reproducibility of these interventions. Future investigations should focus on completing robust analyses of swallowing kinematics and function following tongue pressure training to determine efficacy for swallowing function.

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Section: Literature Retrievalmentioning

confidence: 99%

Section: Patient Characteristicsmentioning

confidence: 99%

Section: Risk Of Biasmentioning

confidence: 99%

Section: Studymentioning

confidence: 99%

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The Effect of Lingual Resistance Training Interventions on Adult Swallow Function: A Systematic Review

2019

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“…For patients who have experienced a stroke, lingual strength is decreased compared to healthy participants [3]. Tongue pressure resistance training has been utilized as an intervention in this population, and has been shown to positively influence tongue strength [4][5][6][7][8]. However, it remains unclear whether increases in tongue pressure amplitude directly impact swallowing physiology, safety, and/or efficiency for patients who complete these interventions [9].…”

Section: Background and Rationalementioning

confidence: 99%

Tongue pressure resistance training for swallowing impairment post-stroke: study protocol for a randomized crossover clinical trial

Smaoui¹,

Richardson²,

Péladeau-Pigeon³

et al. 2019

Preprint

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Introduction For patients who have suffered a stroke, tongue strength may be decreased compared to healthy individuals. Patients with dysphagia following stroke are more likely to experience aspiration pneumonia, which has been associated with higher mortality rates and medical complications. Research on strengthening the tongue in the stroke population has shown positive effects of a tongue resistance training protocol. Research also suggests that swallow safety, or protection of the airway, may be improved as a result of such interventions, however the mechanism of improvement remains poorly understood, particularly whether improvement is attributed to the intervention alone, or to spontaneous recovery. This study aims to determine what aspects of the swallowing mechanism (response time, movement, etc. of different structures) are directly impacted in order to provide guidance to clinicians using such treatments.Methods and analysis A multi-site, assessor-blinded, randomized crossover trial was designed to determine the effects of a 4-week course of tongue pressure intervention supplemented with home practice in participants who experience dysphagia (PAS of 3 or greater) at baseline. An instrumental evaluation of swallowing (videofluoroscopic swallowing study) is utilized at baseline to determine whether swallowing safety is impaired. Additionally, a requirement for reduced tongue pressures (<40 kilopascals) on all three trials was added in order to target patients who would benefit from this training. Participants are randomized into a delayed treatment group or an immediate treatment group to control for the effects of spontaneous recovery. All participants receive the 4 week treatment consisting of 2 weekly sessions with a speech-language pathologist and complete daily homework plans. Videofluoroscopic swallowing studies are also performed pre and post intervention to quantify the degree of change attributed to the intervention. The study launched in May 2019 and will enroll a maximum of 40 participants.Discussion This study will explore the effects of tongue pressure intervention on swallowing parameters in patients presenting with dysphagia post-stroke. Describing how the intervention effects specific swallowing mechanisms will provide guidance to clinicians using such treatments with this population. Trial registration number ClinicalTrials.gov identifier NCT03969095, published May 31 2019; https://clinicaltrials.gov/ct2/show/NCT03969095?term=NCT03969095&rank=1

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Cerebrovascular Accident

Schneider¹,

Maier²

2020

Neurologic and Neurodegenerative Diseases of the Larynx

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Effects of bedside self-exercise on oropharyngeal swallowing function in stroke patients with dysphagia: a pilot study

Cited by 18 publications

References 9 publications

The Effect of Lingual Resistance Training Interventions on Adult Swallow Function: A Systematic Review

The Effect of Lingual Resistance Training Interventions on Adult Swallow Function: A Systematic Review

Tongue pressure resistance training for swallowing impairment post-stroke: study protocol for a randomized crossover clinical trial

Cerebrovascular Accident

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