&lt;p&gt;An intensive swallowing exercise protocol for improving swallowing physiology in older adults with radiographically confirmed dysphagia&lt;/p&gt;

Balou, Matina; Herzberg, Erica G.; Kamelhar, David; Molfenter, Sonja M.

doi:10.2147/cia.s194723

Cited by 57 publications

(48 citation statements)

References 37 publications

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“…The maximal tongue pressure exerted on the hard palate may offer a quantitative parameter for evaluating tongue motor biomechanics during swallowing [2]. The exact and objective evaluation of tongue pressure is thus important for the monitoring of swallowing and oropharyngeal movements [3].…”

Section: Introductionmentioning

confidence: 99%

Analysis of Labial and Lingual Strength among Healthy Chinese Adults in Taiwan

Wang

Lin

et al. 2020

IJERPH

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This study collected 11 parameters regarding the labial and lingual strength for maximum isometric and swallowing tasks among 150 healthy Chinese adults in Taiwan. Measurements were performed using the Iowa Oral Performance Instrument (IOPI). All of the labial and lingual strength parameters were measured three times. The maximal value of three trials represents the pressure of every parameter. The overall mean (±standard deviation) and maximum isometric pressures of the lips, anterior tongue, and posterior tongue were 24.81 ± 5.64, 55.95 ± 14.13, and 53.23 ± 12.24 kPa, respectively. The mean value of posterior tongue strength was less than that of the anterior tongue by approximately 5%. The percentages of maximum isometric tongue pressure during the swallowing of saliva and water were 85% and 80% for the anterior tongue and 90% and 81% for the posterior tongue, respectively. The average endurances for the anterior tongue and posterior tongue were 13.86 ± 7.08 and 10.06 ± 5.40 s, respectively. The maximum isometric pressures were greater than both the saliva and water swallowing pressures, and the saliva swallowing pressures were greater than the water swallowing pressures. A value of 33 kPa in maximum isometric pressure could serve as a demarcation of weak tongue strength for healthy Chinese adults. As for the repeated trials of labial and lingual strength, there were no statistically significant differences for any of the pressures obtained from the 11 labial and lingual strength parameters. The normative data can be used for the objective assessment of labial and lingual strength in healthy Chinese adults.

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Section: Introductionmentioning

confidence: 99%

Analysis of Labial and Lingual Strength among Healthy Chinese Adults in Taiwan

Wang

Lin

et al. 2020

IJERPH

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“…The 365 Healthy Swallowing Coach app requires 7.5 hours per week, which is comparable to “distributed” therapy. Because the intensity needed for “intensive” swallowing exercise protocols varies [ 55 ], further research is needed to elucidate the relationship between the amount of training and therapeutic effects.…”

Section: Discussionmentioning

confidence: 99%

User-Dependent Usability and Feasibility of a Swallowing Training mHealth App for Older Adults: Mixed Methods Pilot Study

Kim¹,

Lee²,

Cho³

et al. 2020

JMIR Mhealth Uhealth

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Background Swallowing difficulties (ie, dysphagia) are common among older adults, with a 13% to 54% prevalence. Adequate interventions to improve the swallowing function of older adults would reduce morbidity and enhance health-related quality of life outcomes. Mobile health (mHealth) apps may help alleviate dysphagia symptoms by providing programs that maximize the intensity and frequency of training without requiring high costs or regular clinic visits. Objective The aim of this pilot study was to assess the usability of swallowing training apps by quantitatively and qualitatively evaluating older adults’ self-reported data, taking into consideration their educational levels and exposure to mobile technology. We conducted surveys and brief interviews while the participants used a swallowing intervention app we developed. We subsequently identified and resolved individual-specific usability issues to improve future implementation of the app protocol for older persons with swallowing difficulties. Methods A total of 11 participants (10 women, 91%; mean age 75.7 years, SD 3.93) from two district-run senior welfare centers took part in this study. The participants were divided into a high-potential group and a low-potential group based on their total number of years of education and smart device usage. To investigate the usability of the app twice (ie, in the second week of the intervention and the postintervention stage), we used mixed methods consisting of both quantitative approaches, namely the System Usability Scale (SUS) and modified Computer Self-Efficacy Scale (mCSES) surveys, and qualitative approaches (ie, interviews). Results The quantitative results of the SUS and mCSES surveys revealed that the high-potential group was more inclined to adopt and learn new technology than the low-potential group. Specifically, within the high-potential group, a Wilcoxon signed-rank test indicated that the postintervention mCSES scores (median 65.50) were significantly higher than those in the second week of intervention (median 54.00; z=–2.023, P=.04). Additionally, the usability scores in the low-potential group were within the “marginal acceptability” range even after completion of an 8-week intervention program. Qualitative analyses via semi-structured interviews yielded promising outcomes regarding app acceptability, training program utilization, emotional responses, and learning experience. Conclusions To the best of the authors’ knowledge, this usability and feasibility study is the first report of a swallowing training app designed to improve the swallowing function of older adults. Future research should consider several issues, such as user characteristics, pretraining education, and the intensity and innate characteristics of the intervention program.

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“…In addition to the conventional swallowing therapy, the patients in the IST group received intensive swallowing training with tongue-hold swallow [ 22 , 23 ]. During direct eating/swallowing training, a patient was asked to hold their tongue gently between their teeth.…”

Section: Methodsmentioning

confidence: 99%

“…Tongue-hold swallow is one part of the exercise protocol for intensive swallowing (IS), which targets the swallowing muscles that are desirable for reversing sarcopenia and age-related dysphagia [ 22 ]. In tongue-hold swallow, patients are asked to hold their tongue gently between their teeth and then swallow their saliva with their tongue in a straight position [ 23 ].…”

Section: Introductionmentioning

confidence: 99%

Effects of Synchronized Neuromuscular Electrical Stimulation (NMES) on the Submental Muscles During Ingestion of a Specified Volume of Soft Food in Patients with Mild-to-Moderate Dysphagia Following Stroke

Zhang

2021

Med Sci Monit

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Background Neuromuscular electrical stimulation (NMES) is a method for producing regular contractions of muscles that have been paralyzed. This study aimed to evaluate the effects of synchronized NMES on the submental muscles during ingestion of a specified volume of soft food in patients with mild-to-moderate dysphagia following stroke. Material/Methods Eighty-three patients with mild-to-moderate dysphagia following stroke were enrolled and randomly divided into 3 groups: conventional training (CT) (n=28), eating training (ET) (n=28), and intensive swallowing training (IST) (n=27). The CT group received conventional swallow training, the ET group was given additional individual feedings with a specified volume of soft food, and the IST group received intensive swallowing training with synchronized NEMS. All of the patients were evaluated before and after the treatment with a modified barium swallow, and the Dysphagia Outcome and Severity Scale (DOSS); the numbers of patients with Stroke-Associated Pneumonia (SAP) and wet voice also were assessed. Results After 6 weeks, DOSS scores improved in patients in all 3 groups, and there were significant differences among the groups in their scores ( P <0.001 for both measures). In the CT and ET groups, there was a statistically significant difference in the number of patients with SAP before and after treatment ( P =0.010 and P <0.001, respectively). There also were fewer cases in the IST group than in the CT ( P =0.042) and ET groups ( P =0.011). After completion of treatment, compared with the first treatment, there were significantly fewer patients with wet voices in the CT ( P <0.001) and IST groups ( P <0.001). Conclusions Feeding a specified volume of soft food plus synchronized NMES of the submental muscles can improve the swallowing function of patients with mild-to-moderate dysphagia following stroke and it reduces their risk of food aspiration.

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<p>An intensive swallowing exercise protocol for improving swallowing physiology in older adults with radiographically confirmed dysphagia</p>

Cited by 57 publications

References 37 publications

Analysis of Labial and Lingual Strength among Healthy Chinese Adults in Taiwan

Analysis of Labial and Lingual Strength among Healthy Chinese Adults in Taiwan

User-Dependent Usability and Feasibility of a Swallowing Training mHealth App for Older Adults: Mixed Methods Pilot Study

Effects of Synchronized Neuromuscular Electrical Stimulation (NMES) on the Submental Muscles During Ingestion of a Specified Volume of Soft Food in Patients with Mild-to-Moderate Dysphagia Following Stroke

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