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The Feasibility of Home-Based Treatment Using Vibratory Stimulation in Chronic Severe Dysphagia.
Kamarunas, Erin; Mulheren, Rachel; Wong, Seng Mun; Griffin, Lindsay; Ludlow, Christy L.
Afiliación
  • Kamarunas E; Department of Communication Sciences and Disorders, College of Health and Behavioral Studies, James Madison University, Harrisonburg, VA.
  • Mulheren R; Voice and Swallow Clinic, Sentara Rockingham Memorial Hospital, Harrisonburg, VA.
  • Wong SM; Department of Communication Sciences and Disorders, College of Health and Behavioral Studies, James Madison University, Harrisonburg, VA.
  • Griffin L; Communication Sciences Program, Department of Psychological Sciences, Case Western Reserve University, Cleveland, OH.
  • Ludlow CL; Department of Communication Sciences and Disorders, College of Health and Behavioral Studies, James Madison University, Harrisonburg, VA.
Am J Speech Lang Pathol ; 31(6): 2539-2556, 2022 11 16.
Article en En | MEDLINE | ID: mdl-36346969
PURPOSE: Previously, externally placed vibratory laryngeal stimulation increased rates of swallowing in persons with and without dysphagia. This study examined the feasibility of using a vibratory device on the skin over the thyroid cartilage for home-based swallowing rehabilitation in long-standing dysphagia. METHOD: Only participants with long-standing dysphagia (> 6 months) following cerebrovascular accident or head/neck cancer who had not previously benefited from dysphagia therapy participated. The device had two modes used daily for 90 days. In automatic mode, participants wore the device when awake, which vibrated for 4-8 s every 5 min to trigger a volitional swallow. In manual mode, participants practiced by activating vibration while swallowing rapidly. Study-related adverse events, such as pneumonia, and device-recorded adherence were tracked. Swallowing function on a modified barium swallow study was assessed at baseline and after 3 months of device use. Outcome measures included the Dysphagia Outcome and Severity Scale (DOSS), Penetration-Aspiration Scale (PAS), and swallowing timing measures. Participants' perceptions of the vibratory device and training were obtained. RESULTS: The intent to treat analysis showed seven of 11 participants completed the study, all with severe chronic dysphagia. Of those seven participants completing the study, two developed respiratory complications (possibly due to pneumonia) that cleared after antibiotic intervention. For prescribed practice trials, adherence was 80% or greater in four of seven participants (57%) whereas prescribed automatic stimulations were met in only two of seven participants (29%). Three participants (43%) had a modest benefit on DOSS. The time to vestibule closure after the bolus passed the ramus was reduced in five participants (71%) on the modified barium swallow study. CONCLUSION: Overall, the results have indicated that intensive home-based practice with stimulation may provide limited functional benefits in severe chronic dysphagia. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.21498591.
Asunto(s)

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neumonía / Trastornos de Deglución Tipo de estudio: Etiology_studies / Guideline Límite: Humans Idioma: En Revista: Am J Speech Lang Pathol Asunto de la revista: PATOLOGIA DA FALA E LINGUAGEM Año: 2022 Tipo del documento: Article Pais de publicación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neumonía / Trastornos de Deglución Tipo de estudio: Etiology_studies / Guideline Límite: Humans Idioma: En Revista: Am J Speech Lang Pathol Asunto de la revista: PATOLOGIA DA FALA E LINGUAGEM Año: 2022 Tipo del documento: Article Pais de publicación: Estados Unidos