11. Effect of IQoro training on impaired postural control and oropharyngeal motor function in patients with dysphagia after stroke.

Conclusion All patients with dysphagia after stroke have impaired postural control. IQoro screen (IQS) training gives a significant and lasting improvement of postural control running parallel with significant improvement of oropharyngeal motor dysfunction (OPMD). Objectives The present investigation aimed at studying the frequency of impaired postural control in patients with stroke-related dysphagia and if IQS training has any effect on impaired postural control in parallel with effect on OPMD. Method A prospective clinical study was carried out with 26 adult patients with stroke-related dysphagia. The training effect was compared between patients consecutively investigated at two different time periods, the first period with 15 patients included in the study more than half a year after stroke, the second period with 11 patients included within 1 month after stroke. Postural control tests and different oropharyngeal motor tests were performed before and after 3 months of oropharyngeal sensorimotor training with an IQS, and at a late follow-up (median 59 weeks after end of training). Result All patients had impaired postural control at baseline. Significant improvement in postural control and OPMD was observed after the completion of IQS training in both intervention groups. The improvements were still present at the late follow-up.

Dysphagia: Proof of effect of IQoro on OPMD and IPC in stroke patients.
Snoring and sleep apnoea: Velum Closure competence is linked to snoring and OSA.

Peer reviewed, Prospective, Cohort pre- and post-study.

To study the frequency of Impaired Postural Control (IPC) in patients with stroke-related dysphagia or Oropharyngeal Motility Disorder (OPMD) and whether IQoro Neuromuscular Training (IQNT) has any effect on IPC in parallel with its effect on OPMD.

26 adult patients with stroke with pathological levels for both OPMD and IPC (F=11, M=15), median age 68 years (range 49–82).

The patients were divided between

• Group 1 (n=15)
  • had suffered stroke more than 1 year before
  • median age 67 years.
  • 100 % had pathological lip and tongue motor function.
  • 10 had a pathological jaw function.
  • 12 had a pathological velum function.
  • 6 had a pathological velopharyngeal closure ability.
  • 14 exhibited misdirected swallowing.
  • 4 patients in this group were fed via PEG.

• Group 2 (n=11)
  • had suffered stroke within 1 month before starting IQoro treatment.
  • median age 69 years.
  • 100 % had pathological lip and tongue motor function.
  • 10 had a pathological jaw function.
  • 12 had a pathological velum closure ability.
  • 8 had a pathological velopharyngeal closure ability.
  • 100 % exhibited misdirected swallowing.
  • 1 patient in this group was fed via PEG. 

108 patients were originally screened for inclusion in Group 2, but many were excluded before recruitment due to the following criteria: deceased (67), second stroke (26), unable to cooperate (15).

IQoro training 3 x 10 seconds, three times per day for a duration of 13 weeks.

Outcome measurements were made at three time points: before training, at end of training, and at a late follow-up (median 59 weeks after end of training).

The following measurements were used at all three timepoints:

• Postural Control according to Castillo Morales (PCCM),
• Postural Assessment Scale for Stroke patients (PASS),
• Oropharyngeal motor function (OPM) – function of the lips, jaw, tongue and velum,
• Swallowing ability (measured using Timed Water Swallow Test – TWST) – lower normal value for swallowing rate ≥ 10 ml / sec
• Pharyngeal sling force (measured using Lip Force meter) – lower normal value ≥ 15 N
• Velopharyngeal Closure Test (VCT) – lower normal value ≥ 10 sec