10. Esophageal dysphagia and reflux symptoms before and after oral IQoro training

Aim To examine whether muscle training with an oral IQoro screen (IQS) improves esophageal dysphagia and reflux symptoms. Methods A total of 43 adult patients (21 women and 22 men) were consecutively referred to a swallowing center for the treatment and investigation of long-lasting nonstenotic esophageal dysphagia. Hiatal hernia was confirmed by radiologic examination in 21 patients before enrollment in the study (group A; median age 52 years, range: 19–85 years). No hiatal hernia was detected by radiologic examination in the remaining 22 patients (group B; median age 57 years, range: 22–85 years). Before and after training with an oral IQS for 6–8 mo, the patients were evaluated using a symptom questionnaire (esophageal dysphagia and acid chest symptoms; score 0-3), visual analogue scale (ability to swallow food: score 0–100), lip force test (≥ 15 N), velopharyngeal closure test (≥ 10 s), orofacial motor tests, and an oral sensory test. Another twelve patients (median age 53 years, range: 22–68 years) with hiatal hernia were evaluated using oral IQS traction maneuvers with pressure recordings of the upper esophageal sphincter and hiatus canal as assessed by high-resolution manometry.
Results Esophageal dysphagia was present in all 43 patients at entry, and 98 percent of patients showed improvement after IQS training [mean score (range): 2.5 (1–3) vs 0.9 (0–2), P < 0.001]. Symptoms of reflux were reported before training in 86 percent of the patients who showed improvement at follow-up [1.7 (0–3) vs 0.5 (0–2), P < 0.001). The visual analogue scale scores were classified as pathologic in all 43 patients, and 100 percent showed improvement after IQS training [71 (30–100) vs 22 (0–50), P < 0.001]. No significant difference in symptom frequency was found between groups A and B before or after IQS training. The lip force test [31 N (12–80 N) vs 54 N (27–116), P < 0.001] and velopharyngeal closure test values [28 s (5–74 s) vs 34 s (13–80 s), P < 0.001] were significantly higher after IQS training. The oral IQS traction results showed an increase in mean pressure in the diaphragmatic hiatus region from 0 mmHg at rest (range: 0-0 mm HG) to 65 mmHg (range: 20–100 mmHg).
Conclusion Oral IQS training can relieve/improve esophageal dysphagia and reflux symptoms in adults, likely due to improved hiatal competence.

Dysphagia: Proof of effect of IQoro on mis-directed swallowing.
Hiatus hernia: Proof of effect of IQoro training on hiatal incompetence and several HH symptoms.
Snoring and sleep apnoea: Velum Closure competence is linked to snoring and OSA.

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

To examine whether training with an IQoro Neuromuscular Training (IQNT) improves esophageal dysphagia and reflux symptoms.

43 patients (F=22, M=21) median age 57 years (range 22 – 85) with esophageal dysphagia of a non-stenotic nature, of which:

• 21 patients with median age 52 years (range 19 – 85) with a confirmed Hiatal hernia,
• 22 patients with median age 57 years (range 22 – 85) exhibited Hiatal hernia symptoms but had no confirmed diagnosis.

All patients had been using PPI medication for more than one year.

IQoro training 3 x 10 seconds three times per day for a duration of 6 months. Outcome measurements were made at two time points: before training and at end of training.

12 patients, median age 53 years (range 22 – 68 years) with hiatal hernia were measured using:

• High Resolution Manometry during IQoro traction to record pressure in the upper esophageal sphincter and hiatus canal.

All patients were measured using:

• Symptom questionnaire (esophageal dysphagia and acid chest symptoms)
• Swallowing questionnaire (ability to swallow food), measured using Visual Analogue Scale (VAS)
• 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
• Orofacial motor tests
• Orofacial sensory test