Hägg M, Tibbling L. The Open Rehabilitation Journal, 2013, 6, pp 26–33.
Abstract as published
Aim This study aimed at evaluating (1) if the oral training effect on stroke related dysphagia differs between two different oral appliances, a palatal plate (PP) and an oral screen (OS), and (2) if the training effect remains at a late follow-up. Methods We included patients with stroke-related dysphagia at two different time periods: the first group of 12 patients studied in 1997–2002 had to train with a PP, the other one of 14 patients studied in 2003–2008 had to train with an OS. All patients were evaluated by a swallowing capacity test (SCT), and by a self-assessed visual analogue scale (VAS) of water swallowing capacity at entry of the study, after 13 weeks of training, and at a late follow-up. Results At end of treatment the SCT had normalized in 33 % of PP patients and in 71 % of OS patients. There was a significant SCT improvement difference between the PP and OS groups in the period from baseline to late follow-up (p < 0.002) in favor of the OS group. VAS as tested at baseline and at end of treatment did not differ significantly between the two groups. Training with PP and with OS produced remaining improvement of SCT and of VAS as assessed at a late follow-up. Conclusion The outcome of OS training on SCT in patients with stroke-related dysphagia seems to be superior to PP training. The improvement as assessed with VAS did not differ between the two groups. Training with PP or OS gives a longstanding improvement of SCT and VAS.
Relevance to conditions
Dysphagia: Proof of effect of IQoro and Palatal plate training on swallowing in stroke patients.
Peer reviewed, Prospective, Cohort pre- and post- study.
To determine (i) whether oral training effect on stroke related dysphagia differs between two different oral devices: a palatal plate (PP) and IQoro neuromuscular training (IQNT) device, and (ii) whether any improvement is still present at late follow-up.
- 12 adult patients with stroke-related dysphagia treated with PP, F=2, M=10, median age 69 (range 46–82).
- 14 adult patients with stroke-related dysphagia treated with IQNT, F=7, M=7, median age 69 (range 55–81).
Prospective chart analysis of outcomes of the two different treatment groups: PP and IQNT.
PP training session duration was 90 minutes per day.
IQoro training session duration was 90 seconds per day.
- Swallowing ability (using Timed Water Swallow Test – TWST) – lower normal value for swallowing rate ≥ 10 ml/sec,
- Self-assessed scoring test (using Visual Analogue Scale – VAS).
Testing was performed at three timepoints: at baseline, end-of-treatment (13 weeks) and at late follow up.
- At end of treatment swallowing ability had normalized in 33 % of patients in the PP group and in 71 % of the IQoro group.
- There was also a significant swallowing ability improvement difference between the PP and IQoro groups in the period from baseline to late follow-up (p < 0.002) in favour of the IQoro group.
- VAS, as tested at baseline and at end-of-treatment, did not differ significantly between the two groups.
- Training with PP and with IQoro produced lasting improvement of swallowing ability as assessed by TWST and VAS at late follow-up.
Statistical significance of result
(p < 0.001) improvement in swallowing ability at end of treatment (PP group = 33 % normalised).
(p < 0.001) improvement in swallowing ability at end of treatment (IQoro group = 71 % normalised).
(p < 0.002) better improvement in IQNT over PP at late follow-up.
Both Palatal Plate and IQoro Neuromuscular Training lead to improvements in swallowing ability as measured by TWST and VAS. Improvements with IQoro Neuromuscular Training are significantly superior, and were achieved at far lower cost and in far shorter training sessions.