Document Detail


Functional and Physiological Outcomes from an Exercise-Based Dysphagia Therapy: A Pilot Investigation of the McNeill Dysphagia Therapy Program.
MedLine Citation:
PMID:  22365489     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Crary MA, Carnaby GD, LaGorio LA, Carvajal PJ. Functional and physiological outcomes from an exercise-based dysphagia therapy: a pilot investigation of the McNeill Dysphagia Therapy Program. OBJECTIVE: To investigate functional and physiological changes in swallowing performance of adults with chronic dysphagia after an exercise-based dysphagia therapy. DESIGN: Intervention study: before-after trial with 3-month follow-up evaluation. SETTING: Outpatient clinic within a tertiary care academic health science center. PARTICIPANTS: Adults (N=9) with chronic (>12mo) dysphagia after unsuccessful prior therapies. Subjects were identified from among patients referred to an outpatient dysphagia clinic. Subjects had dysphagia secondary to prior treatment for head/neck cancer or from neurologic injury. All subjects demonstrated clinical and fluoroscopic evidence of oropharyngeal dysphagia. No subject withdrew during the course of this study. INTERVENTIONS: All subjects completed 3 weeks of an intensive, exercise-based dysphagia therapy. Therapy was conducted daily for 1h/d, with additional activities completed by subjects each night between therapy sessions. MAIN OUTCOME MEASURES: Primary outcomes were clinical and functional change in swallowing performance with maintenance at 3 months after intervention. Secondary, exploratory outcomes included physiological change in swallow performance measured by hyolaryngeal elevation, lingual-palatal and pharyngeal manometric pressure, and surface electromyographic amplitude. RESULTS: Clinical and functional swallowing performances improved significantly and were maintained at the 3-month follow-up examination. Subject perspective (visual analog scale) on functional swallowing also improved. Four of 7 subjects who were initially feeding tube dependent progressed to total oral intake after 3 weeks of intervention. Physiological indices demonstrated increased swallowing effort after intervention. CONCLUSIONS: Significant clinical and functional improvement in swallowing performance followed a time-limited (3wk) exercise-based intervention in a sample of subjects with chronic dysphagia. Physiological changes after therapy implicate improved neuromuscular functioning within the swallow mechanism.
Authors:
Michael A Crary; Giselle D Carnaby; Lisa A Lagorio; Pamela J Carvajal
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-2-24
Journal Detail:
Title:  Archives of physical medicine and rehabilitation     Volume:  -     ISSN:  1532-821X     ISO Abbreviation:  -     Publication Date:  2012 Feb 
Date Detail:
Created Date:  2012-2-27     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  2985158R     Medline TA:  Arch Phys Med Rehabil     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012 the American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
Affiliation:
Department of Speech, Language, and Hearing Sciences, University of Florida, Gainesville, FL.
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