Swallowing Training Combined With Game-based Biofeedback in Post-stroke Dysphagia

Study Overview
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Brief Summary
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The purpose of this study is to determine whether swallowing training combined with game-based biofeedback is effective in the treatment of dysphagia due to stroke.

Detailed Description
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Swallowing maneuvers are very effective if done correctly, but to evaluate the use of force and the extent of laryngeal elevation is very difficult. The therapist often requests the patient to swallow hard or maintain laryngeal elevation. However, it is difficult to provide appropriate feedback to the patient, because it's hard to see the throat muscle contraction and bone displacement,the real point of the force is not clear, only oral and tactile feedback is inadequate and when combined with sensory loss, fatigue or cognition impairment. Biofeedback is defined as the technique of using equipment (usually electronic) to reveal internal physiological events by visual and auditory signals, to teach patients to manipulate the intrinsic physiological activity (Basmajian, 1989).The rationale is thus that if a patient sees his muscle activity, rather than just feels his muscles contract, he will be able to contract his muscles more fiercely and therefore he will be able to train his muscles faster. Past studies have shown that biofeedback can help nerve injury patients control their physiological activities such as swallowing training. The purpose of this study is to determine whether swallowing training combined with game-based biofeedback is effective in the treatment of dysphagia due to stroke.

Official Title
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Swallowing Training Combined With Game-based Biofeedback in Post-stroke Dysphagia

Conditions
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Dysphagia

Intervention / Treatment
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* Device: Game-based swallow biofeedback
* Behavioral: Swallow training without biofeedback


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: stroke above 18 years-old pharyngeal stage dysphagia Exclusion Criteria: on trachea cannot follow one command

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 90 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Game-based swallow biofeedback<br>swallowing training combined with game-based biofeedback in stroke dysphagia patient. | Device: Game-based swallow biofeedback<br>* The intervention are divided into two parts： Traditional swallowing training 30 min by speech therapist. Game-based biofeedback combined with Mendelsohn's maneuver and effortful swallow 30 min by investigator.<br>* Other names: The system was developed by Professor Chen, Jia-Jin and Dr. Li, Chih-Ming from Taiwan's National Cheng Kung University, Institute of Biomedical Engineering.;|
| Active Comparator: Swallow training without biofeedback<br> | Behavioral: Swallow training without biofeedback<br>* The intervention are divided into two parts： Traditional swallowing training 30 min by speech therapist. Mendelsohn's maneuver and effortful swallow without biofeedback 30 min.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Hyoid bone displacement on the ultrasound |  | 6-8 weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Swallow functional ability on the Functional Oral Intake Scale |  | 6-8 weeks | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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stroke, swallowing training, game-based, biofeedback