Outpatient Swallowing Therapy for Subjects With Neurological Illness

Study Overview
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Brief Summary
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Health care staff in the municipalities do not always have the necessary competencies to treat patients with dysphagia. At the present neurorehabilitation hospital dysphagia examinations for outpatients are provided. The objective is to investigate the effect of a specialized outpatient dysphagia unit for subjects with dysphagia following neurological illness. Occupational therapists from the outpatient dysphagia unit will train with subjects for 2-3 weeks, and supervise furter training provided by health care staff in the municipalities.

Official Title
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Outpatient Swallowing Therapy for Subjects With Neurological Illness - a Feasability Study

Conditions
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Dysphagia

Intervention / Treatment
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* Other: Combination of different dysphagia training modalities


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Neurological illness Living in the Region of central Jutland FEDSS score 2-6 Exclusion Criteria: -

Ages Eligible for Study
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Minimum Age: 18 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
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Specialized dysphagia treatment<br>Dysphagia treatment is provided by occupational therapists specialized in dysphagia. | Other: Combination of different dysphagia training modalities<br>* Neuromuscular electrical stimulation, Masako exercises, Mendelsohn maneuver, chin down, mobilization, shaker exercises, eating different food consistencies.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in Fiberoptic Endoscopic Dysphagia Severity Scale (FEDSS) | The FEDSS assess severity of dysphagia, with scores ranging 1-6. Higher scores mean worse outcome. | Baseline and 14 days follow-up | 
| Change in Functional Oral Intake Scale (FOIS) | Level of oral intake with scores ranging 1-7. Higher scores mean better outcome. | Baseline, immediately after the intervention, and 14 days follow-up | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in Penetration Aspiration Scale (PAS) | Assessment of aspiration with scores ranging 1-8. Higher scores mean worse outcome. | Baseline and 14 days follow-up | 
| Change in The Yale Pharyngeal Residue Severity Rating Scale | Assessment of residue location and amount of residue. Two subscales with scores ranging 1-5. Higher scores mean worse outcome. | Baseline and 14 days follow-up | 
| Facio Oral Tract Therapy - Swallowing assessment of Saliva (FOTT-SAS) | Clinical examination of swallowing function. Yes or no to initiation of oral intake (binary outcome). | Baseline, immediately after the intervention, and 14 days follow-up | 
| Dysphagia Handicap Index (DHI) | Questionnaire on experience of dysphagia. 25 items with a toal score ranging 0-100. Higher scores mean worse outcome. Also measures overall severity with scores ranging 1-7. Higher scores means worse outcome. | Baseline, immediately after the intervention, and 14 days follow-up |