Effect of Home Based Swallowing Exercise in Stroke Patients With Dysphagia

Study Overview
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Brief Summary
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Dysphagia is a common problem in post-stroke patients and greatly impaired quality of life. Among them, the strength of tongue and lip muscles played a key role in the oral phase of swallowing and many stroke survivors suffered from these muscles weakness. Iowa oral performance instrument (IOPI) is a standardized portable device that can be used to quantify tongue muscle strength, thus allowing the clinician to set the level of resistance necessary to achieve optimal gains in strength, and also providing visual feedback of performance to the patients to guide training. In this study, we use Videofluoroscopic Swallowing Study (VFSS) to screen for the stroke patient suffering from dysphagia and recruited them into the trial. They then participated in a home based resistance-training program using the tongue depressor, 1 time everyday and each time consisted of 30 repetitions, totally 4 weeks. Various tongue strength variables and subjective scale were obtained before and after the intervention. The purpose of the study was to evaluate the effect of the home based swallowing therapy in the post stroke dysphagia patients.

Official Title
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Effect of Home Based Swallowing Exercise in Stroke Patients With Dysphagia

Conditions
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Dysphagia Following Cerebrovascular Accident

Intervention / Treatment
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* Behavioral: home based IOPI swallow training


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Acute stroke within 1 year, videofluoroscopic swallow study revealed abnormalities Mini-Mental Status Examination >20, could cooperate swallow therapy Exclusion Criteria: Already known dysphagia before stroke event Malocclusion or severe facial palsy Localized oral lesion interfering swallowing

Ages Eligible for Study
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Minimum Age: 30 Years
Maximum Age: 85 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: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Iowa Oral Performance Instrument (IOPI) training group<br>Including conventional speech therapy (tongue range of motion and strength, oral diet suggestion, masseter muscle strengthening) and home- IOPI based resistance training | Behavioral: home based IOPI swallow training<br>* Use IOPI for tongue and labial muscle resistance training. Conventional training was the same as controlled group.<br>|
| No Intervention: controlled group<br>Including conventional speech therapy (tongue range of motion and strength, oral diet suggestion, masseter muscle strengthening) only | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Anterior tongue pressure |  | 1 week after treatment | 
| Posterior tongue pressure |  | 1 week after treatment | 
| Right buccal pressure |  | 1 week after treatment | 
| Left buccal pressure |  | 1 week after treatment | 
| Labial pressure |  | 1 week after treatment | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The score of Eat-10 scale |  | 1 week after treatment | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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dysphagia, ischemic stroke, intracranial hemorrhage