Clinical trial NCT04362228: The Effects of Whole-body Exercise to Improve Swallowing Function in Older Adults With Dementia
Official title: The Effects of Whole-body Exercise to Improve Swallowing Function in Older Adults With Dementia
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Old Age; Dementia
Swallowing Disorder
Cough
Parkinson Disease
Neuro-Degenerative Disease
Keywords: dementia
swallowing
physical exercise
parkinson disease
Lead sponsor: McMaster University
Sponsor class: OTHER
Collaborators: name: Joseph Brant Hospital
First posted: 2020-04-24
Enrollment: 9
Sex: ALL
Minimum age (years): 60
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: NA
Intervention model: SINGLE_GROUP
Primary purpose: TREATMENT

Brief summary: Swallowing impairment (dysphagia) is extremely common in older adults living with dementia due to age-related changes in swallowing and other disease-specific impairments. Dysphagia is commonly managed by modifying diet textures rather than engaging in rehabilitative swallowing therapy. This means that countless people with dementia are left to eat pureed foods and drink thickened liquids, which are unpalatable and lead to malnutrition. As the disease progresses, many are transferred to nursing homes. In Canada, speech-language pathologists, who manage dysphagia, are consultants within nursing homes; therefore, swallowing therapy is non-existent. However, exercise therapy is more commonly available. Rodent models have demonstrated that physical exercise strengthens tongue and vocal-fold musculature, which are critical components of swallowing. Therefore, it is possible that whole-body physical exercise, which increases rate of respiration, will help to strengthen swallowing-related musculature in older adults with dementia. In this study, older adults (65+) with early-stage dementia will complete a 12-week physical exercise program to determine improvement of swallowing function.


Eligibility criteria: Inclusion Criteria:

* \> 59 years of age
* able to walk independently with or without an assistive device for a distance of at least 10 meters
* able to be active for 60 minutes with rest breaks
* abe to independently follow directions
* not involved in active rehabilitation
* a diagnosis of a progressive neurologic disease
* a maximum value for tongue strength \<40 kPa

Exclusion Criteria:

* neurological conditions other than a progressive neurologic disease
* significant cardiovascular conditions
* severe aphasia
* pain, other medical conditions or behavioural issues that would limit safe participation in the exercise program
* individuals with known structural causes of dysphagia
* individuals with known allergies to latex
* individuals receiving swallowing rehab

Primary outcomes:
measure: Change in respiratory function from baseline to end of intervention
timeFrame: baseline, week 4, week 14 and week 16
measure: Change in swallowing function from baseline to end of intervention
timeFrame: baseline, week 4, week 14 and week 16
Secondary outcomes:
measure: Change in aerobic fitness from baseline to end of intervention
timeFrame: baseline, week 4, week 14 and week 16
Other outcomes:
Locations:
city: Hamilton
country: Canada
facility: McMaster University
state: Ontario
Study officials:
References:
citation: Kletzien H, Russell JA, Connor NP. The effects of treadmill running on aging laryngeal muscle structure. Laryngoscope. 2016 Mar;126(3):672-7. doi: 10.1002/lary.25520. Epub 2015 Aug 8.
citation: Kletzien H, Russell JA, Leverson GE, Connor NP. Differential effects of targeted tongue exercise and treadmill running on aging tongue muscle structure and contractile properties. J Appl Physiol (1985). 2013 Feb 15;114(4):472-81. doi: 10.1152/japplphysiol.01370.2012. Epub 2012 Dec 20.