Development of Innovative Feedback Device for Swallowing Therapy
- 156 Downloads
Dysphagia, which results from various disorders, may increase the risk of aspiration pneumonia, dehydration, and malnutrition. The aim of this study was to develop an innovative evaluation and treatment system for swallowing therapy using virtual reality (VR) feedback and electrical stimulation (ES), and to make an initial evaluation of its potential. In this system, the activation of the submental muscle and acceleration of laryngeal movement are used as the evaluation and feedback information. Twenty-one patients with chronic dysphagia for an average of 26.3 months were recruited for the VR feedback study. Each participant underwent 16 treatment sessions. After therapy, the Functional Oral Intake Scale results changed from 3.3 ± 1.5 to 5.0 ± 1.6 with statistical significance (p = 0.000). Thirteen healthy subjects were enrolled in the ES study. ES was applied for more than 2 s while the subjects were swallowing. With and without ES, swallowing triggering times were 456.17 ± 106.92 and 552.13 ± 105.97 ms, respectively. These differences were statistically significant (p = 0.04). Accelerations of laryngeal movement were 0.23 ± 0.1 g (g = 9.8 m/s2) and 0.20 ± 0.08 g, respectively, with a significant statistical difference (p = 0.033). The feasibility of a prototype that combines swallowing evaluation, VR feedback therapy, and synchronized ES is demonstrated for further clinical trials. Further comprehensive clinical studies are needed to verify the clinical efficacy of the device.
KeywordsEvaluation Deglutition disorders Virtual reality Electrical stimulation
- 5.Logemann, J. A. (1998). Evaluation and treatment of swallowing disorders. Austin, TX: Pro-Ed Inc.Google Scholar
- 15.Reddy, N. P., Simcox, D. L., Gupta, V., Motta, G. E., Coppenger, J., Das, A., & Buch, O. (2000). Biofeedback therapy using accelerometry for treating dysphagic patients with poor laryngeal elevation: Case studies. Journal of Rehabilitation Research and Development, 37, 361–372.Google Scholar
- 20.Laver, K., George, S., Thomas, S., Deutsch, J. E., & Crotty, M. (2012). Cochrane review virtual reality for stroke rehabilitation. European Journal of Physical and Rehabilitation Medicine, 48(3), 523–530.Google Scholar
- 23.Fabio, R. P. D. (1987). Reliability of computerized surface electromyography for determining the onset of muscle activity. Physical Therapy, 67, 43–48.Google Scholar
- 24.Vaiman, M., Eviatar, E. (2009). Surface electromyography as a screening method for evaluation of dysphagia and odynophagia. Head & Face Medicine, 5(9). http://www.head-face-med.com/content/5/1/9.
- 25.Poorjavad, M., Moghadam, S. T., Ansari, N. N., Daemi, M. (2014). Surface electrical stimulation for treating swallowing disorders after stroke: A review of the stimulation intensity levels and the electrode placements marziyeh. Stroke Research and Treatment, article ID 918057, 7 pages. doi: 10.1155/2014/918057.
- 32.Benson, H., & Stuart, E. M. (1993). Wellness book: The comprehensive guide to maintaining health and treating stress-related illness. New York: Simon & Schuster.Google Scholar
- 37.NICE (2014). Transcutaneous neuromuscular electrical stimulation for oropharyngeal dysphagia. NICE interventional procedure guidance 490. http://www.nice.org.uk/guidance/ipg490.
- 38.Freed, M. L., Freed, L., Chatburn, R. L., & Christian, M. (2001). Electrical stimulation for swallowing disorders caused by stroke. Respiratory Care, 46(5), 466–474.Google Scholar
- 39.VitalStim Therapy Instructors (2008). Safety Issues regarding the use of VitalStim Therapy. vitalstimtherapy.com. http://www.djoglobal.com/sites/default/files/vitalstim/VitalStim_Contraindications_Precautions.pdf.