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Impact of Effortful Swallow with Progressive Resistance on Swallow Safety, Efficiency and Quality of Life in Individuals with Post-Stroke Dysphagia: Analysis Using DIGEST- FEES and SWAL-QOL

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Indian Journal of Otolaryngology and Head & Neck Surgery Aims and scope Submit manuscript

Abstract

Introduction: Effortful swallow with progressive resistance has a potential clinical implication in improving the oro-muscular strength, swallow safety, and efficiency in elderly individuals. But to date, no studies have explored its benefits in training individuals with post-stroke dysphagia. Aim: The present study investigated the long- term effect of effortful swallow with progressive resistance on swallow safety, efficiency and quality of life in persons with dysphagia following stroke. Method: The study consisted of 5 males (mean age: 41.80yrs ± 9.6yrs) diagnosed with dysphagia post-stroke.  The participants underwent 20 sessions (5 days/week) of intensive effortful swallow with progressive training spread across four weeks. In the first two weeks, the participants performed 10 × 3 sets of effortful swallows with a 50% of resistance load, which was further increased to 15 × 3 sets with a 70% resistance load. Results: DIGEST-FEES safety and overall swallow quality of life significantly improved post-therapy, whereas DIGEST-FEES efficiency and overall swallow grades showed no significant changes. Inter-rater reliability of DIGEST-FEES revealed substantial agreement between judges. Conclusion: The results are promising as the technique improved swallow safety, and swallow quality of life in persons with dysphagia following stroke.

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All data generated or analysed during this study are included in the article. Further enquiries can be directed to the corresponding author.

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Acknowledgements

The authors would like to thank Dr. M. Pushpavathi, Director, AIISH for granting permission to carry out the study and providing the necessary resources and infrastructure. We would also like to thank the University of Mysuru (UOM) for the constant support. The authors also thank the participants of the current study.

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There are no funding sources to declare.

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Authors and Affiliations

  1. Centre for Swallowing Disorders, All India Institute of Speech and Hearing, Mysuru, India

    Bilvashree Chandrashekaraiah

  2. Centre for Swallowing Disorders, All India Institute of Speech and Hearing, Mysuru, India

    Swapna N

  3. Department of ENT, All India Institute of Speech and Hearing, Mysuru, India

    Prakash T. K

Authors
  1. Bilvashree Chandrashekaraiah
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  2. Swapna N
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  3. Prakash T. K
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Contributions

BC and SN: conceptualizing and designing of the research study, seeking ethical approval, drafting the manuscript in whole or in part. BC and PTK: data collection; BC: analyzing the data: All the authors approved the final manuscript.

Corresponding author

Correspondence to Bilvashree Chandrashekaraiah.

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Statement of Ethics

Participant/guardians had given their written informed consent. The ethical clearance according to the Declaration of Helsinki was obtained from the Institutional Review Board, AIISH Ethics committee (AEC), Approval number: No.DOR.9.1/Ph. D/BC/920/2021–2022 dt 10th February, 2023.

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Chandrashekaraiah, B., N, S. & K, P.T. Impact of Effortful Swallow with Progressive Resistance on Swallow Safety, Efficiency and Quality of Life in Individuals with Post-Stroke Dysphagia: Analysis Using DIGEST- FEES and SWAL-QOL. Indian J Otolaryngol Head Neck Surg 75, 2836–2841 (2023). https://doi.org/10.1007/s12070-023-03846-7

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  • DOI: https://doi.org/10.1007/s12070-023-03846-7

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