THE EFFECTS OF A DEVICE-MEDIATED LINGUAL STRENGTHENING PROTOCOL ON RADIATION AND CHEMORADIATION INDUCED DYSPHAGIABradshaw, Natalie (2017) THE EFFECTS OF A DEVICE-MEDIATED LINGUAL STRENGTHENING PROTOCOL ON RADIATION AND CHEMORADIATION INDUCED DYSPHAGIA. Master's Thesis, University of Pittsburgh. (Unpublished)
AbstractIntroduction: Dysphagia, or disordered swallowing, is frequently found in patients with head and neck cancer due to side-effects of non-surgical interventions including radiation and chemoradiation therapies. Device-mediated lingual strengthening exercises have a theoretical basis for effectively mitigating dysphagia in this population, but these exercises have not been shown to be beneficial in the research literature to date. The primary goal of this study was to describe the effects of a device-mediated lingual strengthening protocol, added to standard behavioral therapy, on overall swallowing function as reflected by videofluoroscopic analysis. The secondary goal was to describe performance related observations regarding participant characteristics. Methods: This was a secondary examination of the data from six participants in a larger prospective experimental study. Three participants, assigned to the control group, completed “standard dysphagia therapy,” and three participants, assigned to the experimental group, completed a device-mediated lingual strengthening protocol in addition to “standard dysphagia therapy.” Videofluoroscopic data was collected for all six participants “pre” and “post” treatment. Measurements of videofluoroscopic data were taken for seven durational swallowing kinematic measures, penetration-aspiration scale scores, and pharyngeal retention scale scores. These measurements were taken to assess airway protection, pharyngeal reside, and overall biomechanical efficiency. Only penetration-aspiration scale scores and pharyngeal retention scores were analyzed, due to feasibility. Analysis consisted of mean differences and a normalization to baseline data transformation. Results: Findings revealed a lack of consistent improvements in all participants across all dependent variables. However, two observations were made regarding the medical characteristics of the participants. Specifically, the greatest performance was seen by participants who had less than one year between finishing chemoradiation therapy and commencing dysphagia treatment and who presented with primary lesions in the tonsillar region. Discussion: No consistent improvements were found to support the addition of device-mediated lingual strengthening exercise to “standard dysphagia therapy,” possibly due to variations in the small sample size and flaws in methodology. However, observations indicate that this form of intervention may be useful for patients seeking dysphagia treatment early with primary lesions in the tonsillar region. Share
Details
MetricsMonthly Views for the past 3 yearsPlum AnalyticsActions (login required)
|
![[feed]](/images/feed-icon-32x32.png){kind=icon}