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Effects of oral neuromuscular training on swallowing dysfunction among older people in intermediate care-a cluster randomised, controlled trial
Umea Univ, Dept Odontol, Oral & Maxillofacial Radiol, Fac Med, Umea, Sweden.ORCID iD: 0000-0002-2254-7862
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Research and Development, Gävleborg. Hudiksvall Hosp, Speech & Swallowing Ctr, Dept Otorhinolaryngol, Hudiksvall, Region Gavlebor, Sweden.
Umea Univ, Dept Publ Hlth & Clin Med, Umea, Sweden;Karolinska Inst, Danderyd Hosp, Dept Clin Sci, Stockholm, Sweden.
Umea Univ, Dept Odontol, Oral & Maxillofacial Radiol, Fac Med, Umea, Sweden.
2019 (English)In: Age and Ageing, ISSN 0002-0729, E-ISSN 1468-2834, Vol. 48, no 4, p. 533-540Article in journal (Refereed) Published
Abstract [en]

Objectives: this prospective, cluster randomised, controlled trial investigated the effect of oral neuromuscular training among older people in intermediate care with impaired swallowing. Methods: older people (>= 65 years) with swallowing dysfunction were cluster randomised according to care units for 5 weeks of neuromuscular training of the orofacial and pharyngeal muscles or usual care. The primary endpoint was the change in swallowing rate (assessed with a timed water swallow test) from baseline to the end-of-treatment and 6 months post-treatment. The secondary endpoints were changes in signs of aspiration during the water swallow test, and swallowing-related quality of life (QOL). An intention-to-treat principle was followed, and mixed-effects models were used for data analysis with the clustered study design as a random factor. Results: in total, 385 participants from 36 intermediate care units were screened, and 116 participants were randomly assigned to oral neuromuscular training (intervention; n = 49) or usual care (controls; n = 67). At the end of treatment, the geometric mean of the swallowing rate in the intervention group had significantly improved 60% more than that of controls (P = 0.007). At 6 months post-treatment, the swallowing rate of the intervention group remained significantly better (P = 0.031). Signs of aspiration also significantly reduced in the intervention group compared with controls (P = 0.01). No significant between-group differences were found for swallowing-related QOL. Conclusions: oral neuromuscular training is a new promising swallowing rehabilitation method among older people in intermediate care with impaired swallowing.

Place, publisher, year, edition, pages
OXFORD UNIV PRESS , 2019. Vol. 48, no 4, p. 533-540
Keywords [en]
swallowing disorders, dysphagia, rehabilitation, quality of life, nursing homes
National Category
Otorhinolaryngology
Identifiers
URN: urn:nbn:se:uu:diva-397306DOI: 10.1093/ageing/afz042ISI: 000493371900015PubMedID: 31062842OAI: oai:DiVA.org:uu-397306DiVA, id: diva2:1372735
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2013-2127Swedish Heart Lung FoundationAvailable from: 2019-11-25 Created: 2019-11-25 Last updated: 2019-11-25Bibliographically approved

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