Traditional Swallowing Training Combined with Game-Based Biofeedback in Post-Stroke Dysphagia

• Main Authors: Hsueh-Pei Wang, 王雪珮
• Other Authors: Tyng-Guey Wang
• Format: Others
• Language: zh-TW
• Published: 2013
• Online Access: http://ndltd.ncl.edu.tw/handle/57036799999603932042

碩士 === 國立臺北護理健康大學 === 聽語障礙科學研究所 === 102 === Swallow maneuver is a common technique in traditional dysphagia rehabilitation. It can facilitate the neuromuscular recovery directly and thus regain the normal pharyngeal swallowing mechanism in dysphagia individuals. However, the training effect of swallow maneuver in dysphagia rehabilitation is unsatisfactory since the dysphagic patients might have difficult in performing the expected pharyngeal muscle contraction due to impaired pharyngeal sensation or inadequate learning ability. Previous researches depicted that biofeedback can assist the stroke patients to identify the internal covert physiologic activities of swallowing when applied in swallowing maneuver. This study attempted to recognize the influence of laryngeal elevation exercise, including effortful swallow and Mendelsohn’s maneuver, combined with innovated game-based swallowing biofeedback on swallow physiology, swallow function, and life quality in the stroke dysphagic patients. Twenty stroke patients with dysphagia were randomized into the study group (n=10) and control group (n=10). There were no differences in age, onset time, lesion sites and swallow function between the two groups. Every participant underwent 16 sessions treatment in which one hour for each session and two to three sessions per week. Every section included thirty-minute traditional swallowing treatment and thirty-minute laryngeal elevation exercise. The participants in study group received game-based swallowing biofeedback during the laryngeal elevation exercise. Submental ultrasonography, Functional Oral Intake Scale, and SWAL-QOL were measured before and after 16 sections’ treatment. There was significant improvement in swallow function of both groups after treatment. The study group had greatly significant improvements in the hyoid bone displacement distance, the score of Functional Oral Intake Scale, and actual diet intake in SWAL-QOL than those of control group. The nasogastric tube removal rate of the study group (80%) was higher than the control group (20%). In conclusion, both laryngeal elevation exercise and laryngeal elevation exercise combined with game-based biofeedback group improved the the swallowing function in stroke patients with dysphagia. Moreover, the laryngeal elevation exercise combined with game-based swallowing biofeedback had better effect in swallow function, hyoid bone displacement distance, and SWAL-QOL of the stroke patients with dysphagia than those of laryngeal elevation exercise only.