Early Feasibility of an Activity-Based Intervention for Improving Ingestive Functions in Older Adults with Oropharyngeal Dysphagia

Hansen, Tina; Laursen, Louise; Hansen, Maria Swennergren

doi:10.3390/geriatrics8020044

Cited by 4 publications

(2 citation statements)

References 52 publications

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“…Rehabilitation studies into sarcopenic dysphagia in HNC are embryonic but have demonstrated encouraging results. A recent feasibility trial assessing the benefits of a strength and skill-based dysphagia rehabilitation programme included two participants with HNC who reported positive change [ 92 ]. A case study completed by Hashida et al [ 93 ] demonstrated improvements in sarcopenic dysphagia post-glossectomy following physical therapy, nutritional intervention and dysphagia therapy.…”

Section: Developing Areasmentioning

confidence: 99%

Post-Radiotherapy Dysphagia in Head and Neck Cancer: Current Management by Speech-Language Pathologists

Govender,

Gilbody,

Simson

et al. 2024

Curr. Treat. Options in Oncol.

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Opinion statementDysphagia, difficulty in eating and drinking, remains the most common side effect of radiotherapy treatment for head and neck cancer (HNC) with devastating consequences for function and quality of life (QOL). Over the past decade, 5-year survival has improved due to multiple factors including treatment advances, reduction in smoking, introduction of the human papillomavirus (HPV) vaccine and more favourable prognosis of HPV-related cancers. Increased prevalence of HPV-positive disease, which tends to affect younger individuals, has led to an elevated number of people living for longer with the sequelae of cancer and its treatment. Symptoms are compounded by late effects of radiotherapy which may lead to worsening of dysphagia for some long-term survivors or new-onset dysphagia for others. Speech-language pathology (SLP) input remains core to the assessment and management of dysphagia following HNC treatment. In this article, we present current SLP management of dysphagia post-radiotherapy. We discuss conventional treatment approaches, the emergence of therapy adjuncts and current service delivery models. The impact of adherence on therapy outcomes is highlighted. Despite treatment advancements, patients continue to present with dysphagia which is resistant to existing intervention approaches. There is wide variation in treatment programmes, with a paucity of evidence to support optimal type, timing and intensity of treatment. We discuss the need for further research, including exploration of the impact of radiotherapy on the central nervous system (CNS), the link between sarcopenia and radiotherapy-induced dysphagia and the benefits of visual biofeedback in rehabilitation.

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Section: Developing Areasmentioning

confidence: 99%

Post-Radiotherapy Dysphagia in Head and Neck Cancer: Current Management by Speech-Language Pathologists

Govender,

Gilbody,

Simson

et al. 2024

Curr. Treat. Options in Oncol.

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“…Interventional strategies for dysphagia are frequently employed in patients with Parkinson’s disease, stroke, multiple sclerosis, and oral cancer [ 8 , 14 ]. However, most previous research studies have focused on evaluating the effectiveness of these strategies specifically in stroke patients, with relatively few focusing on hospitalized older adult patients with swallowing difficulties.…”

Section: Introductionsmentioning

confidence: 99%

Enhancing Spiritual Well-Being, Physical Activity, and Happiness in Hospitalized Older Adult Patients with Swallowing Difficulties: A Comparative Study of Thickeners and Swallowing Exercises

Kao,

Lai,

Huang

et al. 2023

Healthcare

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Swallowing difficulties often occur in older adult patients during acute hospitalization, leading to reduced nutritional intake, increased frailty, and various psychosocial challenges. This randomized controlled study aimed to assess the effects of two interventions, thickeners and swallowing exercises, on the spiritual well-being, physical activity, and happiness of older adult patients with swallowing difficulties during acute hospitalization from October 2019 to August 2020. Sample size calculation was performed using a conservative estimate approach, resulting in an estimate-required sample size of 42 participants. The sampling method was a random cluster sampling approach, with three ward rooms assigned to the thickeners group, swallowing exercises group and control group, respectively. Seventy-two participants were assigned to the intervention groups (thickeners or swallowing exercises) or the control group using a 1:1:1 stratified random assignment. Data were collected before and after the intervention, and matched samples were analyzed using t-tests, ANOVA, and generalized estimating equations for statistical analysis. Both intervention groups showed significant improvements in spiritual well-being (p < 0.001), physical activity (p < 0.001), and happiness (p < 0.001) compared to the control group. However, there were no significant differences between the intervention groups. Our findings suggest that interventions involving thickeners and swallowing exercises have positive effects on the spiritual well-being, physical activity, and happiness of older adult patients with swallowing difficulties during acute hospitalization and emphasize the importance of implementing these interventions to enhance the overall well-being and quality of life of this vulnerable patient population.

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Task-Based Eating and Drinking Interventions in Animal Models: A Narrative Review of Functional Improvements and Neuromuscular Adaptations in Age-Related Dysphagia

Hansen,

Staal,

Rauhe Harreby

et al. 2024

Geriatrics

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Background/Objectives: Age-related dysphagia involves sarcopenia and nervous system changes affecting ingestion. The ACT-ING program, a novel task-based occupational therapy intervention, has been developed to improve strength, endurance, and ingestive skills using real-world eating and drinking tasks for older adults with age-related dysphagia. This narrative review evaluates the outcomes and neuromuscular adaptations of task-based eating and drinking interventions in aging animal models to inform potential refinements of the ACT-ING program and interpret results from an ongoing proof-of-concept study. Methods: Publications were obtained from PubMed, SCOPUS, CINAHL, and EMBASE, and selected following the PRISMA guideline. Thirteen randomized trials investigated a task-based fluid-licking intervention in rats, combining strength, endurance, and skill training. Results: Results suggested benefits in improving muscle strength, endurance, and swallowing skills in terms of quantity and speed. Although neuromuscular adaptations were less conclusive, the intervention appeared to induce cortical plasticity and increase fatigue-resistant muscle fibers in the involved muscles. Conclusions: While these findings are promising, methodological concerns and potential biases were identified. Therefore, further research is necessary to refine the ACT-ING program, including both clinical studies in humans and preclinical studies in aging animal models that clearly define interventions targeting all aspects of ingestion-related skills within a motor learning and strength training framework.

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Early Feasibility of an Activity-Based Intervention for Improving Ingestive Functions in Older Adults with Oropharyngeal Dysphagia

Cited by 4 publications

References 52 publications

Post-Radiotherapy Dysphagia in Head and Neck Cancer: Current Management by Speech-Language Pathologists

Post-Radiotherapy Dysphagia in Head and Neck Cancer: Current Management by Speech-Language Pathologists

Enhancing Spiritual Well-Being, Physical Activity, and Happiness in Hospitalized Older Adult Patients with Swallowing Difficulties: A Comparative Study of Thickeners and Swallowing Exercises

Task-Based Eating and Drinking Interventions in Animal Models: A Narrative Review of Functional Improvements and Neuromuscular Adaptations in Age-Related Dysphagia

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