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Proof-of-principle Pilot Study Of Oropharyngeal Air-pulse Application In Individuals With Dysphagia After Hemispheric Stroke.

Julie A. Theurer, J. Johnston, J. Fisher, S. Darling, Rebecca C. Stevens, D. Taves, R. Teasell, V. Hachinski, R. Martin
Published 2013 · Medicine

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OBJECTIVE To test the hypothesis that oropharyngeal air-pulse application is associated with increased swallowing rates in individuals with dysphagia secondary to stroke. DESIGN Case control. SETTING Stroke rehabilitation hospital or home setting. PARTICIPANTS Convenience sample of individuals (N=8) with new-onset dysphagia after stroke. INTERVENTIONS Air-pulse trains were applied to the oropharynx of 8 subjects who presented with dysphagia after hemispheric stroke. Resting swallowing rates were determined for 5 experimental conditions: baseline without air-pulse mouthpiece, baseline with mouthpiece in situ, unilateral right oropharyngeal air-pulse, unilateral left oropharyngeal air-pulse, and bilateral oropharyngeal air-pulse application. Individual swallowing responses were analyzed using a 2-SD band method. MAIN OUTCOME MEASURE Swallowing rate (swallows/min). RESULTS Swallowing rates associated with bilateral air-pulse application were greater than baseline in 4 of the 8 subjects. The 4 subjects who demonstrated this response to air-pulse application had greater baseline swallowing rates than did subjects whose swallowing rates were not altered in association with air-pulse application. CONCLUSIONS Oropharyngeal air-pulse trains can be applied in individuals with swallowing impairment. Air-pulse application is associated with increased resting swallowing rates in some individuals with dysphagia secondary to hemispheric stroke. Further research should extend this proof-of-principle study by examining the efficacy of oropharyngeal air-pulse application in terms of improved swallowing and related outcomes in dysphagic stroke through a large randomized trial.
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