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Effects Of Thermal Application On Dysphagia After Stroke

John C. Rosenbek, JoAnne Robbins, Barbara Fishback, Ross L. Levine

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The influence of thermal application on dysphagia for liquid boluses after multiple cerebrovascular accidents was measured. A month-long trial of thermal application organized according to the guidelines of a single-subject withdrawal or ABAB design was replicated across 7 male subjects. After baseline testing, 6 subjects were randomly assigned to begin the study with a week-long period of thermal application (B stage), and 1 subject was randomly assigned to begin the study with a week-long period of no thermal application (A stage). Subsequent week-long A and B stages were then alternated until each subject had completed the 4-week interval of this study. Progress testing occurred at the end of each stage and at follow-up testing 1 month after the study’s completion. The influence of thermal application on eight duration and four descriptive measures was determined by three judges using visual inspection of data displays. Two of three judges agreed that 2 of the subjects demonstrated decreased Duration of Stage Transition in the absence of any change in the occurrence of aspiration or penetration. Overall, this study failed to reveal strong evidence that 2 weeks of thermal application alternating with 2 weeks of no thermal application improves dysphagia following multiple strokes. Further replications are needed.