Article

OBJECTIVE: To compare the effectiveness of the McNeill Dysphagia Therapy Program,
a systematic exercise-based rehabilitation framework for swallowing remediation,
with traditional swallowing therapy techniques paired with surface
electromyography (sEMG) biofeedback. DESIGN: Matched case-control study. SETTING:
University medical center. PARTICIPANTS: Dysphagic patients referred to an
outpatient swallowing therapy service. INTERVENTIONS: Cases were individually
matched to 2 separate controls for age, sex, and primary medical diagnosis
(N=24). Cases were patients with dysphagia who entered the McNeill Dysphagia
Therapy Program from September 2006 to October 2008. Controls entered a
traditional swallowing therapy program augmented with sEMG biofeedback
(traditional therapy with biofeedback group) from February 1994 to June 1999.
The primary outcome was the proportion of patients who
improved clinical swallowing ability and functional oral intake. The secondary
outcomes were the presence (or not) of tube feeding, physiologic change on
instrumental swallowing studies, and occurrence of aspiration on posttreatment
assessment. RESULTS: Case patients were more likely to demonstrate dysphagia
recovery at posttreatment re-evaluation (adjusted odds ratio for dysphagia
recovery=13.0 [95% CI, 1.27-63.89]; Mantel-Haenszel chi(2)=6.7; P=.009; relative
risk reduction=.69). Dysphagia was reduced by 69% in the McNeill Dysphagia
Therapy Program treatment group compared with the traditional therapy with
biofeedback group. CONCLUSIONS: Both approaches facilitated improved swallowing
function. The McNeill Dysphagia Therapy Program resulted in superior outcomes
compared with traditional dysphagia therapy supplemented with sEMG biofeedback.

Langue : ANGLAIS