Deglutition Disorders Clinical Trial
Official title:
Comparison of Two Therapies for UES Dysphagia
The aim of this research study is to determine the effectiveness of: 1) a traditional
therapy regimen focusing on individual exercises for pharyngeal (throat) and laryngeal
(voice box) musculature and 2) a new therapeutic exercise, the Shaker exercise.
The primary objective of this 5-year project is to identify which of two therapy programs,
the Shaker exercise versus traditional therapy, results in the largest number of stable,
non-oral dysphagic patients who can swallow safely and return to full oral feeding after 6
weeks of intervention. The study is powered adequately so that this aim can be tested
separately for head and neck cancer and stroke patients. Our primary outcome measure is
return to oral feeding, i.e., 100% of nutrition and hydration by mouth.
Secondary aims of this research are:
1. Determine in a descriptive manner whether patients with residue in the pyriform sinuses
who aspirate the residue after the swallow respond better, i.e., a higher percentage of
them can return to 100% oral intake, than patients with residue in the valleculae who
aspirate after the swallow or patients with residue in both locations who aspirate
after the swallow and thus to define the spectrum of indications for the proposed
exercise programs in the two groups of dysphagic patients (stroke and post-chemo
radiation treatment for head and neck cancer) and whether postures enable each patient
type to swallow more bolus types without aspiration at pre- and post
2. Define the pathophysiology underlying the swallow dysfunction and those
pathophysiologic elements which change as a result of each therapy program including
changes in -
1. anteroposterior and lateral diameter of maximum deglutitive UES opening
2. maximum deglutitive laryngeal anterior and superior excursions
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Primary Purpose: Treatment
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