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Effects of oral neuromuscular training on swallowing dysfunction among older people in intermediate care-a cluster randomised, controlled trial.
Umeå University, Faculty of Medicine, Department of Odontology.ORCID iD: 0000-0002-2254-7862
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
Umeå University, Faculty of Medicine, Department of Odontology.ORCID iD: 0000-0001-8807-3500
2019 (English)In: Age and Ageing, ISSN 0002-0729, E-ISSN 1468-2834, article id afz042Article in journal (Refereed) Epub ahead of print
Abstract [en]

OBJECTIVES: this prospective, cluster randomised, controlled trial investigated the effect of oral neuromuscular training among older people in intermediate care with impaired swallowing.

METHODS: older people (≥65 years) with swallowing dysfunction were cluster randomised according to care units for 5 weeks of neuromuscular training of the orofacial and pharyngeal muscles or usual care. The primary endpoint was the change in swallowing rate (assessed with a timed water swallow test) from baseline to the end-of-treatment and 6 months post-treatment. The secondary endpoints were changes in signs of aspiration during the water swallow test, and swallowing-related quality of life (QOL). An intention-to-treat principle was followed, and mixed-effects models were used for data analysis with the clustered study design as a random factor.

RESULTS: in total, 385 participants from 36 intermediate care units were screened, and 116 participants were randomly assigned to oral neuromuscular training (intervention; n = 49) or usual care (controls; n = 67). At the end of treatment, the geometric mean of the swallowing rate in the intervention group had significantly improved 60% more than that of controls (P = 0.007). At 6 months post-treatment, the swallowing rate of the intervention group remained significantly better (P = 0.031). Signs of aspiration also significantly reduced in the intervention group compared with controls (P = 0.01). No significant between-group differences were found for swallowing-related QOL.

CONCLUSIONS: oral neuromuscular training is a new promising swallowing rehabilitation method among older people in intermediate care with impaired swallowing.

TRIAL REGISTRATION: ClinicalTrials.gov: NCT02825927.

Place, publisher, year, edition, pages
2019. article id afz042
Keywords [en]
dysphagia, nursing homes, quality of life, rehabilitation, swallowing disorders
National Category
Medical and Health Sciences Dentistry
Research subject
Medicine; Geriatrics; Odontology
Identifiers
URN: urn:nbn:se:umu:diva-158852DOI: 10.1093/ageing/afz042PubMedID: 31062842OAI: oai:DiVA.org:umu-158852DiVA, id: diva2:1367196
Funder
The Kamprad Family Foundation, 20132115Available from: 2019-11-01 Created: 2019-11-01 Last updated: 2019-11-01

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Hägglund, PatriciaHägg, MaryLevring Jäghagen, Eva
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