Proof-of-principle pilot study of oropharyngeal air-pulse application in individuals with dysphagia after hemispheric stroke

Abstract

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.