Swallowing muscle training for oropharyngeal dysphagia: A non-inferiority study of online versus face-to-face therapy

Introduction The purpose of this study is to show the non-inferiority of the telemedicine therapy versus face-to-face using the exercise therapy of oropharyngeal muscles in 183 patients treated consecutively from 2010 to 2020. Method We conducted a retrospective study comparing two dysphagia treatment groups: online versus face-to-face. Patients were distributed in a non-random way but according to patient's preferences. All patients followed the same pathway and were evaluated at the beginning and at the end of the study using the dysphagia outcome and severity scale and the functional oral intake scale. A non-inferiority analysis approximation was done with delta = 1 in both variables. Results Within a total of 183 patients, 114 (62.3%) used the online treatment and 69 (37.7%) the face-to-face one. The main cause of dysphagia was neurological in the total sample (60.7%) and within both groups. When we evaluate the clinical response, we find that both groups improved regardless of the type of therapy. The confidence interval of the difference between the beginning and the end of treatment did not reach the inferior limit of the delta defined, therefore supporting the no inferiority of online versus presential. Discussion This study shows the no inferiority of the online therapy versus the face-to-face one for the oropharyngeal training of the swallow muscles.

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Media Naturalness Reduction and Compensatory Channel Expansion

System and Technology Advancements in Distance Learning ◽

10.4018/978-1-4666-2032-2.ch008 ◽

2014 ◽

pp. 112-123

Author(s):

Ned Kock ◽

Vanessa Garza

Keyword(s):

Undergraduate Students ◽

Course Delivery ◽

Online Course ◽

Face To Face ◽

College Information ◽

Combined Test ◽

The Face ◽

Channel Expansion ◽

The Difference ◽

Media Naturalness

This study provides a combined test of the media naturalness and channel expansion theories with a study of communication media perceptions and use outcomes in the context of a college information systems course delivery. Data was collected from undergraduate students at the middle and end of a long semester. Approximately half of the students took the course face-to-face, and the other half online. As predicted, based on media naturalness theory, grades were significantly higher in the face-to-face condition than the online condition at the middle of the semester. Consistent with predictions based on channel expansion theory, the difference between grades obtained at the middle of the semester disappeared at the end of the semester. This study shows that online course delivery may lead to both negative and positive effects in the same semester, leading to a final outcome that is generally positive. It provides a more nuanced view of online course delivery effects, and clarifies previous empirical findings that appear paradoxical at first glance.

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Upgrading rural Japanese nurses’ respiratory rehabilitation skills through videoconferencing

Journal of Telemedicine and Telecare ◽

10.1258/1357633001935653 ◽

2000 ◽

Vol 6 (2_suppl) ◽

pp. 69-71 ◽

Cited By ~ 4

Author(s):

I Sawada ◽

A Sugiyama ◽

A Ishikawa ◽

T Ohyanagi ◽

K Saeki ◽

...

Keyword(s):

Distance Learning ◽

Clinical Skills ◽

Pilot Project ◽

Face To Face ◽

Before And After ◽

The Face ◽

The Difference ◽

Medical University ◽

Japanese Nurses ◽

Respiratory Rehabilitation

We examined the effect of distance learning on nurses’ clinical skills in a rural Japanese hospital. The subject matter was respiratory rehabilitation. After one face-to-face session, two 30min sessions were delivered by videoconferencing to staff nurses working in a 100–bed rural hospital 250 miles (400 km) from Sapporo Medical University. A self-rating questionnaire was distributed before and after the sessions. Responses were collected from 15 out of 32 nurses participating in the face-to-face session (47%). Before the first videoconferencing session, ‘always use’ and ‘sometime use’ the new skills were rated by 67% of nurses, but after the second videoconferencing session ‘always use’ and ‘sometimes use’ were rated by 73% and ‘never use’ at 0%. This implies that there was increased use of new skills after the second session, although the difference was not significant. The nurses’ opinions about the effectiveness for patients increased from 8% to 27% after the second session, which was significant. The pilot project indicated the usefulness of distance learning for upgrading nurses’ clinical practice in one rural Japanese hospital and suggested ways in which videoconferencing can be used in future.

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Abstract TP157: Functional Oral Intake Scale is Associated With Poorer Outcomes Following Stroke

Stroke ◽

10.1161/str.51.suppl_1.tp157 ◽

2020 ◽

Vol 51 (Suppl_1) ◽

Author(s):

Juli T De Souza ◽

Sérgio Paiva ◽

Priscila Ribeiro ◽

Suzana Tanni ◽

Marcos Minicucci ◽

...

Keyword(s):

Protective Factor ◽

Oropharyngeal Dysphagia ◽

Tube Feeding ◽

Adult Life ◽

Oral Intake ◽

Oral Feeding ◽

Early Evaluation ◽

Food Consistency ◽

Specific Protocol ◽

Functional Oral Intake Scale

Background: Stroke is the leading cause of disability in adult life. Oropharyngeal dysphagia occurs in 65-90% of patients, and its identification in the acute phase of stroke can prevent complications. Objective: Verify whether Functional Oral Intake Scale (FOIS) score during stroke hospitalization is associated with functional capacity, as assessed by the modified Rankin Scale (mRs), and mortality 90 days after stroke. Methods: A prospective cohort study evaluating 201 patients hospitalized in the Stroke Unit was carried out. Dysphagia was evaluated during hospitalization using both a specific protocol to evaluate swallowing biomechanics and FOIS, in which FOIS 1-3 - tube feeding, 4-5 - oral feeding requiring food consistency changes, and 6-7 - oral feeding with no changes in food consistency. mRs≥3 90 days after discharge was considered disability. The data were adjusted for the NIHSS score, sex, age, type of stroke, and presence of thrombolysis. Significance level of 5%. Results: Of the 201 patients evaluated, 42.8% (86) who had dysphagia were older, had a higher severity of stroke, and pneumonia rate . A FOIS score of 6-7 may be a protective factor against disability (mRs≥3) (OR:0.17; CI:0.005-0.56; p=0.004), and FOIS 1-3 at hospital discharge increased the risk of mRs≥3 (OR:14.97; CI: 2.68-83.65; p=0.002) and mortality (OR:9.79; CI:2.21-43.4; p=0.003) within 90 days after stroke. Pneumonia was the leading cause of death, however dysphagia and FOIS 1-3 at discharge were associated with death from any cause. Important to highlight that the interaction of FOIS 1-3 at discharge and pneumonia further enhanced mortality chance (OR:113; CI:1.40-9.097; p=0.035). Conclusion: Dysphagia or FOIS 1-3 at discharge are markers of poor prognosis after stroke. Our data suggest the importance of early evaluation of dysphagia and closely monitoring the tube fed patients following stroke.

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A Comparison of a Client’s Satisfaction between Online and Face-to-face Counselling in a School Setting

Pertanika Journal of Science and Technology ◽

10.47836/pjssh.29.s1.08 ◽

2021 ◽

Vol 29 (S1) ◽

Author(s):

Zaida Nor Zainudin ◽

Siti Aishah Hassan ◽

Nor Aniza Ahmad ◽

Yusni Mohamad Yusop ◽

Wan Norhayati Wan Othman ◽

...

Keyword(s):

Short Form ◽

School Setting ◽

Control Group ◽

Social Distancing ◽

Face To Face ◽

Counselling Needs ◽

The Face ◽

The Difference ◽

The Government ◽

Experimental Group

During the current Covid-19 pandemic, the social relationship between humans has changed. As noticed, lockdowns and social distancing have become new norms. Unavoidably, counselling services were also affected with social distancing rules, especially in the school setting. Thus, online counselling or e-counselling has begun to gain in popularity, allowing counsellors to offer their services in an alternative way. In order to evaluate the suitability of e-counselling during the current pandemic, a client’s satisfaction towards e-counselling and face-to-face counselling needs to be investigated. This study aims to explore the effectiveness of these two counselling approaches using the level of the client’s satisfaction and its implication towards counselling practises during the outbreak. Quantitative data were obtained using the Client’s Satisfaction Inventory Short-Form (CSI-SF) questionnaire. The experimental design consisted of a total of 60 study subjects in two groups, namely the control group using the face-to-face Counselling method and the experimental group using the e-Counselling method. Based on the results, the difference in mean score showed that the mean difference in the experimental group was slightly higher than the control group. This finding indicates that e-counselling clients have a higher satisfaction compared to the face-to-face approach. The implications of this data are discussed on the role of school, school counsellor, and the government in enhancing the service of e-counselling during the current pandemic.

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Peningkatan functional oral intake scale dan kualitas hidup pada miastenia gravis pasca rehabilitasi menelan

Oto Rhino Laryngologica Indonesiana ◽

10.32637/orli.v46i1.150 ◽

2016 ◽

Vol 46 (1) ◽

pp. 79

Author(s):

Erlina Julianti ◽

Teti Madiadipoera ◽

Ratna Anggraeni ◽

Bambang Purwanto ◽

Sinta Sari Ratunanda

Keyword(s):

Quality Of Life ◽

Oropharyngeal Dysphagia ◽

Oral Intake ◽

Rehabilitation Program ◽

Test Design ◽

Open Label ◽

Swallowing Rehabilitation ◽

Quasi Experimental ◽

Functional Oral Intake Scale

Latar belakang: Miastenia gravis (MG) merupakan penyakit autoimun yang mengganggu transmisineuromuskular karena berkurangnya reseptor asetilkolin di tautan saraf otot sehingga dapat menyebabkandisfagia orofaring. Disfagia pada MG dapat menyebabkan aspirasi yang meningkatkan morbiditas,mortalitas, dan menurunnya kualitas hidup.Tujuan: Menganalisis perbaikan disfagia orofaring padapasien MG dengan melihat peningkatan functional oral intake scale (FOIS) pada pemeriksaan fiberopticendoscopic evaluation of swallowing (FEES) dan untuk mengetahui perbaikan kualitas hidup denganmenggunakan swallowing quality of life (SWAL-QoL) pasca program rehabilitasi menelan.Metode:Penelitian ini merupakan quasi experimental open label pre and post-test design dan data dianalisisdengan menggunakan uji Wilcoxon. Penelitian berlangsung di Poliklinik Ilmu Kesehatan Telinga HidungTenggorok Bedah Kepala Leher Rumah Sakit Dr. Hasan Sadikin Bandung sejak Januari − April 2013 pada10 subjek penelitian. Diagnosis dibuat berdasarkan anamnesis, pemeriksaan fisik, penilaian FOIS denganmelihat konsistensi makanan yang aman ditelan berdasarkan temuan pemeriksaan FEES sebelum dansesudah mengikuti program rehabilitasi menelan selama 6 minggu dan penilaian kualitas hidup dengankuesioner SWAL-QoL.Hasil: Didapatkan perbedaan bermakna (p=0,002) pada hasil FOIS dan perbedaanbermakna pada seluruh domain kuesioner SWAL-QoL setelah program rehabilitasi menelan (p<0,05).Kesimpulan: Terdapat peningkatan FOIS sebagai perbaikan disfagia orofaring, serta peningkatan kualitashidup pada pasien MG sesudah program rehabilitasi menelan. Kata kunci: Disfagia, miastenia gravis (MG), functional oral intake scale (FOIS), fiberoptic endoscopicevaluation of swallowing (FEES), kualitas hidup ABSTRACTBackground: Myasthenia gravis (MG) is an autoimmune disorder of neuromuscular transmissionassociated with acetylcholine receptor deficiency at the neuromuscular junction which may causeoropharyngeal dysphagia. Oropharyngeal dysphagia in MG patients can cause aspiration which result inmorbidity, mortality, and decreased quality of life. Objective: To analyze the improvement of oropharyngealdysphagia in MG patients by evaluating the functional oral intake scale (FOIS) on fiberoptic endoscopicevaluation of swallowing (FEES) examination and to determine the improvement of quality of life byswallowing quality of life (SWAL-QoL). Method: This study was an open label quasi experimental pre andpost-test design and the data was analyzed using the Wilcoxon statistical test. This study was conductedin Otorhinolaryngology-Head and Neck Surgery Department Dr. Hasan Sadikin General Hospital duringJanuary until April 2013 towards 10 subjects. Diagnosis based on anamnesis, physical examination,FOIS assessment in order to describe the consistency of safe food ingested during FEES examinationand SWAL-QoL questionnaire assessment before and after swallowing rehabilitation programme for 6weeks. Results: There were significant differences (p=0.002) in FOIS result and significant differencesin all domains SWAL-QoL questionnaire after swallowing rehabilitation program (p<0.05). Conclusion:There was an improvement of oropharyngeal dysphagia as seen in increased FOIS score and improvementof quality of life after swallowing rehabilitation program. Keywords: Dysphagia, myasthenia gravis (MG), functional oral intake scale (FOIS), fiberoptic endoscopyevaluation of swallowing (FEES), quality of life Alamat korespondensi: Dr. Erlina Julianti, Sp.THT-KL.,M.Kes. RSUD Kabupaten Bekasi, CibitungBekasi. Email: [email protected].

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Validation of the Italian Version of the Functional Oral Intake Scale (FOIS-It) Against Fiberoptic Endoscopic Evaluation of Swallowing and Nutritional Status

Dysphagia ◽

10.1007/s00455-021-10257-9 ◽

2021 ◽

Author(s):

Aurora Ninfa ◽

Nicole Pizzorni ◽

Angelo Eplite ◽

Claudia Moltisanti ◽

Antonio Schindler

Keyword(s):

Nutritional Status ◽

Rating Scale ◽

Oropharyngeal Dysphagia ◽

Oral Intake ◽

Endoscopic Evaluation ◽

Severity Rating ◽

Group Validity ◽

Functional Oral Intake Scale ◽

Spearman’S Correlation ◽

Etiological Heterogeneity

AbstractThe Functional Oral Intake Scale (FOIS) is a reliable and valid tool to assess functional oral intake of food and liquids in patients with oropharyngeal dysphagia (OD). Its validity was established for stroke patients against Videofluoroscopic Swallowing Study in English and Chinese and against Fiberoptic Endoscopic Evaluation of Swallowing (FEES) in German. FOIS was cross-culturally validated into Italian (FOIS-It), but construct validity against instrumental assessment and nutritional status was not investigated. The study aims at contributing to the validation of the FOIS-It, by performing convergent and known-group validity against FEES and nutritional status in patients with OD of different etiologies. Overall, 220 adult patients with OD of etiological heterogeneity were recruited. FOIS-It score and Body Mass Index (BMI) were collected. FEES was performed to assess swallowing safety and efficiency based on the Penetration-Aspiration Scale (PAS) and the Yale Pharyngeal Residue Severity Rating Scale (YPRSRS). Moderate to weak associations with PAS (ρ = − .37, p < .01), YPRSRS in the pyriform sinuses (ρ = − .20, p < .01), and BMI (ρ = .24, p < .01) were detected with Spearman’s correlation. FOIS-It distribution was compared with the Mann–Whitney U and Kruskal–Wallis tests. Significantly lower FOIS-It scores were detected among patients with penetration/aspiration (PAS > 2) and penetration (PAS > 2 ≤ 5) for all consistencies (p < .01), aspiration (PAS > 5) of liquids and semisolids (p < .001), residue in the pyriform sinuses (YPRSRS > 3) with semisolids (p < .001) and solids (p = .02), and malnutrition (BMI ≤ 18.5; p = .019). FOIS-It appears as a valid tool to assess functional oral intake against FEES’ measures of swallowing safety and efficiency and nutritional status in patients with OD of etiological heterogeneity.

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Transformative Potential of Constructivist Blended Problem-Based Learning in Higher Education

Information Technology and Constructivism in Higher Education ◽

10.4018/978-1-60566-654-9.ch012 ◽

2009 ◽

pp. 182-202 ◽

Cited By ~ 1

Author(s):

Roisin Donnelly

Keyword(s):

Higher Education ◽

Professional Development ◽

Academic Staff ◽

Problem Based Learning ◽

Learning Technologies ◽

Online Discussions ◽

Face To Face ◽

The Face ◽

E Learning ◽

The Difference

This chapter critically explores the design and implementation of a blended problem-based learning (PBL) module for academic professional development in higher education. A core aspect of the chapter is the overview of the design framework used for the application and specific use of learning technologies in the PBL module. As it would appear that E-Learning courses are often lauded on the basis of their constructivist approach to learning, but in reality sustained inter-student contact and discussion can be difficult, an underlying purpose of the chapter is to show how interactional analysis helps in understanding the potential of transformative pedagogy within blended PBL. This chapter aims to highlight how emerging constructivist theories of learning may be applied to the blend of PBL and E-Learning. It addresses the need for an analysis of the interactions taking place in blended PBL with a specific focus on academic staff who are engaged in professional development in higher education in Ireland. It applies the relevant constructivist theories to the face-to-face PBL tutorials, online discussions, focus group interview texts and reflective papers generated over two years in a professional development module involving 17 academic staff. The chapter concludes with an analysis of the difference that the blended delivery made to both tutors and participants and discusses the design implications of a blended PBL model for the practice of academic development.

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Prevalence of oropharyngeal dysphagia in hereditary spastic paraplegias

Arquivos de Neuro-Psiquiatria ◽

10.1590/0004-282x20190180 ◽

2019 ◽

Vol 77 (12) ◽

pp. 843-847 ◽

Cited By ~ 1

Author(s):

Laís Alves Jacinto-Scudeiro ◽

Gustavo Dariva Machado ◽

Annelise Ayres ◽

Daniela Burguêz ◽

Marcia Polese-Bonatto ◽

...

Keyword(s):

Assessment Tool ◽

Genetic Diseases ◽

Oropharyngeal Dysphagia ◽

Oral Intake ◽

Swallowing Function ◽

Cross Sectional ◽

Hereditary Spastic Paraplegias ◽

Swallowing Dysfunction ◽

Clinically Significant ◽

Functional Oral Intake Scale

ABSTRACT Hereditary spastic paraplegias (HSP) are a group of genetic diseases characterized by lower limb spasticity with or without additional neurological features. Swallowing dysfunction is poorly studied in HSP and its presence can lead to significant respiratory and nutritional complications. Objectives: The aim of this study was to evaluate the frequency and clinical characteristics of dysphagia in different types of HSP. Methods: A two-center cross-sectional prevalence study was performed. Genetically confirmed HSP patients were evaluated using the Northwestern Dysphagia Patient Check Sheet and the Functional Oral Intake Scale. In addition, self-perception of dysphagia was assessed by the Eat Assessment Tool-10 and the Swallowing Disturbance Questionnaire. Results: Thirty-six patients with spastic paraplegia type 4 (SPG4), five with SPG11, four with SPG5, four with cerebrotendinous xanthomatosis (CTX), three with SPG7, and two with SPG3A were evaluated. Mild to moderate oropharyngeal dysphagia was present in 3/5 (60%) of SPG11 and 2/4 (50%) of CTX patients. A single SPG4 (2%) and a single SPG7 (33%) patient had mild oropharyngeal dysphagia. All other evaluated patients presented with normal or functional swallowing. Conclusions: Clinically significant oropharyngeal dysphagia was only present in complicated forms of HSP Patients with SPG11 and CTX had the highest risks for dysphagia, suggesting that surveillance of swallowing function should be part of the management of patients with these disorders.

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Efficacy of a comprehensive dysphagia intervention program tailored for the residents of nursing homes

Journal of Frailty & Aging ◽

10.14283/jfa.2020.56 ◽

2020 ◽

pp. 1-4

Author(s):

R. Fong ◽

S.W.K. Wong ◽

J.K.L. Chan ◽

M.C.F. Tong ◽

K.Y.S. Lee

Keyword(s):

Nursing Homes ◽

Intervention Program ◽

Oropharyngeal Dysphagia ◽

Oral Intake ◽

Caregiver Training ◽

Interventional Study ◽

Feeding Assessment ◽

Functional Oral Intake Scale ◽

Management Of Dysphagia ◽

Swallowing Assessment

Oropharyngeal dysphagia is a widespread condition in older people and thus poses a serious health threat to the residents of nursing homes. The management of dysphagia relies mainly on compensatory strategies, such as diet and environmental modification. This study investigated the efficacy of an intervention program using a single-arm interventional study design. Twenty-two participants from nursing homes were included and had an average of 26 hours of intervention, including oromotor exercises, orosensory stimulation and exercises to target dysphagia and caregiver training. Four of the 22 participants exhibited improvement in functional oral intake scale (FOIS) but was not statistically significant as a group. All oromotor function parameters, including the range, strength, and coordination of movements, significantly improved. These results indicate that this intervention program could potentially improve the oromotor function, which were translated into functional improvements in some participants’ recommended diets. The validity of this study could be improved further by using standardized swallowing and feeding assessment methods or an instrumental swallowing assessment.

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Supporting the Use of Rudimentary Vocalizations

Perspectives on Augmentative and Alternative Communication ◽

10.1044/aac23.3.132 ◽

2014 ◽

Vol 23 (3) ◽

pp. 132-139 ◽

Cited By ~ 1

Author(s):

Lauren Zubow ◽

Richard Hurtig

Keyword(s):

Rett Syndrome ◽

Visual Cues ◽

Acoustic Analysis ◽

Eye Gaze ◽

Research Question ◽

Primary Research ◽

Multiple Modalities ◽

Face To Face ◽

Perceptual Judgments ◽

The Face

Children with Rett Syndrome (RS) are reported to use multiple modalities to communicate although their intentionality is often questioned (Bartolotta, Zipp, Simpkins, & Glazewski, 2011; Hetzroni & Rubin, 2006; Sigafoos et al., 2000; Sigafoos, Woodyatt, Tuckeer, Roberts-Pennell, & Pittendreigh, 2000). This paper will present results of a study analyzing the unconventional vocalizations of a child with RS. The primary research question addresses the ability of familiar and unfamiliar listeners to interpret unconventional vocalizations as “yes” or “no” responses. This paper will also address the acoustic analysis and perceptual judgments of these vocalizations. Pre-recorded isolated vocalizations of “yes” and “no” were presented to 5 listeners (mother, father, 1 unfamiliar, and 2 familiar clinicians) and the listeners were asked to rate the vocalizations as either “yes” or “no.” The ratings were compared to the original identification made by the child's mother during the face-to-face interaction from which the samples were drawn. Findings of this study suggest, in this case, the child's vocalizations were intentional and could be interpreted by familiar and unfamiliar listeners as either “yes” or “no” without contextual or visual cues. The results suggest that communication partners should be trained to attend to eye-gaze and vocalizations to ensure the child's intended choice is accurately understood.

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