YouTube as a Source of Patient Information Regarding Exercises and Compensated Maneuvers for Dysphagia

Objective: Acquiring online health-related information has become increasingly widespread. In this study, we aimed to evaluate the quality of the most-viewed YouTube videos on dysphagia regarding exercises and compensated maneuvers. Method: We searched for the keywords “dysphagia exercise”, “dysphagia rehabilitation”, “dysphagia maneuver”, “dysphagia therapy”, and “dysphagia compensation” on YouTube on 5 February 2021. The educational quality of videos on YouTube was investigated based on the Global Quality Scale (GQS) and categorized into three groups: high-, intermediate-, and low-quality. The modified DISCERN tool was used to evaluate the reliability of the YouTube videos. Video parameters were compared between the groups according to the quality of the videos. Results: Of the 51 videos evaluated, according to the GQS, 54.9% (n = 28) were of high-quality, 35.3% (n = 18) were of intermediate-quality, and 9.8% (n = 5) were of low-quality, respectively. When the video parameters were compared among the groups, there were no significant differences in the number of views, likes, dislikes, or comments per day (p > 0.05). However, there was a significant difference in the DISCERN scores between the groups (p < 0.001). Conclusion: YouTube can be deemed as a predominant source for high-quality videos on dysphagia exercise and compensated maneuvers. However, YouTube should be accepted as a mixed pool, with high-, intermediate-, and low-quality videos. Therefore, healthcare professionals, such as physicians and therapists, should verify the suitability and quality of the video, and suggest it to the patient, to ensure that the patient obtains the appropriate information.

Dysphagia Therapy in Adults with a Tracheostomy: A Scoping Review Protocol

Background Swallowing impairment (dysphagia) and tracheostomy coexist. Research in this area has often provided an overview of dysphagia management as a whole, but there is limited information pertaining to specific dysphagia therapy in the tracheostomy population. The aim of this scoping review is to provide detailed exploration of the literature with regards to dysphagia therapeutic interventions in adults with a tracheostomy. The scoping review will describe current evidence and thus facilitate future discussions to guide clinical practice.Methods A scoping review using the Joanna Briggs Institute and Preferred Reporting Items for Systematic Reviews guideline will be used. Ten electronic databases from inception to July 2021and grey literature will be searched. From identified texts forward and backward citation chasing will be completed. Data extraction will compose of population demographics, aetiology and dysphagia therapy (type, design, dose and intensity). Number of citations and papers included into the scoping review will be presented visually.Discussion The scoping review aims to expand upon the existing literature in this field. A detailed description of the evidence is required to facilitate clinical discussions and develop therapeutic protocols in a tracheostomised population. The results of this scoping review will support future research in dysphagia therapy and provide the basis for development of best practice guidelines.

Evaluating the Use of Oral Trials for Inpatient Dysphagia Management: An Initial Cross-Sectional Database Study

Purpose Oral trials, otherwise known as swallow trials or tasters, are widely used in dysphagia management. However, to date, no studies have investigated the effectiveness of oral trials or outlined how the approach is utilized in everyday practice. This article aims to start a dialogue regarding this much-used but little-evidenced dysphagia intervention by exploring three main aspects to (a) identify the patient demographics and environments in which oral trials are used in hospital, (b) explore clinical decision making around the approach, and (c) consider clinical implications around current findings and future areas for research. Method A cross-sectional examination of 118 patients on the dysphagia caseload of a United Kingdom–based inpatient speech and language therapy team was conducted. Statistical analysis explored demographic differences between oral trials groups and the rest of the dysphagia caseload. Results Twenty-three of 118 (19.5%) individuals on the caseload were or had been on oral trials during admission. Individuals in the oral trials group were significantly more likely to have a neurological diagnosis than the full oral intake group (78.3% vs. 30.5%, p < .001). There was a lack of uniformity in oral trials recommendations, and the rationale behind quantity and types of diet or fluids offered was unclear. Conclusions This study begins to evidence the use of a dysphagia therapy not previously explored within existing literature. It highlights the wide use of oral trials within the hospital trust observed. Based on current evidence, it would be difficult for clinicians to know how to implement oral trials as an intervention. Further research is required both to explore the effectiveness of this approach and also to develop a consensus within practice around how, why, and when oral trials are offered. This would ensure an equitable and effective service is offered and would ensure a high standard of evidence-based practice within dysphagia management.

Dysphagia Therapy in Adults with a Tracheostomy: A Scoping Review Protocol

Background Swallowing impairment (dysphagia) and tracheostomy coexist. Research in this area has often provided an overview of dysphagia management as a whole, but there is limited information pertaining to specific dysphagia therapy in the tracheostomy population. The aim of this scoping review is to provide detailed exploration of the literature with regards to dysphagia therapeutic interventions in adults with a tracheostomy. The scoping review will describe current evidence and thus facilitate future discussions to guide clinical practice. Methods A scoping review using the Joanna Briggs Institute and Preferred Reporting Items for Systematic Reviews guideline will be used. Ten electronic databases from inception to July 2021and grey literature will be searched. From identified texts forward and backward citation chasing will be completed. Data extraction will compose of population demographics, aetiology and dysphagia therapy (type, design, dose and intensity). Number of citations and papers included into the scoping review will be presented visually. Discussion The scoping review aims to expand upon the existing literature in this field. A detailed description of the evidence is required to facilitate clinical discussions and develop therapeutic protocols in a tracheostomised population. The results of this scoping review will support future research in dysphagia therapy and provide the basis for development of best practice guidelines.

Isolated Dysphagia in a Patient with Medial Medullary Infarction – Effects of Evidence-Based Dysphagia Therapy: A Case Report

Medial medullary infarction (MMI) is a vascular occlusion in the medulla oblongata leading to certain constellations of neurological symptoms and seriously affecting the patient. Effective evidence-based treatment of severe dysphagia as sole symptom of MMI has not yet been reported. This case study aims to report successful effects of evidence-based therapy based on findings of dysphagia symptoms and pathophysiology of swallowing by flexible endoscopic evaluation of swallowing (FEES) in severe isolated dysphagia after MMI. FEES was performed to evaluate swallowing pathophysiology and dysphagia symptoms in a 57-year-old male with severe dysphagia after MMI. On the basis of FEES findings, simple and high-frequent evidence-based exercises for improvement of swallowing were implemented: thermal stimulation of faucial arches, Jaw Opening Exercise, and Jaw Opening Against Resistance. After 7 weeks of high-frequent evidence-based therapy and regular FEES evaluation the patient was set on full oral diet with no evidence of aspiration risk. In a first case report of isolated dysphagia in MMI our case illustrates that high-frequent evidence-based dysphagia therapy in combination with FEES as the method to evaluate and monitor swallowing pathophysiology can lead to successful and quick rehabilitation of severely affected dysphagic patients.

Creating a universal questionnaire based on the protocols for assessing the severity of dysphagia

Dysphagia affects our most basic functions — the ability to eat and drink. It negatively affects the quality of life of patients, especially in the elderly, which can lead to exhaustion, dehydration, aspiration pneumonia and, ultimately, death. Dysphagia and its severity should be assessed accurately and in a timely manner. Many questionnaires have been proposed to monitor the severity and effectiveness of dysphagia therapy. This paper analyzes ten different self-assessment questionnaires for quality of life. Almost all currently available questionnaires need to be finalized. Based on the DHI (Dysphagia Disability Index) questionnaire, we proposed a special questionnaire that has a number of advantages over the others, it takes into account the age of patients, is universal, and is also suitable for assessing dysphagia, both before and after treatment.

YouTube as a Source of Patient Information for Exercise and Compensated Maneuver of Dysphagia (Preprint)

BACKGROUND Acquiring online health-related information has become increasingly widespread. OBJECTIVE In this study, we aimed to evaluate the quality of the most viewed YouTube videos on dysphagia on exercise and compensated maneuver. METHODS We searched for the keywords “dysphagia exercise,” “dysphagia rehabilitation,” “dysphagia maneuver,” “dysphagia therapy,” and “dysphagia compensation” on YouTube on February 5, 2021. The educational quality of videos on YouTube was investigated based on the Global Quality Scale (GQS) and categorized into three groups: high-, intermediate-, and low-quality. The modified DISCERN tool was used to evaluate the reliability of the YouTube videos. Video parameters were compared between the groups according to the quality of the videos. RESULTS Of the 51 videos evaluated, according to the GQS, 54.9% (n = 28), 35.3% (n = 18) quality, and 9.8% (n = 5) were of high-, intermediate- and low-quality, respectively. When the video parameters were compared among the groups, there were no significant differences in the number of views, likes, dislikes, or comments per day (p > 0.05). However, there was a significant difference in the DISCERN scores between the groups (p < 0.001). CONCLUSIONS YouTube can be deemed as a predominant source for high-quality videos on dysphagia exercise and compensated maneuvers. However, YouTube should be accepted as a mixed pool with high-, intermediate-, and low-quality videos. Therefore, healthcare professionals, such as physicians and therapists, should verify the suitability and quality of the video, and suggest it to the patient, to ensure that the patient gets the appropriate information.

Dysphagia Management in Culturally-Linguistically Diverse Populations

Culturally competent management of adults with swallowing disorders involves more than simply including ethnically appropriate foods in dysphagia therapy. It requires an understanding of the client's health beliefs, challenges, and unique cultural perspective regarding all aspects of food to ensure unbiased and culturally appropriate services are provided. This chapter begins with an overview of dysphagia management followed by a closer look at cultural beliefs regarding food and ethical conflicts that may arise. The strategies for shared decision-making presented help create a culturally sensitive dynamic between the clinician and the patient/family that positively influence therapy outcomes. The chapter concludes with a case study that highlights the importance of ethnographic interviewing needed to establish understanding and trust between the clinician and an elderly Mexican woman and her family. The strategies and techniques presented here can be applied across all cultures to achieve successful management of dysphagia.