Dysphagia is an easier pill to swallow with video technology

Video-assisted swallowing therapy (VAST) significantly improves swallowing-associated outcomes in cognitively intact Parkinson's disease patients, research suggests.

Yael Manor (Aviv Sourasky Medical Center, Tel Aviv, Israel) and colleagues found that cognitively intact Parkinson's disease patients who were exposed to videos of the swallowing process (VAST) in general, as well as to their own swallowing, showed an improvement in quality of life and swallowing function.

Indeed, as shown by fiber-optic endoscopic evaluation of swallowing (FEES), the improvement in swallowing function, as assessed by the amount of food residue in the pharynx, was significantly greater in the VAST group (n=21) than in the control group (n=21). Specifically, scores in patients assigned to VAST fell from 1.73 at baseline to 0.44 immediately postintervention, compared with from 1.48 to 0.95 in controls.

The authors note that repeated forceful swallows, entailing the conscious act of squeezing hard with the oral and pharyngeal muscles while swallowing, was the compensatory technique that was adopted by the majority of the study and control groups.

Manor and team found that the VAST group showed significant improvements in the burden and symptoms components of the Swallowing-Quality of Life questionnaire (SWAL-QOL) compared with the control group between pre-therapy and 4-weeks post-therapy.

Furthermore, between 4- and 6-weeks post-therapy, the VAST group showed significant improvements in all five components of the SWAL-QOL, including eating desire, social functioning, and mental health, compared with the control group.

As reported in Parkinsonism and Related Disorders, there was a significantly greater improvement in pleasure of eating (POE) during the course of therapy in the VAST group compared with the controls.

"We propose that detailed visual assistance improves the understanding and implementation of the strategies and enhances the patients' motivation to practice," remark Manor and team.

"The VAST highlights the connection between patients' level of quality of life, degree of POE, and the level of satisfaction from the therapy program to swallowing disorders and intervention outcomes."

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