Comparison of two levels of inpatient dysphagia treatment dosages on swallowing outcomes

Current research reveals great variability in many aspects of service delivery for swallowing rehabilitation, including dosage or intensity of treatment. Therefore, there is a need to investigate the effects of treatment intensity on swallowing rehabilitation outcomes. The purpose of this study is to determine whether two levels of treatment intensity produce different patterns of swallowing recovery for inpatients with neurogenic dysphagia. Blinded analysis of pre- and post-treatment videofluoroscopic measures of swallowing were completed for six inpatients at the Rehabilitation Institute of Chicago who were previously randomized to one of two dysphagia exercise programs. One arm consisted of traditional 30-minute treatment sessions, while the other arm consisted of 60-minute treatment sessions. This study contributes to the literature by exploring the following question: Do inpatients with neurogenic dysphagia receiving either 30-minute or 60-minute dysphagia treatment sessions exhibit differences in post-treatment gains on a videofluoroscopic swallow study? A descriptive, but non-significant, advantage was found for 60-minute dysphagia treatment sessions during inpatient neurorehabilitation when compared to 30- minute sessions, specifically in regard to timing and thyroid kinematics. Dysphagia rehabilitation administered more intensively may better improve swallowing physiology in neurotic dysphagia. More research is needed to define more specific parameters of optimal treatment intensity to maximize swallowing recovery