Impact of Effortful Swallow with Progressive Resistance on Swallow Safety, Efficiency and Quality of Life in Individuals with Post-Stroke Dysphagia: Analysis Using DIGEST- FEES and SWAL-QOL.

Introduction: Effortful swallow with progressive resistance has a potential clinical implication in improving the oro-muscular strength, swallow safety, and efficiency in elderly individuals. But to date, no studies have explored its benefits in training individuals with post-stroke dysphagia. Aim: The present study investigated the long- term effect of effortful swallow with progressive resistance on swallow safety, efficiency and quality of life in persons with dysphagia following stroke. Method: The study consisted of 5 males (mean age: 41.80yrs ± 9.6yrs) diagnosed with dysphagia post-stroke.  The participants underwent 20 sessions (5 days/week) of intensive effortful swallow with progressive training spread across four weeks. In the first two weeks, the participants performed 10 × 3 sets of effortful swallows with a 50% of resistance load, which was further increased to 15 × 3 sets with a 70% resistance load. Results: DIGEST-FEES safety and overall swallow quality of life significantly improved post-therapy, whereas DIGEST-FEES efficiency and overall swallow grades showed no significant changes. Inter-rater reliability of DIGEST-FEES revealed substantial agreement between judges. Conclusion: The results are promising as the technique improved swallow safety, and swallow quality of life in persons with dysphagia following stroke.