None listed
Conditions
Brief summary
This randomised controlled trial aims to determine the effect of Expiratory Muscle Strength Training (EMST) on treating dysphagia in critical illness. Early research has suggested that strengthening the swallowing and respiratory musculature, through a type of treatment called “Expiratory Muscle Strength Training (EMST)”, might be helpful in improving swallowing function to assist the transition back to eating and drinking after a period of not having any food or drink by mouth. However, what is currently not known is that if this is any better than our “usual care”.
Interventions
Expiratory muscle strength training (EMST) + usual dysphagia care
EMST is a treatment designed to strengthen the expiratory (breathing out) muscles. It involves blowing into a small device against a pressure load. The device is called the EMST150 and the participant will need to breathe into it for 5 sets of 5 breaths, 5 days per week, for 5 weeks. The pressure load is increased as the participant gets stronger, similar to increasing the amount of weight you might lift at the gym as you get str
Expiratory muscle strength training (EMST) + usual dysphagia care EMST is a treatment designed to strengthen the expiratory (breathing out) muscles. It involves blowing into a small device against a pressure load. The device is called the EMST150 and the participant will need to breathe into it for 5 sets of 5 breaths, 5 days per week, for 5 weeks. The pressure load is increased as the participant gets stronger, similar to increasing the amount of weight you might lift at the gym as you get stronger. Each session will take approximately 20 minutes. Treatment sessions will be conducted face-to-face under the guidance of the study speech pathologist.
Sponsors
Sydney Local Health District
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
1. Individuals aged 18 years or over admitted to ICUs at study sites being treated with the intent to survive. 2. Patients must have received >7 days of prolonged invasive ventilation. 3. Tracheostomy and non-invasive ventilation may have formed part of treatment. 4. Dysphagia as defined by Clinical Swallowing Examination (CSE) with abnormal rating on the FOIS outcome measure scales (detailed further in methods).
Exclusion criteria
1. Patients whose swallow function is not suitable to be assessed due to poor prognosis for survival as determined by managing intensivist. 2. Patients whose swallow function is not suitable to be assessed post-extubation for surgical reasons e.g. gastrointestinal surgery. 3. Patients unable to participate in prescribed therapy regime due to inadequate cognitive capacity, recent H&N surgery, end stage respiratory disease, uncontrolled hypertension. 4. Previous history of dysphagia or dysphonia. Patients who are not able to receive endoscopic assessments or participate in EMST.
Outcome results
None listed