Swallowing problems in frail older people Digestive System
Conditions
Interventions
People will be recruited when they are medically safe to be so, from Acute Frailty wards/Units at Queen Elizabeth Hospital and Southmead Hospital. When they agree to take part, consent will be sought.
Sponsors
Lewisham and Greenwich NHS Trust
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: 1. Medically stable (systolic BP > 110; Heart rate > 60 bpm, MEWS = 4 14 5. Able to provide consent (Different media will be provided to patients to enable consent to occur e.g. pictures; Speech Therapy support) 6. No significant breathlessness (St Georges COPD Score) 7. Not requiring oxygen 8. No past history of stroke or neurological disease 9. No evidence of severe rheumatoid arthritis (risk of neck instability)
Exclusion criteria
Exclusion criteria: 1. Failure to provide consent to take part in the study 2. Progressive medical conditions (some malignancy, neurological disease) 3. MoCA < 14 4. Dysphagia requiring active intervention at the time of assessment 5. Dysphagia secondary to surgical treatment of head and neck cancer
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| 1. Recruitment rates across two NHS hospital sites assessed using the number recruited per month and the total in the study period recorded using REDcap trial management software 2. Willingness to be recruited to the study assessed using the number of people who refuse and their reasons for refusing recorded using REDcap trial management software 3. Study retention (<30% drop out) assessed using number not completing the study relative to the number agreeing to participate recorded using REDcap trial management software 4. Compliance: 80% of exercises undertaken daily assessed using the Exerphager app, which will show the exercise data for all sessions completed 5. The absence of adverse incidents assessed using the number of reports using REDcap trial management software 6. Acceptability of intervention assessed using a 5-point questionnaire 7. Mechanics of swallowing assessed using videofluoroscopy (reduced PTT; reduced residue post swallow) 8. Aspiration prevention assessed by analysing laryngeal movement, UES opening and tongue base retraction visualised using videofluoroscopy 9. Swallow speed assessed using TWST (time taken to drink 90 ml of water) 10. Ease of use of the CTAR-SwiFt feedback system assessed using using verbal feedback and the Swift-ball usability questionnaire 11. Swallowing ability assessed using FOIS (food oral intake score). It is scored between 1 and 7. 0 refers to being unable to eat or drink. 7 is normal diet. This is completed by medical staff. 12. Dysphagia-related quality of life assessed using the Swal-Qol questionnaire 13. Health status assessed using the EQ-5D questionnaire 14. Strength and mobility assessed using Timed Up and Go test. Participants must stand from sitting, walk 3 m, then turn around, walk back to the chair and sit down again. All measures are assessed at baseline, 12 weeks and 24 weeks. | — |
Countries
England, United Kingdom
Outcome results
None listed