Intervention group
dysphagia, SLPs
DYSPHAGIA
The group rehabilitation program comprised daily 60-minute sessions, five times per week for a duration of 8 weeks. No more than five participants and two SLPs were assigned to each team. The SLPs have over 5 years of professional practice experience. Additionally, family members or other caregivers were permitted to be an observer during the sessions. The group rehabilitation program included:Rehabilitation oral and facial exercises: including facial exercises, lip exercises, tongue exercises, jaw exercises, respiration muscle exercises, Masako exercises, Shaker exercises, Airway Protection Techniques.Game-based surface electromyographic biofeedback training (GBsEMGBF): The training protocol utilizes a XY¯K¯TY¯I type swallowing nerve and muscle electrical stimulator (Made in China), integrated with game-based surface electromyographic biofeedback. All operations used disposable adhesive electrodes, with the two main electrodes affixed to the hyoid bone and the mandibular joint respectively. The reference electrode was affixed to the 2 cm side of the main electrode. Before starting training, each patient received necessary explanations, and Mendelssohn’s gimmick was informed of the standard waveform when he swallowed. The instruent was set to” GAME mode” during training sessions. The patients were instructed to follow Mendelssohn’s swallowing techniques, and we observed whether the waveform on the screen was consistent with the standard waveform. We ensured that both waveforms matched in order to achieve a higher score. The patients earned the corresponding achievements and rewards through accumulation of scores.Participants experience sharing: Select patients who exhibit discernible treatment outcomes to effectively communicate their treatment experiences, thereby enhancing patients’ confidence in the efficacy of the treatment.Individual direct feeding training, including adjustments to bolus volume, food texture, and posture compensation techniques, lasts for approximately 20 minutes. All of the basic and specialized training can be timely adjusted based on evaluations by the medical team and modified by the SLP according to each patient’s specific condition.Each session lasted 40 min of basic training, and the total duration was 1.5 h. The patients were allowed to take a 1-min break between each basic training session.This study used a check-in and punch-in system to guarantee that patients completed the required amount of instruction. Additionally, our program design allowed for flexibility; if a participant missed a training session, we offered make-up sessions. Strategies for increasing training responses include: (a) elucidating the potential benefits of the training procedure in aiding patients’ recover from dysphagia; (b) providing prizes to participants before the completion of the training; and (c) guaranteeing to keep participants’ personal information confidential.