Changes in Bolus Transit as an Effect of Vitalstim Intervention: A Case Study

Date of Graduation

Spring 2007

Degree

Master of Science in Communication Sciences and Disorders

Department

Communication Sciences and Disorders

Committee Chair

Lynette Goldberg

Abstract

Electrical stimulation of laryngeal muscles (VitalStim) is an increasingly popular treatment strategy for adults with dysphagia. However, the evidence base for this strategy is limited. The purpose of this study was to compare changes in swallowing following a period of VitalStim and more traditional intervention in an adult with dysphagia. The participant was randomly assigned to VitalStim or traditional treatment for 10 sessions. Intervention techniques then were to be reversed for a further 10 sessions. Documentation of each swallow was to be measured through videofluoroscopic examination on days 1, 11, and 21. The movement of the swallowed liquids was measured at the five landmarks recommended by Leonard and McKenzie (2006). Data were obtained at the beginning and end of the 10 day VitalStim period. The participant then elected to withdraw from the study in order to continue with the VitalStim treatment. Available pre- and post- VitalStim bolus transit measurements indicated improvements in the participant's swallow, although it remained delayed. Aspiration, as measured by a swallowing safety scale (Ludlow et al., 2007), continues to be a problem. However, the participant felt strongly that VitalStim was effective. Results highlight (a) the value of using the five landmarks to measure bolus transit and the complementary role of the swallowing safety scale, and (b) the need for clinicians to maintain detailed descriptive data. Results also highlight the difficulties clinicians face in conducting carefully controlled studies to document the efficacy of new approaches to treatment.

Keywords

VitalStim protocol, dysphagia treatment, swallowing, bolus transit, clinical research

Subject Categories

Communication Sciences and Disorders

Copyright

© Jane Eloise Peterson

Citation-only

Dissertation/Thesis

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