There is a possibility that dysphagia is more common than the published data suggest, because many older people do not report problems or have learnt to live with them. With age, there is an increased risk of aspiration due to changes in motor function, which is often subtly compensated for. In those admitted with a diagnosis of community-acquired pneumonia, up to 90% may have aspirated saliva or food. Up to 30% of older people living at home may have dysphagia, and 28% of older people are identified as aspirating saliva on instrumentation. Many (55%) older frail people admitted to hospital will have difficulties with swallowing (dysphagia). reduce the need for supplemental feeding, improve patient satisfaction with oral intake and swallowing-related quality of life, decrease the occurrence of chest infections and reduce hospital admissions and related healthcare costs. It is suggested that this will further impact clinical, patient and healthcare economic outcomes, i.e. Conclusionsīy improving the ability to swallow, using our chin tuck exercise intervention, in frail older patients admitted to hospital with pneumonia, it is anticipated that patients’ oral intake will improve. bolus flow rates, laryngeal elevation, base-of-tongue retraction). A sub-sample of study participants will complete videofluoroscopic assessments of swallowing function before and after the intervention to evaluate the physiological changes (e.g. chin tuck strength, Functional Oral Intake Scale, SWAL-QOL, EQ-5D and swallow speed). Additionally, we will assess the usability and acceptability of the intervention device and the performance of different clinical outcome measures (e.g. We will assess the feasibility outcomes, including rates of participant recruitment and retention, compliance with the exercise regime and adverse incidents. The intervention period will last for 12 weeks, the final follow-up assessment will be conducted at 24 weeks. Study participants will be randomised into one of three groups: standard care, low intensity (once daily) CTAR-SwiFt exercise or high intensity (twice daily) CTAR-SwiFt exercises. We will recruit 60 medically stable patients over the age of 75 years who have been admitted with a diagnosis of pneumonia to the acute frailty wards at two participating hospitals in the UK. The aim of this study is to evaluate the feasibility of assessing the effectiveness of the CTAR-SwiFt intervention in reducing dysphagia and community-acquired pneumonia, prior to a larger-scale multi-centre randomised controlled trial. The CTAR-SwiFt intervention consists of a feedback-enabled exercise ball that can be squeezed under the chin, with real-time feedback provided via a mobile application. We have developed a swallowing exercise rehabilitation intervention (CTAR-SwiFt) by adapting a previously established swallowing exercise to ensure patient safety and ease of execution in the frail elderly population. Swallowing difficulties (dysphagia) and community-acquired pneumonia are common in frail older people and maybe addressed through targeted training of the anterior neck musculature that affects the swallow.
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