Development of Eclectic Dysphagia Management Program for Management of Neurogenic Oropharyngeal Dysphagia (NOD): A Preliminary
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Abstract
Aim: The Eclectic Dysphagia Management Program (EDMP) is a structured framework integrating multiple therapeutic strategies to manage neurogenic oropharyngeal dysphagia (NOD). This study evaluates its effectiveness through a pilot and main study, focusing on assessment refinement and individualized therapy application.
Methods: The EDMP was developed through a systematic literature review (PRISMA), expert consensus, and a pilot study with five participants (mean age 59.9 ± 1.79 years). The main study included 145 participants (mean age: 61.98 ± 4.20 years) diagnosed with NOD via Fiberoptic Endoscopic Evaluation of Swallowing (FEES), Mann Assessment of Swallowing Ability (MASA), and Dysphagia Handicap Index (DHI). Therapy sessions were structured into four phases, incorporating compensatory, rehabilitative, and NMES-assisted strategies. Statistical analysis included the Wilcoxon Signed-Rank Test and effect size calculations.
Results: Significant post-therapy improvements were observed in PAS (pre: 4 ± 1.12; post: 1 ± 0.74, p < 0.001), MASA (pre: 141.80 ± 10.16; post: 175.40 ± 5.00, p < 0.001), and DHI (pre: 63.47 ± 4.36; post: 16.07 ± 4.56, p < 0.001). Therapy duration peaked in the 12th session (63.27 ± 0.77 minutes). Effect sizes for MASA (0.88), PAS (0.90), and DHI (0.88) confirmed a strong therapeutic impact.
Conclusion: The EDMP offers a standardized, yet flexible, dysphagia management approach, effectively improving swallowing function, safety, and quality of life. Future studies should validate findings through larger, multi-site randomized controlled trials (RCTs).
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