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The Swallow Exercise Aid (SEA 2.0) exercises (printed with permission of the participant). Top left: start position, Top right: Chin Tuck Against Resistance (CTAR), Bottom left: Jaw Opening Against Resistance (JOAR), Bottom right: Effortful Swallow Against Resistance (ESAR) with 50% of maximum range of motion

The Swallow Exercise Aid (SEA 2.0) exercises (printed with permission of the participant). Top left: start position, Top right: Chin Tuck Against Resistance (CTAR), Bottom left: Jaw Opening Against Resistance (JOAR), Bottom right: Effortful Swallow Against Resistance (ESAR) with 50% of maximum range of motion

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Article
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The aims of this exploratory study and clinical phase II trial were to assess the specific nature and extent of dysphagia in laryngectomized patients with self-reported dysphagia, and its rehabilitation potential using the novel Swallowing Exercise Aid (SEA 2.0). Twenty laryngectomized patients participated in a six-week exercise program with the S...

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... Total laryngectomy can lead to numerous changes, the most obvious being the loss of the natural voice, but also the loss of upper airway functions (the moistening, heating, and filtering of air), resulting in pulmonary problems and the loss of olfaction. After the surgery, the patient has to adapt to the altered anatomy and its lifelong consequences, leading to physical, emotional, psychological, and social changes that affect their average daily functioning and quality of life [5]. ...
... While after such major surgery people expect and become accustomed to some Total laryngectomy can lead to numerous changes, the most obvious being the loss of the natural voice, but also the loss of upper airway functions (the moistening, heating, and filtering of air), resulting in pulmonary problems and the loss of olfaction. After the surgery, the patient has to adapt to the altered anatomy and its lifelong consequences, leading to physical, emotional, psychological, and social changes that affect their average daily functioning and quality of life [5]. ...
... The altered physiology and biomechanics of swallowing are another significant effect. While after such major surgery people expect and become accustomed to some degree of diminished swallowing functioning, studies show that long-term self-reported swallowing problems can appear in as much as 72% of patients after TL (total laryngectomy) [5]. The estimates of the frequency of swallowing problems (dysphagia) after TL usually range from 17 to 70%. ...
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Objectives: This study aims to determine the efficacy of prophylactic swallowing exercises on swallowing function in patients undergoing total laryngectomy for laryngeal cancer. Methods: The design was a randomized controlled trial set in one tertiary care academic medical center. A total of 92 patients undergoing total laryngectomy for stages III and IV laryngeal cancer performed five targeted swallowing exercises for a period of three months after their surgery, starting two weeks after the surgery. Weekly swallowing therapy sessions were held with the patients in order to encourage adherence and proper technique. The controls received no preventive exercise and were referred for swallowing treatment following the surgery, as well as radiation therapy if necessary. The Functional Oral Intake Scale (FOIS) and the Performance Status Scale for Head and Neck Cancer Patients (PSS-H&N) were used to measure swallowing function at the baseline, one week following the surgery, and three, six, nine, and twelve months following the surgery. Results: Right after the surgery, there were no statistically significant variations between the intervention and control groups in the FOIS scores (p value = 0.64), the Eating in Public subscale scores (p value = 1) and Normalcy of Diet subscale scores (p = 0.33) of the PSS-H&N. The scores were significantly better among the intervention patients at months 3, 6, 9, and 12 for all the scores, with p values smaller than 0.000. Conclusions: Although not immediately following the surgery, the patients who engaged in prophylactic swallowing exercises showed improvements in their ability to swallow at 3, 6, 9, and 12 months following their procedure.
... Still, up to 72% of the patients suffer from self-reported dysphagia, which can significantly affect their quality of life [1,3,4]. Despite the fact that the first laryngectomy for cancer was performed over one and a half century ago [5], to our knowledge, no effective swallowing rehabilitation program for this patient population has been developed and evaluated, aside from pharyngeal dilatation in case of an overt stenosis [6]. ...
... The training program assessed in the clinical phase II rehabilitation trial met all muscle strengthening principles, by using the CE-marked Swallowing Exercise Aid 2.0 (SEA2.0) [1]. The SEA2.0 is a handheld device that offers adjustable resistance, ranging from 20 to 160 Newton (N) in eight steps, enabling customized training that aligns with patients' capability and allows for progression over time to ensure sufficient overload as muscle strength increases [1]. ...
... [1]. The SEA2.0 is a handheld device that offers adjustable resistance, ranging from 20 to 160 Newton (N) in eight steps, enabling customized training that aligns with patients' capability and allows for progression over time to ensure sufficient overload as muscle strength increases [1]. ...
Article
Background This study investigated long‐term outcomes of dysphagia rehabilitation with an adjustable resistance training device (Swallowing Exercise Aid, SEA2.0) in laryngectomized individuals. Methods Seventeen laryngectomized participants who participated in a Clinical Phase II Trial were reevaluated at T3 (approximately 6 months after T2), including an interview, PROMS, oral intake, and swallowing capacity. Results of T3 were compared with the earlier time points T0 (baseline), T1 (after 6 weeks of training), and T2 (after 8 weeks of rest). Results All outcomes at T3 remained improved compared to T0. Compared to findings at T2, participants reported some deterioration in swallowing at T3. Swallowing capacity and oral intake slightly decreased. Swallowing‐related quality of life slightly improved. Conclusions Benefits of swallowing rehabilitation with the SEA2.0 in laryngectomized individuals are still noticeable long term. The need for continued exercising to fully maintain improved function is likely, but the required intensity and extent should be determined in further research.
... In the literature, the consequences of dysphagia, such as dehydration, malnutrition, and aspiration pneumonia [6] are included in the general symptomatology, while the "real" symptoms such as aspiration with consequent cough, changes in the quality of voice timbre (moist, raspy voice), bolus regurgitation, and postglutitional residues in the oral cavity or pharynx [6,7] are included in the specific symptomatology. According to data from clinical practice, several authors in their studies [8][9][10] state that patients most often complain of difficult bolus propulsion and slow swallowing, i.e., prolonged duration of meals, retention of food in the throat, regurgitation, multiple attempts to swallow, and feeling of tightness in the throat. The cause of the aforementioned disorders is precisely the altered anatomy and physiology of the reconstructed pharynx (neopharynx) [8,11]. ...
... According to data from clinical practice, several authors in their studies [8][9][10] state that patients most often complain of difficult bolus propulsion and slow swallowing, i.e., prolonged duration of meals, retention of food in the throat, regurgitation, multiple attempts to swallow, and feeling of tightness in the throat. The cause of the aforementioned disorders is precisely the altered anatomy and physiology of the reconstructed pharynx (neopharynx) [8,11]. ...
... It is also possible to use a medical technique that is applied in the rehabilitation of the oro-motor abilities of the articulator, such as VitalStim Plus Electrotherapy and the Iowa Oral Performance Instrument, as well as the use of the Novel Swallowing Exercise Aid (SEA 2.0) [8,34]. ...
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Laryngectomy is a surgical procedure that leaves mutilating functional consequences for the patient, one of which is often a swallowing disorder. Swallowing disorders after laryngectomy can be of varying degrees and can occur at any time in the postoperative period. Some consequences that interfere with swallowing difficulties after laryngectomy are: edema, pain in the soft tissues of the cheeks and neck, dental problems, xerostomia, hyposalivation or fibrosis of masticatory muscles, and odynophagia. The diagnostic processing of dysphagia includes detailed anamnestic data collection, instrumental and clinical evaluation of swallowing, and self-assessment of swallowing. Swallowing rehabilitation is individual and carried out by an interdisciplinary team within a healthcare facility that has the necessary medical equipment and aids to care for patients with dysphagia and the consequences of dysphagia. The purpose of rehabilitation is to provide the patient with safe oral feeding that will meet his nutritional needs and prevent the possible consequences of dysphagia. Detecting early clinical signs of dysphagia enables timely therapeutic intervention and prevention of secondary consequences of dysphagia, which is especially important in oncology patients.
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The chin tuck against resistance (CTAR) exercise is a therapeutic method developed to activate and strengthen the oropharyngeal muscles related to swallowing in patients experiencing post-stroke dysphagia. However, existing CTAR exercises could be improved by considering the complex characteristics of the suprahyoid muscles. To investigate the efficacy of multidirectional (md-) CTAR on tongue pressure and suprahyoid muscle activity in older adults. Thirty-four older adults were enrolled and randomly assigned to two groups (n = 17/group). Group 1 performed md-CTAR exercises in the left and right diagonal and vertical directions, using the prototype device developed for this study. In contrast, group 2 performed only the vertical-directional (vd-) CTAR exercise using the same device as group 1. Both groups performed the same exercise for 5 days over 6 weeks. Outcome measures were tongue pressure, tongue thickness, and suprahyoid muscle activity, which were evaluated using the Iowa Oral Performance Instrument, ultrasound, and surface electromyography, respectively. As a results, group 1 exhibited significantly higher maximal tongue pressure, tongue thickness, and suprahyoid muscle activity during swallowing than group 2 (p < .05). In conclusion, This study demonstrated that the md-CTAR exercise was more effective than the vd-CTAR exercise in activating the suprahyoid muscles while promoting greater maximal tongue pressure and thickness in older adults.