The purpose of the study is to test and optimize the feasibility of an activity-based resistance training program for patients with sarcopenic dysphagia. The study is a feasibility study designed as a multiple-case study with quantitative and qualitative data sources related to a number of feasibility outcomes and clinical outcomes during and after the intervention. Participants are 15 patients\> 65 years of age are referred for dysphagia assessment by an Occupational Therapist (patients may be admitted to several different wards (endocrinology, pulmonary medicine, infectious medicine, gastrology). The intervention is offered during hospitalization and after discharge for a maximum of 12 weeks.
Study Type
OBSERVATIONAL
Enrollment
11
The ACT-ING program is based on a task-oriented approach within motor behavior theories and combines resistance training principles with goal-directed and task-specific swallowing exercises in eating and drinking activities through a client-centered procedure informed by self-determination theory.
Hvidovre University Hospital
Hvidovre, Denmark
Intervention tolerance
Time-series of participants rated level of concern for aspiration on a 100 mm VAS-scale ((left side = no concerns and right side = maximal concerns). The success criterion is that 80% of the VAS scales are in the area of 'no concerns' for aspiration.
Time frame: During two therapy sessions per week in 12 weeks
Adverse effects
Any expected and unintended events during the therapy sessions and the self-training are recorded.
Time frame: During two therapy sessions per week in 12 weeks
Intervention usefulness
Participant self-report on the subscale 'Value/usefulness' from the Intrinsic Motivation Inventory (IMI). The subscale covers 7 items to be rated on a 7-point Likert scale (1=Not at all true to 7=very true). A high score indicate high usability.
Time frame: Up to 12 weeks
Acceptability
Semi-structured interviews based on the Theoretical Framework of Acceptability
Time frame: Up to 12 weeks
Emotional wellbeing and global quality of life
Two single VAS items using a horizontal line from 0 (worst imaginable emotional well-being / worst imaginable quality of life) to 100 mm (perfect emotional wellbeing /perfect quality of life).
Time frame: Baseline and up to 12 weeks
Mealtime performance
The McGill Ingestive Skills Assessment-version 2 (MISA2). The total score range from 36-108, where higher score indicate higher performance
Time frame: Baseline and up to 12 weeks
Functional oral intake
Functional Oral Intake Scale (FOIS) with a score range of 1( no oral intake) to 7 (Total oral diet with no restrictions).
Time frame: Baseline and up to 12 weeks
Nutritional status
The modified Mini Nutritional Assessment Scale-Short Form (MNA-SF). The total score range from 0 to 14, where a score \<8 indicates malnutrition, 8-11 indicates risk of malnutrition, and \>11 indicates no malnutrition.
Time frame: Baseline and up to 12 weeks
Tongue strength and endurance
Iowa Oral Performance Instrument (IOPI).
Time frame: Baseline and up to 12 weeks
Intervention progress _ swallow difficulty
Self-reported swallowing difficulty of saliva, liquid and food (100 mm VAS scale (left side = no difficulties and right side = unable to swallow).
Time frame: During two therapy sessions per week in 12 weeks.
Intervention progress_ intensity
Self-perceived effort from 0 (at rest) to 10 (extremely hard).
Time frame: During two therapy sessions per week in 12 weeks.
Intervention progress _ Swallow ability
Records on observed number of successful/unsuccessful swallows.
Time frame: During two therapy sessions per week in 12 weeks.
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