Development of therapeutic exercises manual for Oro-Pharyngeal Dysphagia, Phase II: Efficacy of therapeutic exercises manual for Oro-Pharyngeal Dysphagia

Objective: To determine the effectiveness of ten therapeutic exercises on the patients of Oro-pharyngeal Dysphagia (OD) clinically diagnosed with one structural disorder (Head and neck cancer; HNC) and two neurological disorders (Traumatic Brain Injury; TBI and Cerebral Vascular Accidents; CVA). Methodology: The Quasi experimental study (pretest-posttest design) was conducted, gathering a sample of 75 patients with mild to moderate Oro-pharyngeal Dysphagia (OD) severity through purposive sampling technique from Govt. and private hospitals without no age and geneder limits. The patients with neurological diseases, nasogastric (NG) tube and tracheostomy were excluded. Two screening test (a) Glassgow Coma Scale (GCS) and (b) The Repetitive Saliva Swallowing Test (RSST) were used to investigate patient’s consciousness and voluntarily swallow, respectively. To quantify the effectiveness of therapeutic manual, The Eating Assessment Tool (EAT-10) was employed as baseline (pre-test and post-test). Therapeutic protocol was received by the patients twice a week for six weeks in the clinical setting and post test was administered on patients’ follow-ups and some through online calls. Results: Using SPSS version 26, Shapiro-Wilk test demonstrated normality in the data distribution showing kurtosis (+10, -10) and skewness (+3, -3) values falling within their ranges. Consequently, parametric tests: One-way between-subject ANOVA was employed to compare the statistical significant mean difference between the groups (HNC, TBI, CVA) on EAT-10 score measuring the effect of therapeutic exercises manual for OD. Paired sample t-test was run to investigate the mean difference of EAT-10 scores within subjects before and after the implication of therapeutic exercises manual. One-way between-subject ANOVA identified a significant mean difference of EAT-10 score between three groups F (2, 72) = 17.64, p< .05, with large effect size (η2= .970). Paired sample t-test results indicated a significant mean difference (t= 80.884, df= 74, p< .005, one-tailed) with large effect size (d = .82) within the subjects before and after the intervention. Conclusion: So, findings addressed a large improvement in Oro-Pharyngeal Dysphagia after the implementation of therapeutic exercises manual.