Improving swallow function in progressive dysphagia associated with Huntington's Disease

Abstract

This study examined the effects of oral-motor, respiratory, and pharyngeal strengthening exercises on dysphagia in individuals with Huntington's disease. In a pre-test, post-test design, five participants voluntarily implemented the aforementioned exercises daily for a four-week period. The function of the oral-motor, pharyngeal, and respiratory structures was measured both at baseline and at study completion. In addition, participants provided a self-rating of their swallow function prior to and subsequent to implementation of the selected exercises. Swallowing function was also examined through an informal bedside evaluation and documented by a clinician at baseline and at conclusion of the study. A statistically significant improvement in the function of the oral-motor, pharyngeal, and respiratory structures was noted. No statistically significant improvement was noted in the participants self-rating of their swallow function; however, four of the five participants appeared to maintain and/or improve swallow function as reported by the individual and as noted on the informal bedside evaluation by the clinician. In conclusion, the null hypothesis could not be rejected. It could not be concluded that the selected exercises improved dysphagia based upon the participants self-rating of swallow function. However, as a statistically significant improvement in oral-motor function was realized, the findings raise concerns as to the sensitivity of swallow-screening measures for individuals with Huntington's disease. It is critical that an objective swallow-screening measure be developed sensitive to the ramifications of Huntington's disease and various other disorders affecting cognition.