The Impact of Thermal-Tactile Stimulation on Dysphagia in Patients with Acquired Brain Injury

Research Objectives: To examine how different patient populations with dysphagia due to acquired brain injury (ABI) respond to thermal-tactile stimulation (TTS) treatment functionally as measured by change in Functional Oral Intake Scale (FOIS) scores.

Design: Retrospective chart review study

Setting: An acute rehabilitation facility

Participants: The records of sixty consecutive adults who were referred for Video Fluoroscopic Swallowing Study (VFSS) were screened for inclusion (had an ABI and participated in TTS without NMES).

Interventions: Patients participated in TTS treatment without NMES.

Main Outcome Measures: Functional Oral Intake Scale (FOIS)

Results: Paired Samples Test and Pearson Correlation were used. The sample included 20 males and 40 females between the ages of 19 and 91 (M=66.82, SD=15.27). Length of stay ranged from 9 to 98 days (M=35.03, SD=18.95). Group 1 was made up of 15 (25%) patients with traumatic BI and Group 2 (other BI) was made up of 45 patients with stroke (40 or 66.7%), anoxic injury (2 or 3.3%) and other neurologic conditions (3 or 5%). Admission FOIS ranged from 1 to 5 (M=1.68, SD=1.5). Discharge FOIS ranged from 1 to 7 (M=4.13, SD=2.16). Change in FOIS ranged from 0 to 6 (M=2.45, SD=2.12). Admission FIM-cog scores ranged from 5 to 32 (M=13.91, SD=8.91). Discharge FIM-cog scores ranged from 5 to 35 (M=19.11, SD=9.09). FOIS improved from admission to discharge of -2.45 SD 2.12 (t[59]=-8.96, p< 0.001). Older subjects had less change in FOIS (r=0.27, p=0.038). Those with longer length of stay had more FOIS change (r=0.28, p=0.032). Controlling for age, length of stay, and FIM-cog scores at admission, individuals with TBI (Group 1) made greater gains, F(1,55)=4.9, p=0.031.

Conclusions: Dysphagia treatment with TTS resulted in a statistically significant improvement in FOIS scores, with a greater degree of change noted for patients with a diagnosis of TBI versus other ABI when controlling for age and length of stay.

Author(s) Disclosures: Financial disclosures: Coleen Cook, Danielle Busch and Irene Ward are full-time salaried employees of Select Medical Corporation. Anthony Lequerica is a full-time salaried employee of The Kessler Foundation.