NCT01370083

Brief Summary

People with swallowing impairment experience particular difficulty swallowing thin liquids safely; the fast flow of liquids makes them difficult to control. The tongue plays a critical role in containing liquids in the mouth, channeling the direction of their flow towards the pharynx (throat) and controlling their flow along that channel. The investigators are engaged in a program of research to better understand tongue function in swallowing, particularly with respect to controlling the flow of liquids. In this study the investigators will compare two different tongue-pressure resistance training protocols, to determine whether a protocol that emphasizes strength-and-accuracy or one that emphasizes pressure timing work better for improving liquid flow control in swallowing.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
14

participants targeted

Target at below P25 for phase_2

Timeline
Completed

Started Sep 2011

Typical duration for phase_2

Geographic Reach
1 country

1 active site

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

June 3, 2011

Completed
6 days until next milestone

First Posted

Study publicly available on registry

June 9, 2011

Completed
3 months until next milestone

Study Start

First participant enrolled

September 1, 2011

Completed
3.8 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

June 1, 2015

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

June 1, 2015

Completed
7 months until next milestone

Results Posted

Study results publicly available

December 30, 2015

Completed
Last Updated

February 8, 2016

Status Verified

January 1, 2016

Enrollment Period

3.8 years

First QC Date

June 3, 2011

Results QC Date

November 24, 2015

Last Update Submit

January 14, 2016

Conditions

Keywords

DysphagiaViscosityTonguePressure

Outcome Measures

Primary Outcomes (1)

  • Change in Swallow Response Time for 5 cc Thin Liquid Swallows

    Swallow response time (the time duration between bolus passing the ramus of the shadow of the mandible and onset of hyolaryngeal excursion for airway protection 5cc thin liquid barium boluses in videofluoroscopy. Measures \> 350 ms are considered to reflect impairment and a heightened risk of penetration-aspiration. The participant's mean swallow response time will be calculated across a series of 3 X 5 cc swallows and then reduced to a binary score \< vs \> 350 milliseconds.

    Post treatment (12 weeks)

Secondary Outcomes (2)

  • Penetration-Aspiration Scale Score for 5 cc Thin Liquid Swallows

    Post-treatment (12 weeks)

  • Tongue-palate Pressure Amplitude for Maximum Isometric Pressures

    Post-treatment value

Study Arms (2)

Stroke: TPPT

EXPERIMENTAL

Adults with dysphagia post stroke (within 4-16 weeks of onset) who have radiographically confirmed difficulties with thin liquid bolus control. Individuals will complete 24 sessions of tongue-pressure-profile training over 8-12 weeks.

Behavioral: Tongue Pressure Profile Training

Stroke: TPSAT Control

ACTIVE COMPARATOR

Individuals with dysphagia (within 4-16 weeks post stroke) who demonstrate difficulties with thin liquid control on videofluoroscopy. Individuals will complete 24 sessions of tongue-pressure strength-and-accuracy training over 8-12 weeks.

Behavioral: Tongue-Pressure Strength-and-Accuracy Training

Interventions

60 tongue-pressure tasks per session, emphasizing control of the slope of tongue pressure release, informed by biofeedback. Pressures will be measured using a hand-held oral manometer (Iowa Oral Performance Instrument) with signals displayed on a computer.

Also known as: Iowa Oral Performance Instrument
Stroke: TPPT

60 tongue-pressure tasks per session, emphasizing maximum effort strength tasks and accuracy targets within 20-95% of each patient's maximum, informed by biofeedback. Pressures will be measured using a hand-held oral manometer (Iowa Oral Performance Instrument) with amplitude output in kiloPascals displayed on an LCD screen.

Also known as: Iowa Oral Performance Instrument
Stroke: TPSAT Control

Eligibility Criteria

Age18 Years - 100 Years
Sexall
Healthy VolunteersYes
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Individuals with dysphagia characterized by prolonged swallow response duration for 5 cc boluses of thin liquid (i.e., \> 350 ms, confirmed in videofluoroscopy).

You may not qualify if:

  • premorbid reported history of swallowing, motor speech, gastro-esophageal or neurological difficulties.
  • prior history of surgery to the speech apparatus (other than routine tonsillectomy or adenoidectomy).

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Toronto Rehabilitation Institute - University Health Network

Toronto, Ontario, M5G 2A2, Canada

Location

Related Publications (1)

  • Steele CM, Bayley MA, Peladeau-Pigeon M, Stokely SL. Tongue pressure profile training for dysphagia post stroke (TPPT): study protocol for an exploratory randomized controlled trial. Trials. 2013 May 7;14:126. doi: 10.1186/1745-6215-14-126.

MeSH Terms

Conditions

Deglutition Disorders

Condition Hierarchy (Ancestors)

Esophageal DiseasesGastrointestinal DiseasesDigestive System DiseasesPharyngeal DiseasesOtorhinolaryngologic Diseases

Results Point of Contact

Title
Prof. Catriona Steele
Organization
Toronto Rehabilitation Institute - University Health Network

Study Officials

  • Catriona M Steele, Ph.D.

    Toronto Rehabilitation Institute

    PRINCIPAL INVESTIGATOR

Publication Agreements

PI is Sponsor Employee
No
Restrictive Agreement
No

Study Design

Study Type
interventional
Phase
phase 2
Allocation
RANDOMIZED
Masking
SINGLE
Who Masked
OUTCOMES ASSESSOR
Purpose
TREATMENT
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Senior Scientist

Study Record Dates

First Submitted

June 3, 2011

First Posted

June 9, 2011

Study Start

September 1, 2011

Primary Completion

June 1, 2015

Study Completion

June 1, 2015

Last Updated

February 8, 2016

Results First Posted

December 30, 2015

Record last verified: 2016-01

Locations