Background Impaired swallowing (dysphagia) is reported in all stages of Huntington’s Disease (HD) and aspiration pneumonia is the most common cause of death. Sparse research has evaluated dysphagia rehabilitation in this population.
Aims This study evaluated a skill-based swallowing training protocol in individuals with HD.
Methods Twelve participants with diagnosed HD and dysphagia completed 10 sessions of daily skill-based therapy in two weeks using Biofeedback in Strength and Skill Training software and surface electromyography hardware. A within-subject A-B-A design was utilised to include two-week blocks of no treatment pre-therapy as baseline and post-therapy for retention. Swallowing was evaluated using the Timed Water Swallowing Test (TWST), Test of Masticating and Swallowing Solids (TOMASS), manofluoroscopy, ultrasound and the Swallowing Quality of Life Questionnaire (SWAL-QoL).
Results Instrumental assessment of biomechanics demonstrated significant improvements in liquid bolus transit times (p < 0.05). Upper oesophageal sphincter (UES) distension decreased post-therapy (p = 0.02). There were no significant treatment effects observed in the TWST and TOMASS data; however subjectively, 5 patients reported clinical improvements, including elimination of overt signs of aspiration post-therapy. Manofluoroscopic measures of timing and amplitude moved closer to normative data, but no significant treatment effect was found. Of the 17 outcome measures, 13 demonstrated reduced within-session variability post-therapy; these did not reach statistical significance. A significant improvement in quality of life was reported post-therapy (p < 0.05) and maintained.
Conclusions This study provides preliminary evidence that this skill-based training is a feasible rehabilitation option for HD. Further evidence is required to evaluate the effectiveness of this protocol according to dysphagia signs and disease stage.
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