No Food or Drink Does Any Good Until It is Swallowed: a Proof-of-concept Study on Occupational Therapy Rehabilitation for Frail Elders with Dysphagia

What this Trial Is About

Researchers are evaluating a new occupational therapy intervention designed to improve swallowing abilities and prevent further muscle weakening in older adults with dysphagia, or difficulty swallowing. This proof-of-concept study aims to determine if the intervention can enhance eating skills, tongue strength, orofacial function, nutritional status, and quality of life. It also explores how support and motivation affect engagement during hospitalization and community rehabilitation after discharge. The intervention uses a client-centered, task-oriented approach with real objects in realistic settings. Participants perform goal-directed swallowing exercises involving advancing steps of altered bolus volume and consistency, guided by a 17-level task hierarchy and predetermined progression rules. The therapy includes 2 to 3 individual, face-to-face sessions per week lasting up to 45 minutes each, over a maximum of eight weeks. Between sessions, participants practice swallowing exercises during daily meals as self-training. Throughout the study, participants will be assessed using multiple measures including the McGill Ingestive Skills Assessment version 2, Functional Oral Intake Scale, Nordic Orofacial Test, Mini Nutritional Assessment, and Iowa Oral Performance Instrument. Self-reported swallowing difficulties, emotional wellbeing, quality of life, and psychological needs related to exercise will also be evaluated. These assessments occur from enrollment to the end of treatment at 8 weeks to monitor swallowing function, nutritional status, and therapy engagement.

Occupational Therapy Rehabilitation for Frail Elders with Dysphagia