Swallowing Therapy in People with Parkinson’s Disease using Principles of Motor Learning and Ultrasound Biofeedback
Effect of Swallowing Therapy on efficiency of eating and drinking in People with Parkinson’s Disease using Principles of Motor Learning and Ultrasound Biofeedback
The University of Sydney
6 participants
May 14, 2025
Interventional
Conditions
Summary
Dysphagia (i.e., swallowing difficulties) is common among people with Parkinson’s Disease (PwPD). Parkinson’s Disease results in movements that are smaller and slower than desired. There is limited research evidence on intervention options that improve tongue movement patterns in PwPD. This study aims to develop and test an intervention program that works on improving tongue movement patterns when eating and drinking with the use of ultrasound visual feedback and principles of motor learning. The study will use a single case experimental design to determine the effectiveness of the developed intervention in reducing the time taken to eat and drink as well as its impact on quality of life in PwPD. The hypothesis is that PwPD with dysphagia who participate in a four-week intervention using ultrasound visual feedback and principles of motor learning will show improvements in their swallowing efficiency.
Eligibility
Inclusion Criteria7
- Participants with:
- Confirmed diagnosis of Idiopathic Parkinson’s Disease by a neurologist
- Self-reported changes in swallow function in the last 12 months
- Ability to assent to participation in study (either verbal or written)
- Presence of oral phase dysphagia as assessed by a speech pathologist.
- Medically stable
- Living in the community
Exclusion Criteria7
- Participants with:
- Other concomitant neurological disorders
- A history of head and neck cancer
- Unmanaged hearing or vision difficulties
- Nil by Mouth status.
- Unable to communicate in English
- Hospitalised with a respiratory tract infection in the last 12 weeks.
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Interventions
Intervention Name: Swallow Therapy with Ultrasound Biofeedback In this approach, an ultrasound probe will be placed under the participant’s chin and a real time video image of the tongue within the mouth will be seen while the participant is eating or drinking. This approach is referred to as ultrasound biofeedback. The intervention will consist of swallowing liquids or food with ultrasound biofeedback on the tongue movement pattern while swallowing. This is an individual intervention and will be delivered three times a week across four weeks. Each intervention session will take approximately 45-60 minutes and involve up to 50 swallows (either fluid, food, or saliva swallows). The intervention will be conducted face to face by a speech pathologist with more than five years of experience in managing swallowing difficulties. The intervention will take place at either the University of Sydney SPEECH Clinic or the participant’s home within metropolitan Sydney at a mutually convenient time. No home practice is required. The intervention will be individually titrated in terms of (a) frequency and duration of the treatment sessions, (b) the duration and frequency of breaks provided (c) the type of foods and fluids used, (d) the amount and type of feedback provided and (e) the number of times the participant is asked to swallow. These components will be altered based on participants’ fatigue level and response to the intervention protocol. Participant’s fatigue level will be monitored during each intervention session while the participant’s response to the therapy protocol will be reviewed on the 1st intervention session each week. To maintain treatment fidelity, intervention will be conducted as per a pre-written intervention protocol. Treatment fidelity will be reviewed by an independent speech pathologist for a random 20% selection of intervention sessions during the study using a checklist to ensure adherence to the intended protocol.
Locations(1)
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ACTRN12624001252505