8. Effect of oral IQoro and palatal plate training in post-stroke, four-quadrant facial dysfunction and dysphagia: A comparison study.

Hägg M., Tibbling L. Acta Otolaryngol. 2015 Sep;135(9):962–8.

Abstract as published

Conclusion Training with either a palatal plate (PP) or an oral IQoroR screen (IQS) in patients with longstanding facial dysfunction and dysphagia after stroke can significantly improve facial activity (FA) in all four facial quadrants as well as swallowing capacity (SC). Improvements remained at late follow-up. The training modalities did not significantly differ in ameliorating facial dysfunction and dysphagia in these patients. However, IQS training has practical and economic advantages over PP training. Objectives This study compared PP and oral IQS training in terms of (i) effect on four-quadrant facial dysfunction and dysphagia after a first-ever stroke, and (ii) whether the training effect persisted at late follow-up. Methods Patients were included during two periods; 13 patients in 2005–2008 trained with a PP, while 18 patients in 2009–2012 trained with an IQS. Four-quadrant facial dysfunction was assessed with an FA test and swallowing dysfunction with a SC test: before and after a 3-month training period and at late follow-up. FA and SC significantly improved (p < 0.001) in both groups. FA test scores after training and at late follow-up did not differ significantly between the groups, irrespective of whether the interval between stroke incidence and the start of training was long or short.

Relevance to conditions

Dysphagia: Proof of effect of IQoro and PP on swallowing, facial paresis in stroke patients.

Study type

Peer reviewed, Prospective, Randomized, Cohort pre- and post-study.

Aim

To compare Palatal Plate (PP) and IQoro Neuromuscular Training (IQNT) in terms of (i) effect on four-quadrant facial dysfunction and dysphagia after a first-ever stroke, and (ii) whether the training effect persisted at late follow-up.

Patients

  • 13 adult patients with PP, F=2, M=11, median age 68 (range 46–82). Median 59 weeks post stroke.
  • 18 adult patients with IQNT, F=9, M=9, median age 66 (range 53–81). Median 5 weeks post stroke.

Methods

13 patients in 2005–2008 trained with a PP for 90 minutes per day, while 18 patients in 2009–2012 trained with an IQoro for 90 seconds per day. Patients were evaluated at baseline, after 3 months of treatment and at late follow-up (>1 year).

Outcome measurements

  • Facial Activity Test (FAT)
  • Swallowing ability (using Timed Water Swallow Test – TWST) – lower normal value for swallowing rate ≥ 10 ml / sec.

Results

Facial activity and swallowing ability significantly improved (p < 0.001) in both groups. FAT scores at end-of-training and at late follow-up did not differ significantly between the groups, irrespective of whether the interval between stroke incidence and the start of training was long or short.

Statistical significance of result

(p < 0.001) swallowing ability (TWST) for both PP and IQNT treatments.
(p < 0.001) orofacial sensory and motor test (FAT) for both PP and IQNT treatments.

Conclusion

There is little difference between the effectiveness of palatal plate and IQoro neuromuscular treatments, but large practical and economic advantages in using IQoro. The results support the evidence that improvement is not a result of spontaneous remission.