Published articles relating to research around IQoro®, and the results of therapy based on its use.
Art. # 1 – Intervention study of orofacial regulation therapy combined with palate plate
Art. # 2 – Validation of the lip force meter, including the lowest normal value for lip strength, or more correctly the strength in the buccinators mechanism, calculated using the Muppy oral screen.
Art. # 3-12, 16 (published) + Art. # 15, 17, 18 (in progress) – Intervention study with IQoro®.
Several studies were made in secret before the patents for, and registered mark of, IQoro® were approved. For this reason the product name or pictures of the device could not be published, instead the generic description ‘oral screen’ was used.
Art. # 1, 3-5, 11, 12, 14, 16, 17 – Studies of oropharyngeal dysphagia.
Art. # 3 – After 5 to 8 weeks’ training with IQoro® 97 % of patients were improved, of which 66 % recovered a normal swallowing function, this being independent of whether treatment was started soon after the stroke, or later.
Art. # 4 – Discovered a significant correlation between lip force (LF) and swallowing capacity (SC) amongst patients with stroke (p = 0.012), but not amongst healthy subjects. LF was independent of age amongst healthy subjects, but SC reduced with increased age (p < 0.0001), although not to a pathological level. A regression analysis shows that the variation in SC was affected by LF and age to an extent of 73 %.
Art. # 5 – After 13 weeks of training with IQoro® (30 sec x 3 times per day) 71 % of stroke patients regained a normal swallowing function compared with patients that trained with a palate plate (30 min x 3 times per day). This positive effect remained, as seen at the long term checkup, 18 months after training ceased.
Art. # 6, 7, 8 – Studies of facial dysfunction and treatment show three* significant improvements after 12 weeks training with IQoro®; and that the effect remained 18 months later in articles 7 and 8. This positive effect with IQoro® was seen to be irrespective of whether the treatment started soon after stroke, or several years later.
Art. # 9, 10 – Studies of patient with esophageal dysphagia incl. misdirected swallowing, reflux, etc. for averagely 4 years (range 1-28 years) shows three* significant improvements after 6 to 8 months training with IQoro® 30 sec x 3 times per day. Training was required for several months where patients have had their difficulties for many years. Continued maintenance training two times a day, preferably before mealtimes, is probably required for best effect.
Art. # 11 – Studies of postural control, separate orofacial muscle groups, PEG-fed shows three* significant improvements in postural control, orofacial muscles, oro-pharyngeal dysphagia, and that the 5 PEG-fed patients could eat and drink and have their PEGs removed after 13 weeks’ training with IQoro®. This applied to 4 of 5 patients, the remaining patient having the PEG removed later. The effect remained as shown at the long-term checkup 18 months later.
Art. # 5, 7, 8, 11, 12, 14, 16, 17 – Studies which include long-term checkups.
Art. # 12-15, 17-18 – Not yet published.
Art. # 16 - SOFIA (Swallowing function, Oral health and Food Intake in old Age) – a national intervention study of training with IQoro®, short-term residents in care homes for the elderly in five counties in Sweden. The Swedish universities in Umeå, Örebro and Karlstad are involved with three Ph.D. students - a speech therapist, nurse and dental hygienist. More studies will be published.
Hägg M. Sensory motor brain plasticity in stroke patients with dysphagia. A methodological study on investigation and treatment. Faculty of Medicine, Uppsala University, 2007. Thesis
1. (Included in thesis, Paper I) Hägg M. Larsson B. Effects of Motor and Sensory Stimulation in Stroke Patients with Long-lasting Dysphagia. Dysphagia 19:219-230, 2004
2. (Included in thesis, Paper II) Hägg M, Olgarsson M. Anniko M. Reliable Lip force measurement in healthy controls and in patients with stroke: A methodological study. Dysphagia 2: pp291-296, 2008.
3. (Included in thesis, Paper IV) Hägg M, Anniko M. Lip muscle training in stroke patients with dysphagia. ActaOto-Laryngologica, 128 (9): pp1027-1033, 2008.
4. (Included in thesis, Paper III) Hägg M, Anniko M. Influence of lip force on swallowing capacity in stroke patients and in healthy subjects. ActaOto-Laryngologica 130: pp1204-8, 2010.
5. Hägg M, Tibbling L. Longstanding effect and outcome differences of palatal plate and oral screen training on stroke-related dysphagia. The Open Rehabilitation Journal, 2013, 6, pp 26-33
6. Hägg M.,Tibbling L. Four-quadrant Facial Function in Dysphagic Patients after Stroke and Healthy Controls. Neurology Research International Volume 2014, Article ID 672685,
5 pages, http://dx.doi.org/10.1155/2014/672685
Open access: http://www.hindawi.com/journals/nri/2014/672685/
7. Hägg MK., Tibbling LI. Effects on facial dysfunction and swallowing capacity of intraoral stimulation early and late after stroke. NeuroRehabilitation. 2015;36 (1):101-6. doi: 10.3233/NRE-141197. PMID: 25547771
Open access: http://content.iospress.com/download/neurorehabilitation/nre1197?id=neurorehabilitation%2Fnre1197
8. Hägg M., Tibbling L. Effect of oral IQoro® and palatal plate training in post-stroke, four-quadrant facial dysfunction and dysphagia: A comparison study. Acta Otolaryngol. 2015 Sep;135(9):962-8. doi:10.3109/00016489.2015.1042043. Epub 2015 May 7. PMID: 25947252
9. Hägg M, Tibbling L, Franzén T. Effect of IQoro® training in hiatal hernia patients with misdirected swallowing and esophageal retention symptoms
Acta Otolaryngol. 2015 Jul;135(7):635-9.
10. Hägg M, Tibbling L, Franzén T. Esophageal dysphagia and reflux symptoms before and after oral IQoro® training. World J Gastroenterol 2015; 21(24): 7558-7562
Open access: http://www.wjgnet.com/1007-9327/full/v21/i24/7558.htm
11. Hägg M., Tibbling L. Effect of IQoro® training on impaired postural control and oropharyngeal motor function in patients with dysphagia after stroke.
Acta Otolaryngol 2016; 136 (7):742-748. DOI:10.3109/00016489.2016.1145797 http://dx.doi.org/10.3109/00016489.2016.1145797.
12. Hägglund P., Olai L., Ståhlnacke K., Persenius M., Hägg M., Andersson M., Koistinen S., Carlsson E., Study protocol for the SOFIA project: Swallowing function, Oral health, and Food Intake in old Age: a descriptive study with a cluster randomized trial. BMC Geriatrics 2017, 17:78. DOI 10.1186/s12877-017-0466-8 Open access: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5364593/
13. Hägglund P., Fält A., Hägg M., Wester P., Levring Jäghagen E. Swallowing dysfunction as risk factor for undernutrition in older people admitted to Swedish short-term care: a cross-sectional study. Aging Clin Exp Res. 2018 Apr 16. doi: 10.1007/s40520-018-0944-7
14. Franzén T., Tibbling L., Hägg M. Oral neuromuscular training relieves hernia-related dysphagia and GERD symptoms as effectively in obese as in non-obese patients. Acta Oto-Laryngologica, DOI: 10.1080/00016489.2018.1503715
15. Hägglund P., Hägg M., Wester P., Levring Jäghagen E. Effects of neuromuscular treatment with an oral training device on swallowing dysfunction among older people in short-term care - a cluster randomized, controlled trial. Submitted to Age and Ageing (AA-18-0733.R1)
16. Hägg M., Hägglund P., Larsson B., Levring Jäghagen E., Wester P. Oral Screen training in patients with dysphagia after stroke – a prospective randomized open-label study with blinded evaluators.
17. Hägg M., Tibbling L. Meal observation test, on post-stroke long-lasting dysphagia, compared with a timed swallowing capacity test and VAS before, after the end of oral neuromuscular training, and at a late follow-up.
18. Snoring study
(Articles are in Swedish, the following is a translation of the articles’ titles into English)