ORCID Profile
0000-0002-6749-9390
Current Organisations
Danderyd University Hospital
,
Karolinska Institutet
,
Remeo
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Publisher: MDPI AG
Date: 31-01-2022
DOI: 10.3390/JCM11030776
Abstract: Objective. To assess the effects of neurostimulation (i.e., neuromuscular electrical stimulation (NMES) and pharyngeal electrical stimulation (PES)) in people with oropharyngeal dysphagia (OD). Methods. Systematic literature searches were conducted to retrieve randomised controlled trials in four electronic databases (CINAHL, Embase, PsycINFO, and PubMed). The methodological quality of included studies was assessed using the Revised Cochrane risk-of-bias tool for randomised trials (RoB 2). Results. In total, 42 studies reporting on peripheral neurostimulation were included: 30 studies on NMES, eight studies on PES, and four studies on combined neurostimulation interventions. When conducting meta analyses, significant, large and significant, moderate pre-post treatment effects were found for NMES (11 studies) and PES (five studies), respectively. Between-group analyses showed small effect sizes in favour of NMES, but no significant effects for PES. Conclusions. NMES may have more promising effects compared to PES. However, NMES studies showed high heterogeneity in protocols and experimental variables, the presence of potential moderators, and inconsistent reporting of methodology. Therefore, only conservative generalisations and interpretation of meta-analyses could be made. To facilitate comparisons of studies and determine intervention effects, there is a need for more randomised controlled trials with larger population sizes, and greater standardisation of protocols and guidelines for reporting.
Publisher: Informa UK Limited
Date: 08-04-2016
Publisher: Informa UK Limited
Date: 06-09-2022
DOI: 10.1080/14015439.2022.2117844
Abstract: To investigate: (a) Swedish Speech-Language Pathologists (SLPs) dysphagia management with TMC, including terminology, inter-professional collaboration, and knowledge of standard TMC guides and (b) the current TMC terminology/guides used within university hospitals, in Sweden. Part One surveyed SLPs from 19/21 regions. Recruitment occurred via regional SLP/department managers, the national SLP association and email lists. Non-parametric statistics were employed. Part Two explored TMC guides within the seven university hospitals. The initial survey identified 78 Swedish TMC terms. Overlap of both TMC Variable TMC terminology is used in Sweden, impacting optimal dysphagia management. Future research should focus upon implementation of standardised TMC terminology.
Publisher: MDPI AG
Date: 28-01-2022
DOI: 10.3390/JCM11030685
Abstract: Objective: To determine the effects of behavioural interventions in people with oropharyngeal dysphagia. Methods: Systematic literature searches were conducted to retrieve randomized controlled trials in four different databases (CINAHL, Embase, PsycINFO, and PubMed). The methodological quality of eligible articles was assessed using the Revised Cochrane risk-of-bias tool for randomised trials (RoB 2), after which meta-analyses were performed using a random-effects model. Results: A total of 37 studies were included. Overall, a significant, large pre-post interventions effect size was found. To compare different types of interventions, all behavioural interventions and conventional dysphagia treatment comparison groups were categorised into compensatory, rehabilitative, and combined compensatory and rehabilitative interventions. Overall, significant treatment effects were identified favouring behavioural interventions. In particular, large effect sizes were found when comparing rehabilitative interventions with no dysphagia treatment, and combined interventions with compensatory conventional dysphagia treatment. When comparing selected interventions versus conventional dysphagia treatment, significant, large effect sizes were found in favour of Shaker exercise, chin tuck against resistance exercise, and expiratory muscle strength training. Conclusions: Behavioural interventions show promising effects in people with oropharyngeal dysphagia. However, due to high heterogeneity between studies, generalisations of meta-analyses need to be interpreted with care.
Publisher: Springer Science and Business Media LLC
Date: 22-08-2022
DOI: 10.1007/S00455-022-10498-2
Abstract: Swallowing difficulties are estimated to affect 590 million people worldwide and the modification of food and fluids is considered the cornerstone of dysphagia management. Contemporary practice uses the International Dysphagia Diet Standardisation Initiative (IDDSI), however, the validity and reliability of IDDSI when translated into another language has not been investigated. This study describes the translation process and confirms the validity and reliability of IDDSI when translated into another language (Swedish). The translation used a 12-step process based on the World Health Organization recommendations. Validity was tested using Content Validity Index (CVI) based on three ratings by a panel of 10-12 experts (Dietitians and Speech-Language Pathologists [SLPs]). The translation was rated for linguistic correlation as well as understandability and applicability in a Swedish context. Inter-rater reliability was calculated using Intraclass Correlation Coefficient (ICC) from 20 SLP assessments of 10 previously published patient cases. Significant improvement (p 0.78 and Scale-CVI/Average > 0.8) and very high inter-rater reliability (ICC > 0.9) were demonstrated. Results show that, when using a multi-step translation process, a translated version of IDDSI (into Swedish) demonstrates high validity and reliability. This further contributes to the evidence for use of IDDSI.
Publisher: Elsevier BV
Date: 05-2021
Publisher: Wiley
Date: 24-03-2016
DOI: 10.1002/LARY.25919
Abstract: Laryngeal cancer and its treatment, despite management with organ-preservation treatments, is known to negatively affect voice and functional outcomes. The aim of this study was to determine whether functional outcomes and patient perceptions were improved by combining organ preservation with post treatment function rehabilitation. Randomized controlled trial. Sixty-one patients with carcinoma in situ (Tis) to T4 size laryngeal cancers treated with radiotherapy were prospectively recruited. Thirty patients were randomized into the voice rehabilitation (VR) group and 31 received no VR (control group). The VR group underwent 10 speech pathology sessions postradiotherapy. Voice function was evaluated pre-VR and at 6 and 12 months follow-up using the auditory-perceptual Grade, Roughness, Breathiness, Asthenia, and Strain (GRBAS) scale and patient perception measures. The control group demonstrated significant deterioration in vocal roughness (P = 0.02) between 6 to 12 months, whilst the VR group did not, resulting in a significant difference (P < 0.01) between the two groups at 12 months. A between-group significant difference (P = 0.02) was also observed for breathiness at 12 months. Patient perceptions of improved vocal quality, acceptability, hoarseness, vocal fatigue, and ashamed (of voice) pre- to post-VR improved significantly (P < 0.02) in the VR group, although significant difference (P = 0.03) between groups was observed post-VR for hoarseness only. For this study group representing Tis to T4-size laryngeal cancers, patients receiving voice rehabilitation post radiotherapy demonstrated no functional decline in vocal roughness and perceived their voice to improve to a greater extent post-VR than the control group. 1b. Laryngoscope, 126:2029-2035, 2016.
Publisher: Springer Science and Business Media LLC
Date: 02-04-2017
Publisher: MDPI AG
Date: 14-06-2022
DOI: 10.3390/JCM11123403
Abstract: Our systematic review and meta-analysis of pharyngeal electrical stimulation (PES) and neuromuscular electrical stimulation (NMES) in patients with oropharyngeal dysphagia (OD) is the first paper (Part I) [...]
Publisher: MDPI AG
Date: 14-02-2022
DOI: 10.3390/JCM11040993
Abstract: Objective. To assess the effects of brain neurostimulation (i.e., repetitive transcranial magnetic stimulation [rTMS] and transcranial direct current stimulation [tDCS]) in people with oropharyngeal dysphagia (OD). Methods. Systematic literature searches were conducted in four electronic databases (CINAHL, Embase, PsycINFO, and PubMed) to retrieve randomised controlled trials (RCTs) only. Using the Revised Cochrane risk-of-bias tool for randomised trials (RoB 2), the methodological quality of included studies was evaluated, after which meta-analysis was conducted using a random-effects model. Results. In total, 24 studies reporting on brain neurostimulation were included: 11 studies on rTMS, 9 studies on tDCS, and 4 studies on combined neurostimulation interventions. Overall, within-group meta-analysis and between-group analysis for rTMS identified significant large and small effects in favour of stimulation, respectively. For tDCS, overall within-group analysis and between-group analysis identified significant large and moderate effects in favour of stimulation, respectively. Conclusion. Both rTMS and tDCS show promising effects in people with oropharyngeal dysphagia. However, comparisons between studies were challenging due to high heterogeneity in stimulation protocols and experimental parameters, potential moderators, and inconsistent methodological reporting. Generalisations of meta-analyses need to be interpreted with care. Future research should include large RCTs using standard protocols and reporting guidelines as achieved by international consensus.
Publisher: Informa UK Limited
Date: 04-06-2018
Publisher: Informa UK Limited
Date: 18-11-2014
DOI: 10.3109/17549507.2013.855259
Abstract: This prospective, single-blinded study investigated the validity and reliability of cervical auscultation (CA) under two conditions (1) CA-only, using isolated swallow-sound clips, and (2) CSE + CA, using extra clinical swallow examination (CSE) information such as patient case history, oromotor assessment, and the same swallow-sound clips as condition one. The two CA conditions were compared against a fibre-optic endoscopic evaluation of swallowing (FEES) reference test. Each CA condition consisted of 18 swallows s les compiled from 12 adult patients consecutively referred to the FEES clinic. Patients' swallow sounds were simultaneously recorded during FEES via a Littmann E3200 electronic stethoscope. These 18 swallow s les were sent to 13 experienced dysphagia clinicians recruited from the UK and Australia who were blinded to the FEES results. S les were rated in terms of (1) if dysphagic, (2) if the patient was safe on consistency trialled, and (3) dysphagia severity. Sensitivity measures ranged from 83-95%, specificity measures from 50-92% across the conditions. Intra-rater agreement ranged from 69-97% total agreement. Inter-rater reliability for dysphagia severity showed substantial agreement (rs = 0.68 and 0.74). Results show good rater reliability for CA-trained speech-language pathologists. Sensitivity and specificity for both CA conditions in this study are comparable to and often better than other well-established CSE components.
Publisher: Informa UK Limited
Date: 26-12-2020
Publisher: Informa UK Limited
Date: 30-07-2022
Publisher: Springer Science and Business Media LLC
Date: 31-05-2022
DOI: 10.1007/S00455-022-10465-X
Abstract: Oropharyngeal dysphagia (OD) is prevalent in the elderly and persons with complex medical conditions, resulting in considerable medical and psychosocial consequences and reduced quality of life. Many prevalence studies regard OD in relation to age or diagnosis. Knowledge on the prevalence of OD in different healthcare settings is lacking. This systematic review aimed to estimate the prevalence of OD in adults admitted to hospitals, rehabilitation facilities, nursing homes, and palliative care facilities through meta-analyses. A systematic literature search was completed including all dates up to March 30, 2021. The methodology and reporting were based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Forty-four out of 1,956 screened articles were deemed eligible. Considerable heterogeneity in definitions of OD and type and quality of selected outcome measures were observed. Overall within-group pooled prevalence estimates for OD determined by meta-analysis were 36.5% (95% CI 29.9 − 43.6) in the hospital setting, 42.5% (95% CI 35.8 − 49.5) in the rehabilitation setting, and 50.2% (95% CI 33.3–67.2) in nursing homes. No OD prevalence data were identified for palliative care facilities. Results for between-group analyses of OD prevalence estimates in the hospital setting were non-significant for type of assessment method, diagnostic group, and type of hospital ward, but indicated significantly higher prevalence estimates in nursing homes when using screening compared to patient-report. Future research should provide OD prevalence data for palliative care, achieve consensus in OD-related terminology when performing prevalence studies, and use screening and assessments with optimal diagnostic performance and psychometric properties.
Publisher: Informa UK Limited
Date: 02-05-2017
DOI: 10.1080/17549507.2017.1317360
Abstract: Successful communication is influenced by communication partners, the community and communication environment. This study examines community members' perceptions of voice function following laryngeal cancer management compared to ratings by clinicians and patients. Sixty-six (Tis-T3) laryngeal cancer patients post-radiotherapy, 10 community members and three speech-language pathologists (clinicians) were recruited. Patients completed voice recordings and self-rated voice quality and acceptability, six months post-radiotherapy. Community members and clinicians rated patient voice recordings using (a) Voice Quality/Acceptability questionnaire, (b) Communicative Suitability Scale (voice function in different vocally demanding environments) and (c) a gender perception question. Ratings for voice quality differed significantly (p < 0.001) between community members and clinicians and approached significance (p= 0.08) between community members and patients. No significant difference for voice acceptability was noted between community members and clinicians atients. Community members rated the irradiated voice significantly different (p ≤ 0.02) across communication environments with more vocally demanding environments being rated as "Barely Sufficient". Incorrect sex identification (gender perception) occurred with 25% of females. Community communication partners identify functional voice impairments post-radiotherapy, particularly across more vocally demanding environments and for female speakers. Implications for voice rehabilitation including appropriate patient selection is highlighted.
Publisher: Springer Science and Business Media LLC
Date: 15-07-2022
DOI: 10.1007/S00455-022-10468-8
Abstract: This study investigated the reliability and validity (sensitivity and specificity) of cervical auscultation (CA) using both swallow and pre-post swallow-respiratory sounds, as compared with Flexible Endoscopic Evaluation of Swallowing (FEES). With 103 swallow-respiratory sequences from 23 heterogenic patients, these swallows sounds were rated by eight CA-trained Speech-Language Pathologists (SLPs) to investigate: (1) if the swallow was safe (primary outcome) (2) patient dysphagia status (3) the influence of liquid viscosity on CA accuracy (secondary outcomes). Primary outcome data showed high CA sensitivity (85.4%), and specificity (80.3%) with all consistencies for the safe measurement, with CA predictive values of [Formula: see text] 90% to accurately detect unsafe swallows. Intra-rater reliability was good (Kappa [Formula: see text] 0.65), inter rater reliability moderate (Kappa [Formula: see text] 0.58). Secondary outcome measures showed high sensitivity (80.1%) to identify if a patient was dysphagic, low specificity (22.9%), and moderate correlation (r
No related grants have been discovered for Liza Bergström.