Patients with dysphagia are often asked to use compensatory techniques or manoeuvres to facilitate safe swallowing. For example, they may be taught to do a supraglottic swallow to minimise aspiration or a specific postural adjustment to support bolus flow. These manoeuvres can sometimes be difficult to explain and they require the act of swallowing each sip or food bolus to be brought into the conscious awareness of the dysphagic person. The authors of this paper report on the development and validation of 3D iconographic videos as well as the feasibility of using the videos during telehealth consultations. The videos were developed using a detailed script of the physiological sequence of events that occurred during each manoeuvre. The script was informed by a systematic review of the literature. In this way, nine videos were created including postural techniques such as chin down, head rotation and facilitating manoeuvres such as the supraglottic swallow and the Mendelsohn. The videos were evaluated by expert judges encompassing a range of relevant expertise, who rated the videos on a scale based on specific questions. Adjustments were made and a second round of expert review was invited, obtaining a content validity index of 0.8 for all items. Four of the nine manoeuvres were then tested on 10 patients tailored to their specific dysphagia via a teleconsultation. At the end of the session, patients were asked to complete a questionnaire on their experience of the 3D video. This showed that all patients either agreed or totally agreed that the videos helped their understanding of how to perform the manoeuvre, what happens when the manoeuvre is done and how it helps their swallowing more than verbal explanations alone. The authors highlight that with an ageing population and the greater integration of technology, such innovations will be important in how we reach patients in the community, making our therapies more accessible. They acknowledge limitations and highlight that this is a first step toward refining the videos and undertaking larger studies.
The use of 3D videos to improve patient engagement with compensatory swallowing strategies
Reviewed by Roganie Govender
Physiology and Execution of Swallowing Maneuvers in 3D Videos: Integrating the Technology into Patient Care.
CONTRIBUTOR
Roganie Govender
University College London, Head & Neck Academic Centre, UK.
View Full Profile
