Biofeedback therapy using accelerometry for treating dysphagic patients with poor laryngeal elevation: case studies

Dysphagia, a swallowing disorder, is a problem encountered frequently in the rehabilitation of stroke and head injury patients. In normal individuals, safe passage of a food bolus into the esophagus is ensured by laryngeal elevation and closure of the airway. Inadequate laryngeal elevation can lead to aspiration, choking, and even death. The course of recovery in the current clinical practice is rather tedious. Recently, investigators have developed and evaluated the accelerometry technique for noninvasive assessment of laryngeal elevation. The purpose of the present paper is to present case reports of patients with poor laryngeal elevation treated with computerized biofeedback therapy using dynamic acceleration measurements. Acceleration was measured from the dysphagic patient during swallowing, and was dynamically displayed on the computer screen along with an acceleration signal from a typical, normal subject. The patient was asked to elicit a swallow response such that his/her acceleration display matched the display of the normal subject. Each patient had nine therapy sessions, lasting about half an hour each. All five patients improved significantly in acceleration magnitude and in swallowing function as confirmed by the videofluorography evaluation.