Eclectic Approach to Dysphagia Management in COPD Patients: A Quasi-experimental Study

Background: This study aimed to investigate the effects of an eclectic, tailor-made swallowing therapy program on individuals with chronic obstructive pulmonary disease (COPD) and dysphagia.The subjects were assessed using various clinical and instrumental measures before and after the therapy sessions.Materials and methods: A quasi-experimental design was employed, and 152 COPD subjects (75 males and 77 females) aged between 40 and 65 years were selected through purposive sampling from a time period of June 2023 to October 2024 at B.P. Poddar Hospital & Medical Research LTD., Kolkata.Baseline assessments included pulmonary function tests, spirometry profiles, and subjective evaluations.Objective assessments involved pulse oximetry, the Mann Assessment of Swallowing Ability (MASA), cervical auscultation, and fiberoptic endoscopic evaluation of swallowing (FEES).The therapeutic intervention consisted of 15 sessions of individualized therapy, targeting respiratory strength, oromotor coordination, and swallow reflex.Results: Pretherapy assessments revealed moderate dysphagia and aspiration in the participants.Following the therapy program, significant improvements were observed in oxygen saturation levels, MASA scores, cervical auscultation findings, and PAS scores obtained from FEES.The posttherapy MASA scores indicated no dysphagia, demonstrating a statistically significant improvement compared to the pretherapy scores.The cervical auscultation findings showed controlled coordination between respiration and swallowing, decreased airway secretions, and improved respiratory-swallow patterns.Fiberoptic endoscopic evaluation of swallowing results indicated a reduction in penetration and aspiration, with decreased residue and improved swallow reactions. Conclusion:The swallowing therapy program resulted in significant improvements in swallowing function and respiratory-swallow coordination in individuals with COPD and dysphagia.These improvements were observed through various objective assessments, highlighting the effectiveness of the therapy program in enhancing swallowing safety and efficiency.