Development and effectiveness of exercise rehabilitation system for dysphagia using information and communication technology systems.

Abstract

In older patients, dysphagia is a major risk factor for aspiration pneumonia and choking as it progresses slowly and recurs repeatedly without awareness. Information and communication technology (ICT) is used in various medical fields. However, no feeding or swallowing disorder prevention program has been developed to date and no reports have verified its effectiveness and safety. This study aimed to develop a dysphagia rehabilitation system using ICT and verify its effectiveness. Changes in swallowing function and functional prognosis were examined in 120 patients with aspiration pneumonia: 60 in the control and 60 in the ICT group. Physical therapists performed pulmonary rehabilitation in the control group. There were additional activities within the ICT rehabilitation system, such as motor and swallowing function evaluations, training sessions, and provision of dietary instructions, in addition to the rehabilitation content of the control group. The Functional Oral Intake Scale (FOIS) score, a measure of swallowing function, significantly improved in the ICT group (P<0.001). ICT use was considered an influencing factor of FOIS change (β=0.49, 95% confidence interval, 1.47 to 2.97 P<0.001). ICT use positively affected the Barthel index gain (β=0.49, 95% confidence interval, 14.73 to 32.72 P<0.001). A rehabilitation program using ICT improved swallowing function and the Barthel index. The system can also be used in sparsely populated and rural areas where there are few rehabilitation professionals, and high ripple effects are expected.