Chin tuck against resistance exercise with feedback to improve swallowing, eating and drinking in frail older people admitted to hospital with pneumonia: a randomised controlled feasibility study (CTAR-SwiFt). (Preprint)
Notice bibliographique
Résumé
Background: Community-acquired pneumonia requiring hospital admission is considered to be frequently associated with swallowing difficulties (dysphagia), is common in frail older people. A rehabilitation programme (Chin tuck against resistance (CTAR)) targeting the anterior neck musculature involved in laryngeal movement can improve swallowing safety. We have developed a swallowing exercise rehabilitation intervention (CTAR-SwiFt) by adapting a previously established swallowing exercise to ensure patient safety and ease of execution in the frail elderly population. The CTAR-SwiFt intervention consists of a feedback-enabled exercise ball that can be squeezed under the chin, with real-time feedback provided via a mobile application. Objective: The aim of this study was to assess the “usability” of the CTAR-SwiFt intervention and the feasibility of recruiting participants to take part in a larger-scale multi-centre randomised controlled trial to improve swallowing ability and thus reducing community-acquired pneumonia and hospital admission. Methods: Methods Patients ≥75 years, admitted with a diagnosis of pneumonia to the acute frailty wards at two participating hospitals in the UK were recruited. Patients had to be medically stable. Study participants were randomised to one of three groups: standard care, low intensity (once daily), or high intensity (twice daily) CTAR-SwiFt exercises. The intervention period lasted for 12 weeks, the final follow-up assessment was conducted at 24 weeks. Feasibility outcomes, including participant recruitment rate and retention, compliance with the exercise regime and adverse incidents were assessed. Additionally, we assessed the usability and acceptability of the intervention device and performance of different clinical outcome measures (e.g., Chin Tuck Strength, Functional Oral Intake Scale, SWAL-QOL, EQ-5D and swallow speed). Results: 24 participants were recruited and 21 randomised, which was 40% of target, at the rate of 0.9 recruits per month (0.9-1). Of those approached 87.5% were willing to take part and of those recruited 11 (45.8%) completed the study. The major reason for failing to complete the study was medical with people becoming unwell or being re-admitted to hospital. The outcome measures assessed showed suggested that there was an improvement in the swallow assessed by the EAT-10 and 4QT though there was minimal impact on food intake (FOIS). Quality of life as measured by the EQ5D showed an improvement with time, the low intensity intervention demonstrated the best improvement. Participants were able to partake in the CTAR-SwiFt exercises and improve their consistency of ball squeeze over the course of the intervention, and increase their maximum chin touch strength, by a mean of 21%. Conclusions: CTAR has been demonstrated to improve the ability to swallow in different cohorts of patients. By improving the ability to swallow, in frail older patients admitted to hospital with pneumonia, using CTAR-SwiFt chin tuck exercises, the recurrence of pneumonia, readmission and an improvement in nutrition can be anticipated. Clinical Trial: ISRCTN, ISRCTN12813363. Registered 20 January 2020, https://www.isrctn.com/ISRCTN12813363.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,004 | 0,007 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,001 |
| Méta-épidémiologie (sens large) | 0,002 | 0,003 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,001 | 0,001 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,002 | 0,002 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,008 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».