Development of Innovative Feedback Device for Swallowing Therapy

Dysphagia, which results from various disorders, may increase the risk of aspiration pneumonia, dehydration, and malnutrition. The aim of this study was to develop an innovative evaluation and treatment system for swallowing therapy using virtual reality (VR) feedback and electrical stimulation (ES), and to make an initial evaluation of its potential. In this system, the activation of the submental muscle and acceleration of laryngeal movement are used as the evaluation and feedback information. Twenty-one patients with chronic dysphagia for an average of 26.3 months were recruited for the VR feedback study. Each participant underwent 16 treatment sessions. After therapy, the Functional Oral Intake Scale results changed from 3.3 ± 1.5 to 5.0 ± 1.6 with statistical significance (p = 0.000). Thirteen healthy subjects were enrolled in the ES study. ES was applied for more than 2 s while the subjects were swallowing. With and without ES, swallowing triggering times were 456.17 ± 106.92 and 552.13 ± 105.97 ms, respectively. These differences were statistically significant (p = 0.04). Accelerations of laryngeal movement were 0.23 ± 0.1 g (g = 9.8 m/s²) and 0.20 ± 0.08 g, respectively, with a significant statistical difference (p = 0.033). The feasibility of a prototype that combines swallowing evaluation, VR feedback therapy, and synchronized ES is demonstrated for further clinical trials. Further comprehensive clinical studies are needed to verify the clinical efficacy of the device.