Impact of Lingual Endurance Exercise on Rehabilitation of Swallowing Impairments after Ischemic Stroke (K01)
Now Enrolling

Funded by the National Institutes of Health (NIH). The primary aim of this study is to examine the effects of lingual endurance exercise vs sham exercise in participants experiencing post-stroke dysphagia. This study also seeks to better understand lingual exercise training on neuroplasticity. We are currently looking for participants who have difficulty swallowing that are 3-6 months post ischemic stroke. Participants must also be at least 18 years of age and have no history of other neurological conditions. Contact us at 513-479-6439 if you are interested in participating!

Effects of Lingual Endurance Exercise on Rehabilitation of Swallowing Impairment after Ischemic Stroke (Pilot Study)
Study Complete

Funded by the UC CoM Pilot Award and through NIH Shirley Ryan Ability Lab C-STAR Award. The purpose of this study is to determine the impact of lingual endurance exercises on lingual function and the efficacy of lingual endurance training on improving critical aspects of oropharyngeal swallowing in individuals with chronic dysphagia post stroke. 

PRO-ACTIVE TRIAL 

Study Complete

The primary aim of this international, multi-site 3-arm pragmatic randomized clinical trial is to compare the effectiveness of PRO-ACTIVE (high and low intensity) versus RE-ACTIVE swallowing therapy among 952 patients with HNC planning to undergo RT, using duration of feeding tube dependence after RT as the primary outcome. Our secondary aim proposes to compare the relative benefit or harm of these swallowing interventions on secondary outcomes considered relevant to our stakeholder partners.

Lingual Rehabilitation Framework.

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In partnership with our OSU Collaborator, Veena Kallambetu, we are developing a framework of lingual rehabilitation exercises, including Epic templates and dosing guidelines for clinical implementation. Informed by the literature, and decades of combined clinical practice of our team, this framework can serve as a current guide to available approaches to lingual rehab as a part of dysphagia rehab practice. 

DIGEST Stroke Validation Study. 

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In conjunction with our collaborators at MD Anderson Cancer Center, Drs. Kate Hutcheson and Carly Barbon, and Dr. Bonnie Martin-Harris at the Swallowing Cross Systems Collaborative at NU, we are working to validate use of the Dynamic Imaging Grade of Swallowing Toxicity (DIGEST) scale for use in post-stroke populations. The DIGEST scale provides safety and efficiency grades for consequences of swallowing impairment and was originally validated for use in patients who have been treated for head and neck cancers. 

Meal Consumption Impact on Isotonic Lingual Endurance
Study Complete

In collaboration with Moravian University and the University of Neveda Reno, this study has been designed to evaluate lingual endurance before and after mealtime in healthy participants. By comparing results of young adults (18-35) and results in older individuals (65+), we also examine the difference in fatigue in relation to age. Participants will complete lingual tasks that measure isotonic endurance throughout a standardized meal. Contact us if you are interested in participating!

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Ultrasound and Swallowing 

Pending NIH Grant Review 

This study aims to provide essential, fundamental evidence validating ultrasound measurements for characterization of swallowing movements, forming the foundation for future improvements in dysphagia treatment. Older individuals are at increased risk for swallowing impairments (dysphagia), and in many remote care settings (e.g. nursing homes, home health) their treating clinicians do not have access to fluoroscopic imaging equipment for diagnosis, monitoring, and treatment of swallowing disorders. Ultrasound imaging is a promising option that would allow providers and patients to see swallowing movements in real time. This study seeks to establish validity and reliability of ultrasound as a method to objectively characterize swallowing outside the fluoroscopy suite. Funding for this study has been provided by UC College of Medicine Pilot Award Program (PI Howell). Further investigation pending NIH review. 

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Greater Cincinnati Northern Kentucky Stroke Study Epidemiological Investigation of Dysphagia after Stroke. Prior investigations of dysphagia after ischemic or hemorrhagic infarcts have focused primarily on characterizing specific impairments in swallow physiology based on lesion location and extent of white matter disease (WMD). However, factors that increase risk of dysphagia after stroke are poorly understood. This investigation examines factors related to risk of dysphagia after stroke using data from a large population-based study: the Greater Cincinnati Northern Kentucky Stroke Study (GCNKSS). 

DEVICE FACILITATED LINGUAL STRENGTH AND SKILL 

Study Complete

Currently taking data measurements of tongue strength and skill to compare two different devices which are currently used in Speech-Language Pathology for the treatment of dysphagia, the Tongeuometer and IOPI. This study also investigates the relationship between lingual function and swallowing deficits in post-stroke dysphagia. Funding provided by the American Speech-Language Hearing Association Foundation.