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The Capital Region of Denmark - a part of Copenhagen University Hospital

  Swallowing therapy for patients with severeTraumatic Brain Injury:Mapping complex therapeutic procedures as well as the importance of therapist behavior  (PhD project)

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Background

Patients with traumatic brain injury (TBI) are at risk of developing problems with swallowing, eating, drinking, verbal, and nonverbal communication. 1, 2. Preliminary results from this PhD study shows that 93% of the patients admitted to the brain injury unit (BIU), Hvidovre Hospital have some degree of problems with oral intake, 12% develop pneumonia at BIU and 46% get a PEG. Occupational therapist's treats swallowing problems at BIU using a special rehabilitation concept: Facial Oral Tract Therapy (F.O.T.T.TM)3. It is the only swallowing therapy used in Denmark and widely used in Scandinavia, Germany, United Kingdom, Switzerland and Japan, however there is no description of how to use it, no definitions of the different ingredients (techniques) used in the therapy and there is no evidence for its effect.

One important aspect of swallowing therapy and other disciplines involved in the rehabilitation program is the interaction between the therapist and the patient and the patient's engagement in the process 4. However client-therapeutic interaction is very different within rehabilitation of patient with TBI in minimal conscious or vegetative state and there is still a lot to understand about the "best" behavior towards the patients.

Objectives

The overall objective is to assess the incidence and severity of swallowing difficulties is at BIU, Hvidovre Hospital and to describe how the F.O.T.T.TM concept is used in an inpatient traumatic brain injury unit. Second, to develop and validate outcome measures related to F.O.T.T. and to standardize therapist behavior to which very severe injured patients respond in a positive manner.

Methods

F.O.T.T.TM 1: Oral intake and pneumonia

The aim is to estimate the incidence and severity of the patents problems with oral intake at BIU between 1. January 2000 and 31 of December 2005 and the association between oral intake and pneumonia.

F.O.T.T.TM part 2: To develop and implement a treatment algorithm and standardize the clinical evaluation of swallowing for F.O.T.T.TM

The aim of this study is to define and standardize  F.O.T.T. by developing af treatment algorithm. Further to develop a outcome measure for at least one of the four areas of F.O.T.T.

F.O.T.T.TM part 3: Measurement of swallowing.

The aim of this study is to validate the F.O.T.T.TM evaluation of swallowing and the CLA by comparing them with a golden standard: FEES.

F.O.T.T.TM part 4: Positive behavior of the occupational therapist

To assess whether it is possible to standardize non therapeutic specific behavior of the OT (behavior not related to the rehabilitation concepts (F.O.T.T.)), which has special positive impact on patient's response.

StatusCompleted
Period01/06/200601/06/2009
Research programme<ingen navn>

ID: 32499872