Development and evaluation of the effectiveness of the action observation therapy program in patients with neurogenic dysphagia

Action Observation Therapy (AOT) has emerged as a potential neurorehabilitation therapy to promote motor control for individuals with neurogenic dysphagia (ND), facilitating neural plasticity through activation of the mirror nervous system. The aim of this study was to investigate the effect of GHT-based swallowing training program on suprahyoid (SH) muscle activation, dysphagia symptom severity, swallowing function, swallowing-related quality of life and emotional state in individuals with ND. 34 participants with ND were randomly allocated to the AOT group (n = 17) or control group (n = 17). The AOT group watched exercise videos before doing these exercises, and the control group performed the same exercises without the videos. Individuals in the AOT group first watched videos of the task performed by a real person and then performed the exercises based on the video. All participants received a training program for 4 weeks, 5 sessions per week, 20 sessions in total. SH muscle activation by surface electromyography (sEMG), dysphagia symptom severity by Eating Assessment Tool-Turkish Version (T- EAT 10), swallowing function by Swallowing Ability and Function Evaluation (SAFE), swallowing-related quality of life by Turkish Swallowing Quality of Life Questionnaire (T-SWAL-QOL) and depressive symptoms by Beck Depression Scale (BDS) were evaluated. Post-treatment SH amplitude level and T-EAT-10 scores were significantly lower in the AOT group compared to the control group (p=0.001, p=0.012). There was a significant improvement in SAFE after treatment in the AOT group (p<0.05), however there was no significant difference between the two groups (p>0.05). Both groups showed similar improvement in terms of quality of life and depression scores (p>0.05). AOT-based swallowing training has a positive effect on swallowing function, quality of life and depressive symptoms in individuals with ND. AOT-based swallowing training may be a better neurorehabilitation method to improve SH muscle activation and dysphagia symptom severity.