The use of sensory and chemesthetic stimuli in the treatment of oropharyngeal dysphagia: scoping practice in the UK and Ireland

Background: This study was conducted as part of a wider study to discover if speech and language therapists working in the UK and Ireland are using sensory and chemesthetic stimuli in oropharyngeal dysphagia treatment and management and the reasoning behind its use. This is the qualitative component of the study. From analysis of the literature it appears that sensory and chemesthetic stimuli are not being utilized in oropharyngeal dysphagia therapy (Foley et al 2008; McCurtin 2012). Research evidence has emerged in recent years on the effectiveness of these stimuli. Objectives: To explicate the reasoning behind why speech and language therapists use or do not use sensory and chemesthetic stimuli in the management and treatment of dysphagia. Methods: A survey methodology was used. The survey link and recruitment email was sent out to the secretaries of dysphagia Special Interest Groups in Ireland and the UK. Thematic analysis was used. Results: Six main themes emerged. These themes include – what stimuli are used and when, to improve, risk factors, client benefits, lack of knowledge, lack of evidence and external factors. Both sensory and chemesthetic stimuli were reported as being used. A super-theme was developed from analysis of these themes entitled ‘Practice as specific, individual and safety conscious inhibited by barriers of a lack of knowledge, practicality and procedure’. This will be further explained in the discussion of results. Conclusions: From detailed analysis of the results the findings suggest that speech and language therapists have a clearly reasoned and though out approach for the management of dysphagia clients. The reasons for non-use can be described as around issues of practicality and knowledge with a lack of evidence also cited as problematic.