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Introducing Synchrony

Nurse and Patient

Developed by Accelerated Care Plus (ACP), Synchrony is a new comprehensive clinical program for the treatment of Dysphagia. The program includes evidence-based protocols, proprietary technologies, ASHA-approved SLP training and ongoing support for post-acute and chronic rehabilitation providers.

Program Objectives and Benefits

  • Improve outcomes and quality of life for individuals with Dysphagia
  • Reduce facility costs related to Dysphagia
  • Reduce hospital recidivism
  • Reduce aspiration pneumonia, malnutrition, dehydration and other complications
  • Introduce new treatment options for patients and residents who may not have responded to traditional therapies
  • Strengthen census and referrals through clinical expertise and progressive treatment techniques

The Synchrony program uses an exclusive electrical stimulation waveform called PENS or “Patterned Electrical Neuromuscular Stimulation” to enhance muscle strength and coordination required for normal swallowing. This patented approach is used in conjunction with the world's first virtual reality augmented sEMG biofeedback system for the treatment of Dysphagia. This unique technology, called the OMNIsEMG®, enables Speech Language Pathologists and their patients to visualize swallowing activity, and guide therapeutic intervention. Patients participate in a variety of virtual reality based exercise activities that are therapeutic, fun, and engaging. While “immersed” in these activities, patients exercise for longer periods with greater intensity, which can help improve swallowing performance and outcomes.

Dysphagia Overview

Dysphagia Diagram and Drawing

Dysphagia (Dys-PHA-ja) is a medical term used to describe difficulty with swallowing… typically due to muscle or nerve damage.

Dysphagia impacts the physical, social, and emotional quality of life for millions of Americans and can lead to serious medical complications including dehydration, malnutrition, and aspiration pneumonia.

Dysphagia Statistics

  • Approximately 15 million people have Dysphagia in the U.S.
  • 1 million new cases are reported each year
  • Up to 74% of skilled nursing residents have symptoms of Dysphagia - from mild to severe
  • Approximately 60,000 individuals die annually from complications of Dysphagia
  • Annual costs for patients with Dysphagia can exceed $30,000 per year

Impact of Dysphagia

  • Serious complications such as dehydration, malnutrition, aspiration pneumonia, higher rates of infection, as well as increased long term institutionalization
  • Patients with Dysphagia are 2x as likely to be admitted to hospital with decubitus ulcers
  • Aspiration pneumonia leading to hospital recidivism - patients with Dysphagia are 5x more likely to be admitted to hospital
  • Compromised quality of life and an inability to participate in many normal social activities
  • Impact to emotional well-being that can eventually lead to depression

Improving Outcomes

Synchrony™ technologies and treatment protocols are based on evidence-based literature demonstrating favorable outcomes for the treatment of Dysphagia. Specifically, they address the nerve and muscle dysfunction typically associated with Dysphagia to help improve swallowing performance.

Omnistim® FX2 “Patterned Electrical Neuromuscular Stimulation”

Clinical Benefits

  • Helps re-establish normal nerve and muscle firing patterns
  • Helps recruit and strengthen muscles involved with normal swallowing
  • Effective with neurological symptoms associated with stroke, Parkinson's Disease, Multiple Sclerosis, Cerebral Palsy, etc. that may cause Dysphagia
  • PENS patents include applications for the treatment of Dysphagia

OMNIsEMG® Virtual Reality Augmented Biofeedback

Clinical Benefits

  • Enables SLPs and patients to visualize swallowing activity
  • Produces “real-time” swallowing data to guide treatment and patient interaction
  • Virtual reality enhanced activities engage patients to improve exercise performance
  • Captures objective measurement data for treatment progression and outcomes

Clinical Research

  • Rehabilitation literature increasingly demonstrates that neuroplastic changes are possible even in chronically involved, aged individuals
  • Behavioral swallow therapy can recruit alternative, lesser involved or non-impaired brain centers resulting in improved, yet modified, deglutition
  • An ever-increasing number of clinical Dysphagia studies show positive changes in swallowing behavior, including subjects with chronic conditions

Synchrony™ Program Components

System Highlight photos

Omnistim® FX2 “Patterned Electrical Neuromuscular Stimulation” (PENS): With multiple technology patents, this exclusive electrical stimulation waveform helps re-establish normal nerve and muscle firing patterns. The PENS waveform provides superior neuromuscular re-education, as well as effective treatment for the muscle weakness that typically accompanies this condition. PENS is also used to help “warm-up” muscles prior to using the OMNIsEMG® system described below and other therapeutic exercise techniques. Complete SLP training is provided around this system.

Omnistim FX2 Clinical Objectives

  • Improve swallow coordination
  • Enhance neuromuscular performance related to swallow
  • Increase oropharyngeal muscle force output

OMNIsEMG® Virtual Reality Assisted Therapy: Using biofeedback signals, this unique Virtual Reality Assisted System allows SLPs and patients to “see the swallow” during treatment for the first time. This important capability helps SLPs evaluate the quality of a swallow to guide therapeutic intervention, and to capture objective measurement data to demonstrate treatment progression and outcomes. The system also features several game-like, interactive activities shown on a monitor, which helps motivate patients for greater exercise duration and intensity. Complete SLP training is provided around this system.

OMNIsEMG® Clinical Objectives

  • Enable SLPs and their patients to visualize swallow activity
  • Provide visual and auditory feedback to facilitate swallow behavioral change
  • Encourage greater exercise intensity and duration through “immersive” virtual reality augmented activities
  • Optimize application of progressive resistance exercise principles using system output data
  • Provide real-time assessment of treatment effectiveness
  • Capture objective measurement data for swallowing time periods and muscle activity for treatment guidance and documentation

Clinical Research

To view clinical research abstracts related to Dysphagia and the Synchrony™ program, click the grey bars below.

Skill training for swallowing rehabilitation in patients with Parkinson's disease.

Arch Phys Med Rehabil. 2014 Jul;95(7):1374-82. doi: 10.1016/j.apmr.2014.03.001. Epub 2014 May 9. Athukorala RP1, Jones RD2, Sella O3, Huckabee ML3. Author information

Abstract

Objective: To examine the effects of skill training on swallowing in individuals with dysphagia secondary to Parkinson's disease (PD) and to explore skill retention after treatment termination.

Design: Within-subject pilot study with follow-up after 2 weeks of treatment and after a 2-week nontreatment period.

Setting: Clinic in a research institute.

Participants: Patients (N=10; mean age, 67.4y) included 3 women (mean Hoehn and Yahr score, 2.6) and 7 men (mean Hoehn and Yahr score, 2.4).

Intervention: Patients underwent 10 daily sessions of skill training therapy focused on increasing precision in muscle contraction during swallowing using visual feedback.

Main Outcome Measures: Data from the timed water swallow test, Test of Mastication and Swallowing Solids, surface electromyography (sEMG) of submental muscles, and swallowing-related quality of life questionnaire were collected at 2 baseline sessions (conducted 2wk apart) at the end of treatment and after 2 nontreatment weeks to assess skill retention.

Results: Immediately after posttreatment, the swallowing rate for liquids (P=.034), sEMG durational parameters of premotor time (P=.003), and preswallow time (P.001) improved. A functional carryover effect was seen from dry to water swallows (P=.009). Additionally, swallowing-related quality of life improved (P=.018). Reassessment at 2 weeks after treatment termination revealed short-term retention of treatment effects.

Conclusions: A skill-based training approach produced functional, biomechanical, and swallowing-related quality of life improvements in this cohort indicating compelling evidence for the effectiveness of this novel approach for dysphagia rehabilitation in PD

Outcomes of swallowing rehabilitation in chronic brainstem dysphagia: A retrospective evaluation.

Dysphagia. 1999 Spring;14(2):93-109. Huckabee ML1, Cannito MP. Author information

Abstract

This study examines the functional and physiologic outcomes of treatment in a group of 10 patients with chronic dysphagia subsequent to a single brainstem injury. All patients participated in a structured swallowing treatment program at a metropolitan teaching hospital. This program differs from more traditional swallowing treatment by the inclusion of surface electromyography biofeedback as a treatment modality and the completion of 10 hr of direct treatment in the first week of intervention. A retrospective analysis of medical records and patient questionnaires was used to gain information regarding medical history, site of lesion, prior interventions, and patient perception of swallowing recovery. Physiologic change in swallowing treatment, as measured by severity ratings of videofluoroscopic swallowing studies, was demonstrated in nine of 10 patients after 1 week or 10 sessions of treatment. Functional change was measured by diet level tolerance after 1 week of treatment, at 6 months, and again at 1 year posttreatment. Eight of the 10 patients were able to return to full oral intake with termination of gastrostomy tube feedings, whereas two demonstrated no long-term change in functional swallowing. Of the eight who returned to full oral intake, the average duration of tube feedings following treatment until discontinuation was 5.3 months, with a range of 1-12 months. Six patients who returned to oral intake maintained gains in swallowing function, and two patients returned to nonoral nutrition as the result of a new unrelated medical condition.

Functional benefits of dysphagia therapy using adjunctive sEMG biofeedback.

Dysphagia. 2004 Summer;19(3):160-4. Crary MA1, Carnaby Mann GD, Groher ME, Helseth E. Author information

Abstract

This article describes a retrospective analysis of functional outcome, time in therapy, and cost per unit of functional change in patients who received therapy for pharyngeal dysphagia. Twenty-five patients presenting dysphagia following stroke and 20 patients with dysphagia following treatment for head/neck cancer completed a systematic therapy program supplemented with surface electromyographic (sEMG) biofeedback. Eighty-seven percent (39/45) of all patients increased their functional oral intake of food/liquid including 92% of stroke patients and 80% of head/neck cancer patients. Patients with dysphagia following stroke demonstrated greater improvement than those in the head/neck cancer group. Patients in the stroke group completed more therapy sessions thus increasing the total cost of therapy, but they made more functional progress resulting in lower costs per unit of functional change than patients in the head/neck cancer group. Limitations of this study are described in reference to implications for future clinical research on the efficacy of this therapy approach.

Synchrony™ Education and Training

Educational and Training information

ACP provides complete SLP Training around the Synchrony™ program, with ongoing training and support from ACP’s team of SLP Clinical Program Consultants. Training includes:

  • Initial installation and basic system operation
  • All subsequent training includes CEU-Approved Education and Lab Training
    • A 5-hour “on-site” course around ACP’s OMNIsEMG® system
    • A 7-hour “seminar-style” course can be provided for multiple facilities
    • A 2.5-hour “on-site” course for the Omnistim® FX2 PENS system
  • ACP is an ASHA Approved Continuing Education Provider

  • Dysphagia 5-HR
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  • Dysphagia 7-HR
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Patient Success Stories

  • Synchrony Subdural Hematoma aspiration pneumonia Intubation
  • Synchrony PENS Chronic Obstructive Pulmonary Disease Pneumonia
  • Synchrony PENS CVA Pneumonia
  • PENS sEMG Dysphagia Radial Nerve Impingement

Press Room

For downloadable images regarding the Synchrony system, click on the links below.



     
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Videos

  • “Kangaroo” exercise visualization
Revolutionizing Rehabilitation