Summary

Summary

  • The technology described in this briefing is IQoro. It is a neuromuscular training device used for stimulating the nerves and strengthening the muscles in the face, mouth, throat, oesophagus, and diaphragm.

  • Swallowing therapy is the usual treatment for dysphagia (difficulty starting to swallow) after a stroke. The innovative aspect is that the company claims swallowing exercises can be more accurately and effectively done using IQoro. No similar technologies are currently recommended in care guidelines.

  • The intended place in therapy would be as well as standard speech and language therapy in people with stroke-related dysphagia.

  • The main points from the evidence summarised in this briefing are from 4¬†observational studies including 113¬†adults in Sweden with stroke-related dysphagia. They show that IQoro may be at least as effective as swallowing exercises done with a prosthetic device (palatal plate). One study found improvement with IQoro use regardless of whether the patients had early or late intervention.

  • Key uncertainties around the evidence are the lack of high-quality, randomised studies and the unclear effect of IQoro compared with NHS standard care or spontaneous improvement.

  • The cost of IQoro is ¬£116 per unit (excluding VAT). The resource impact would be additional to standard care. This may be offset if less time is needed for swallowing therapy with a speech and language therapist, or there is reduced need for enteral tube feeding.