The primary outcome was changes in swallowing rate measured by TWST [10–12] at the end of treatment compared with baseline and 12 months post-treatment, within each group and comparing the intervention group with the control group. Secondary outcomes were changes in lip force measured by a lip-force test [6] at the end of treatment compared with baseline and 12 months post-treatment, comparing the intervention group with the control group. Swallowing dysfunction according to VFS, including the presence of aspiration-penetration as sign of unsafe swallowing as well as premature spillage and pharyngeal residue as signs of ineffective swallowing, was assessed for comparison with the TWST results.
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