IQoro for stroke-related dysphagia

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.