Some patients at NCH&C develop swallowing difficulties after stroke, brain injury or as a result of illness. This can affect the coordination and timing of swallowing and make it difficult to eat and drink normally.
BiSSkiT stands for Biofeedback in Strength and Skill Training and is used as a therapy for people with swallowing difficulties. It is a specialised programme which is not yet widely used in the UK, so it doesn’t fall under normal NHS funding but NCH&C Charitable Fund have provided the software and licencing to deliver this service to patients on Beech Ward, Norwich Community Hospital.
A small biofeedback device links up with a laptop to show patients a waveform of the activity of their suprahyoid muscles (which are important muscles for safe swallowing). When they swallow, the waveform should peak, and the BiSSkiT programme gives the person a target to ‘hit’ with their swallow. The target size increases or decreases depending on success.
The software helps patients to develop a better understanding of how to control their swallowing when it has been disrupted by illness or stroke and the aim is to help patients develop a safer and more timely swallow. The device helps to improve recovery, regain independence and to provide a better quality of life.
One of the major outcomes is a safer swallow. For example, one patient went from completely nil by mouth to being able to eat and drink modified diet and fluids after using BiSSkiT for just 3 weeks.
“It is easy to understand and not uncomfortable to use.” Patient feedback.