**8. Scientific evidence of the effectiveness of neuromuscular treatment**

The effectiveness of neuromuscular training is supported by more than a dozen scientific studies conducted at university hospitals in Sweden. This section will present abstracts from three studies that are of particular relevance to HH and reflux.

In all three studies [16–18] quoted here the patients were long-term users of PPI medication before the studies began. In a Medtech Innovation Briefing [21] produced by the UK's National Institute for Health and Care Excellence in 2019 they quoted, "all patients continued with their PPI medication as advised. As symptoms reduced, patients ceased to medicate. Use or cessation of PPIs was under the control of the patients' doctors. At end-of-training in the 3 studies quoted 93%, 58% and 61% that they ceased all PPI medication, the remainder mostly reduced dose and intake frequency". For this reason, medication can be excluded as the cause for improvement.

Overall, the studies showed success rates in the region of 98%, this is the same result reported by IQoro customers [19] in a survey conducted in 2020.

In these scientific studies of neuromuscular training there was particular focus on measurement methods. Patients were recruited as suffering from intermittent oesophageal dysphagia (IED) and reflux despite PPI medication from 1 year to many years and this was confirmed by a comprehensive test battery.

The test methodologies used were:


In all cases tests were made in the recruiting process, at baseline, and at end-oftreatment; however, all patients were contacted by telephone or in the clinic two or three times to verify compliance before follow-up at end-of-treatment.

#### **8.1 Oesophageal dysphagia and reflux symptoms before and after oral**

**IQoro® training. Hägg M, Tibbling L, Franzén T. World J Gastroenterol 2015; 21(24): 7558–7562. DOI: 10.3748 / wjg.v21.i24.7558** [16]**.**

*Introducing an Innovative Oral Neuromuscular Treatment of the Underlying Reason… DOI: http://dx.doi.org/10.5772/intechopen.96773*
