**Table 5.**

*Analysis of subjects by BMI grouping - age, gender, and GERD symptom duration.*

• Misdirected swallowing was significantly more common in Group C.

After IQoro neuromuscular training, the following was observed in all three BMI groups:

	- Timed Water Swallow Test (TWST) values, which were significantly (p < 0.01) more improved in Group C (severely obese) than in Group A (normal weight).
	- pharyngeal sling force, which was significantly (p <sup>&</sup>lt; 0.05) more improved in Group B (moderately obese) than in Group A.

#### **Conclusion**

IQoro neuromuscular training (IQNT), a non-surgical treatment for IED and other GERD symptoms in hiatal hernia patients, is equally successful in treating moderately or severely obese patients as in treating sufferers of normal weight. Obesity in itself does not, therefore, seem to be a handicap in treating IED and other GERD symptoms by IQNT.

#### *7.1.2.4 Customer survey*

In an email survey in June 2021 of all IQoro users that had purchased within the previous 15 months, users were canvassed on the effectiveness of IQoro treatment for dysphagia. Totally 4440 responses were received of which 3436 were specifically treating classic reflux symptoms caused by Hiatus hernia, the rest of the responses were from people treating symptoms associated with dysphagia after stroke or snoring and sleep apnoea. Patients had trained for 1 month or more.


#### **Table 6.**

*Improved outcomes in hiatal hernia related symptoms.*

76%–84% of respondents reported symptom improvement, it can be assumed that some of those not yet reporting improvements had only trained for a short while (**Table 6**).

## **Conclusion**

A large population, 3436 people, using IQoro to treat reflux symptoms showed positive outcome experiences. This survey differs from the studies quoted elsewhere in this chapter in that the results shown are not at end-of-training in all cases. Many had not trained long enough at the time of the survey to experience the full effect in symptom reductions: some having only trained for as little as 1 month. Nevertheless, 76% - 85% reported symptom improvements since starting training.

#### *7.1.3 NICE Medtech innovation briefing*

In March 2019 the UK's National Institute for Health and Care Excellence (NICE) developed a Medtech Innovation Briefing (MIB) [49] regarding the use of IQoro to treat Hiatus hernia, it points out the innovative nature of the device and its potential to save the NHS money.

*"The NICE MIB highlights the innovative nature of IQoro as being its uniqueness in treating Hiatus Hernia through an exercise regime with an oral device. It also highlights that the resource impact of using IQoro could be to reduce costs for the NHS in the long term, one of the main points of our analysis of possible cost savings in this briefing is the device's potential to be resource releasing when compared to long term PPI maintenance*."

#### **8. Conclusions**

All versions of dysphagia have an unsatisfactory range of treatment options. Swallowing difficulties, reflux, and other manifestations are often met with compensatory strategies instead of the treatment of the underlying causes. IQoro is simple, inexpensive, non-invasive, and takes just 90 seconds per day.

#### *Introducing IQoro: A Clinically Effective Oral Neuromuscular Treatment for Dysphagia DOI: http://dx.doi.org/10.5772/intechopen.101144*

IQoro is proven both in clinical practice and in research studies to be highly effective in treating the underlying causes of the conditions and symptoms described in this book. The evidence base for its efficacy is strong.

This innovative device and treatment are shown to be effective in treating all types of dysphagia in the pre-oral, oral, pharyngeal, and esophageal phases. Similarly, Hiatus hernia and its resulting reflux symptoms can be addressed successfully. In all of these conditions, it is shown that time from onset of the condition stroke or Hiatus hernia for example, to the time when IQoro treatment starts, does not affect the positive outcome results of the treatment. The stroke studies show that improvements achieved at end-of-treatment persist at long-term follow-up. Several studies and evaluations show that patients with PEG feeding tubes have had them removed after IQoro therapy.

All healthcare professionals working with dysphagia and its related conditions should want to know more about IQoro and how it improves patient outcomes and gives clinicians an important and powerful new treatment option.
