By Robert Francis
Like many ideas that prove their worth, it started with a small comment. Around 1994, Rick McAdoo, then a speech-language pathologist at North Hills Hospital, watched his friend, Russ Campbell, a physical therapist at the same hospital, work with a patient using some of the myriad of electrotherapy tools available. “I said something like, ‘If only we had tools like yours,’” said McAdoo. It was almost a joke, he notes. At the time speech-language pathologists like McAdoo were treating swallowing difficulties or dysphagia, using two tools – a tongue depressor and ice.
“As a dysphagia clinician in the early 1990s, there were little-to-no treatment tools for speech therapists,” said McAdoo. “I saw first-hand how far behind speech therapy was in treating disorders because of muscle weakness. That got us to thinking, ‘Why don’t we have tools like that?’” Now, nearly 20 years later, Campbell and McAdoo, along with Ronda Polansky, a fellow speech-language pathologist, are busy with the results of that comment. “It was Rick’s idea to blend the disciplines together,” said Campbell. “Together Rick, Ronda and I did a meta-analysis on what would be appropriate parameters of this unique [device]. That’s kind of how we came up with this idea.” They implemented the idea fairly quickly.
“We did our own clinical trial with it and within a year we had data on up to 100 patients,” said Campbell. Ampcare LLC, established in 2007, received clearance in Oct. 2013 from the FDA to market the company’s Effective Swallowing Protocol Therapy System to treat dysphagia. Ampcare’s treatment utilizes a powered muscle stimulator, electrodes that target the muscles necessary to rehabilitate swallowing and a posture device that provides a resistive exercise protocol. It has been validated by clinical studies in the U.S. and United Kingdom. How important could this new treatment be? Medically, very important. Dysphagia, or difficulty with swallowing, is a medical condition that affects more than 18 million Americans. For many individuals with a pre-existing condition such as a stroke, head and neck cancer or a progressive neurological disease such as Parkinson’s, it can be life threatening. Without proper management, dysphagia can lead to choking and progress to chronic malnutrition, aspiration pneumonia and possibly death. Pneumonia, largely arising from swallowing problems, is the fifth leading cause of death of Americans over 65 years of age. But it’s more than that, says Campbell, president and CEO of Ampcare.
Most people take swallowing for granted even though they usually do it more than 700 times a day, Campbell said. “As clinicians, we take life for granted,” said Campbell. “Life should be a celebration. If you take life for granted, you’re going to take swallowing for granted. What I like to believe is you celebrate through two things primarily – food and fellowship.” People with dysphagia are typically treated with diet modifications and swallowing exercises, but if those techniques don’t work a feeding tube is recommended. For many patients, that results in a loss of independence. “The best thing we can do is help patients realize the value in their life. I can’t think of a better way of helping them realize their value than improving their nutrition and hydration status. We’re providing that value to them, saying, ‘Look, you can celebrate life and we know it takes food and fellowship to do that and we can help rehabilitate you so you can do that stuff.’ It’s nice to be a part of that.” Ampcare’s treatment uses electrodes that target the muscles surrounding the throat necessary to rehabilitate swallowing and a powered muscle stimulator. The amount of the charge is small because the many nerves and muscles in the area are sensitive. “You have billions of sensory receptors on the neck, so you couldn’t just take traditional electrical stimulation and put it on the neck – it would be painful,” said Campbell. “You don’t want to cause a patient discomfort because that means they’re less likely to come back for more therapy.” The third component in the treatment is a posture device that provides postural stability and builds strength though resistive exercise.
One local user of the device said it has proven effective. “As a provider in today’s health care environment, effectiveness, quality and value are first and foremost on our dashboard,” said Carmen Vitton, COO of Rehab Synergies, a provider of occupational, physical and speech-language therapy in Arlington. “The Ampcare protocol, device and electrodes deliver consistent treatment allowing patients to return to their least restrictive consistency and texture.” Campbell said the company was initially financed by the three principals, but they have since received outside funding from a variety of sources. Developing the specialized stimulator, posture device and protocol for using it was funded through various grants, including money from the Texas Speech and Hearing Association and the UK Swallowing Research Group, a British organization. Christopher R. Watts at the Department of Communication Sciences & Disorders at Texas Christian University, was among the researchers to help with the development. Along the way, the company has been honored with a second place award in the 2013 Fort Worth Business Assistance Center Plan Competition and was named a Tech Titan in the “Technology Inventor” category by the Dallas-based Metroplex Technology Business Council (MTBC). Ampcare operates out of TECH Fort Worth, a nonprofit technology incubator at the James E. Guinn Complex in South Fort Worth. “I really believe it is a kind of holistic approach,” Campbell said. “We all get into the medical field to help people, and when you can contribute to the total scientific score of helping someone and combine two disciplines…it’s just a nice marriage.”