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Kagaya, Hitoshi, and Yoko Inamoto. "Possible Rehabilitation Procedures to Treat Sarcopenic Dysphagia." Nutrients 14, no. 4 (February 12, 2022): 778. http://dx.doi.org/10.3390/nu14040778.
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Sarcopenic dysphagia requires the presence of both dysphagia and generalized sarcopenia. The causes of dysphagia, except for sarcopenia, are excluded. The treatment for sarcopenic dysphagia includes resistance training along with nutritional support; however, whether rehabilitation procedures are useful remains unclear. In this narrative review, we present possible rehabilitation procedures as a resistance training for managing sarcopenic dysphagia, including Shaker exercise, Mendelsohn maneuver, tongue-hold swallow exercise, jaw-opening exercise, swallow resistance exercise, lingual exercise, expiratory muscle strength training, neuromuscular electrical stimulation, and repetitive peripheral magnetic stimulation. We hope that some procedures mentioned in this article or new methods will be effective to treat sarcopenic dysphagia.
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Swigert, Nancy B. "Cross-Training In Dysphagia Still Unacceptable." ASHA Leader 11, no. 7 (May 2006): 3–14. http://dx.doi.org/10.1044/leader.an2.11072006.3.
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Coyle, James. "Tele-Dysphagia Management: An Opportunity for Prevention, Cost-Savings and Advanced Training." International Journal of Telerehabilitation 4, no. 1 (June 6, 2012): 41–46. http://dx.doi.org/10.5195/ijt.2012.6093.
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Many patients survive severe stroke because of aggressive management in intensive care units. However, acquiring pneumonia during the post-onset phase significantly reduces both the quality and likelihood of survival. Aspiration pneumonia (AP), a relatively recent addition to the list of the pneumonias, is associated with dysphagia, a swallowing disorder that may cause aspiration of swallowed food or liquids mixed with bacterial pathogens common to saliva, or by aspiration of gastric contents due to emesis or gastroesophageal reflux. While it is within the purview of speech-language pathologists to provide evaluation, treatment, and management of dysphagia, the number of patients with dysphagia is growing faster than the number of qualified dysphagia clinicians. Because dysphagia consultations via telepractice are feasible and relatively accessible from a technological standpoint, they offer a promising strategy to bring the expertise of distant dysphagia experts to patients in underserved areas. Tele-dysphagia management has the potential to increase patients’ survival, enhance the expertise of primary, local clinicians, and reduce healthcare costs. Even a modest reduction in either hospital admissions for aspiration pneumonia, or in the length of stay for AP, could save the US health care system hundreds of millions of dollars each year. Wide spread tele-dysphagia management offers significant opportunities for prevention, cost-savings and advanced training, and is therefore worthy of consideration by stakeholders in the health care system and university training programs.
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Gurevich, Naomi, Danielle R. Osmelak, and Sydney Osentoski. "A Preliminary Study of Nursing Practice Patterns Concerning Dysphagia Diet Modification: Implications for Interprofessional Education With SLPs." Perspectives of the ASHA Special Interest Groups 6, no. 4 (August 20, 2021): 897–911. http://dx.doi.org/10.1044/2021_persp-20-00088.
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Purpose Speech-language pathologists (SLPs) are trained to evaluate and treat dysphagia. One treatment method is to modify diet consistency or viscosity to compensate for swallowing dysfunction and promote a safer intake; this typically involves softening solids and thickening liquids. Thickening liquids is not safer for all patients, and modification of dysphagia diets without adequate training may reduce the quality of dysphagia patient care. Over 90% of SLPs working in health care report exposure to nurses who regularly downgrade dysphagia diets without an SLP consult. This study explores dysphagia diet modification practices of nursing staff with and without dysphagia training. Method Practicing nurses and student nurses ( N = 298) in the United States were surveyed regarding their dysphagia diet modification training and practice patterns. Additionally, a pre-/posttest design was used to determine the efficacy of a short general tutorial on willingness to modify diets without an SLP consult. Results Downgrading diets without an SLP consult is a common practice. Fewer than one third of nurses (31.41%) would avoid it, whereas 73.65% would avoid upgrading without SLP consult. Formal dysphagia training made little difference to this practice. The short general tutorial also had no beneficial effect, in fact slightly reducing the willingness to consult SLPs. Conclusions Dysphagia diet modification practice by nurses is pervasive in U.S. health care. This is a previously unexplored but common issue SLPs face in work settings. This study identifies a need to clarify guidelines and increase interprofessional education between both professions to improve patient care.
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Steele, Catriona. "Tongue-Pressure Resistance Training: Workout for Dysphagia." ASHA Leader 15, no. 6 (May 2010): 10–13. http://dx.doi.org/10.1044/leader.ftr1.15062010.10.
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Huang, JY, DY Zhang, Y. Yao, QX Xia, and QQ Fan. "Training in Swallowing Prevents Aspiration Pneumonia in Stroke Patients with Dysphagia." Journal of International Medical Research 34, no. 3 (May 2006): 303–6. http://dx.doi.org/10.1177/147323000603400310.
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This study investigated the frequency of aspiration pneumonia in conscious stroke patients fed by a family member and examined the effect of introducing training in swallowing techniques by nurses. A total of 96 consecutive patients presenting with dysphagia due to acute stroke were included in the study. Patients presenting between January 2000 and July 2003 ( n = 48) were fed orally by a family member given general nursing information (group A), whereas those presenting between August 2003 and March 2005 ( n = 48) were fed orally by an experienced nurse trained in specific swallowing techniques (group B). All patients were examined daily for the presence of aspiration pneumonia. The incidence of aspiration pneumonia was 33.3% in group A and 6.3% in group B ( P < 0.05). The incidence of aspiration pneumonia in dysphagic stroke patients who are orally fed is still high. Training in swallowing during oral feeding offers clear protection against pneumonia in conscious stroke patients.
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C. Broz, Charles, and Rhonda K. Hammond. "Dysphagia." Nutrition & Food Science 44, no. 5 (September 2, 2014): 407–13. http://dx.doi.org/10.1108/nfs-03-2013-0035.
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Purpose – The purpose of this study was to survey current culinary, hospitality and nutrition students to determine their level of knowledge about dysphagia, or swallowing impairment, and the dysphagia diet. In addition, the study provided a means by which to gauge current students’ awareness of health-care foodservice as a career option. Design/methodology/approach – A pilot study conducted in 2009 indicated that health-care foodservice workers were unaware of many of the risks associated with the dysphagia diet. A second study was conducted in 2012 to obtain an idea of the perceptions and knowledge levels of culinary, hospitality and nutrition students about dysphagia. Subjects included students across the three disciplines at two large universities in the Midwestern USA, and a private culinary school on the east coast of the USA. The instrument consisted of a traditional paper survey containing 18 questions. A total sample size of n = 139 surveys was collected and analyzed. Findings – Results of the survey suggests that current university students are lacking in some areas of knowledge concerning dysphagia patients and their dietary needs. Education and training are indicated, as the number of patients suffering from some degree of dysphagia is only going to increase as the US population ages. Findings also indicate that many introductory-level students are unaware of health-care foodservice as a viable career choice in industry. Research limitations/implications – The primary limitations to this research were the relatively small sample size, and the fact that most students surveyed were not interested or aware of health-care foodservice as a viable industry career choice. This study would be greatly enhanced by contacting professors/instructors at several universities representing the Northeast, Midwest, and east and west coasts of the USA. Educating future foodservice professionals at the introductory level would allow industry leaders to make students aware of this large and necessary sector of the foodservice industry. Likewise, there is no doubt that food preparers, food deliverers and foodservice managers in health care will come in contact with a patient with some level of dysphagia as our population ages. More research to strengthen this body of data is indicated, as are similar studies across broader ranges of the population. Practical implications – The occurrence of dysphagia is growing as the US population ages. That fairly little research has been done is somewhat alarming. There is a need for standardization of recipe formulas, benchmarking viscosities of dietary liquids and solids and training of food preparers. The symptom is found in very large populations in the USA, as well as in Europe. Also, the fact that dysphagia has so many potential causes makes the symptom that much more of a health issue. More research is certainly called for to better prepare potential institutional foodservice employees for the next 20 years. Originality/value – Millions of Americans currently suffer from at least some degree of dysphagia. This number is expected to increase as the Baby Boomer generation reaches retirement age. The USA will be populated by more elderly people than ever before, and will thus host more individuals suffering from swallowing impairment. Health-care foodservice, including hospital and long-term care foodservice will certainly become a viable career choice for current students of culinary arts, nutrition and hospitality.
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Sharma, Shobha, Elizabeth C. Ward, Clare Burns, Deborah Theodoros, and Trevor Russell. "Training the allied health assistant for the telerehabilitation assessment of dysphagia." Journal of Telemedicine and Telecare 18, no. 5 (July 2012): 287–91. http://dx.doi.org/10.1258/jtt.2012.111202.
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We examined the effect of knowledge and task specific training provided to an allied health assistant (AHA), prior to her involvement in facilitating assessments of dysphagia (swallowing disorders) via telerehabilitation. The AHA received four hours of training, which included basic theoretical information regarding dysphagia as well as hands-on training with simulated patients. A written test examining swallowing function and its evaluation was completed pre- and then immediately post-training, and then again after the 15th and 30th of 31 consecutive patient assessments. In addition, after each set of 5 clinical dysphagia assessments completed with patients following the training, two speech pathologists rated the AHA's competence in relation to performing the tasks and activities required of her during the telerehabilitation swallowing assessment. The AHA also self-rated the perceived level of confidence at these times. Before training, the assistant's knowledge of dysphagia theory was at 40%. Following training, all tests were above the 80% level. The AHA's performance was rated as competent on each evaluation post-training. The AHA also expressed overall satisfaction with the initial training provided and reported feeling confident after the initial sessions with patients. Thus for an AHA with previous clinical experience, competence and perceived comfort in providing assistance in the sessions was achieved with only a few hours of task specific training.
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Syahrun, Syahrun, Alfrina Hany, and Masruroh Rahayu. "MANAGEMENT DYSPHAGIA IN POST-STROKE PATIENTS RECOMMENDATIONS FOR INDONESIAN NURSING INTERVENTION STANDARDS: A LITERATURE REVIEW." MNJ (Malang Neurology Journal) 8, no. 1 (January 1, 2022): 39–48. http://dx.doi.org/10.21776/ub.mnj.2022.008.01.9.
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Background: Dysphagia often occurs in post-stroke patients, causing aspiration that can result in disability or death. Nurses have an essential role to play in preventing these complications as they 24/7 care for patients. However, there is no written standard of nursing care regarding specific interventions of post-stroke dysphagia in reality. Objective: The purpose of this article is to conduct a literature review of interventions that can be made in patients with post-stroke dysphagia so that it can be a recommendation for Indonesian nursing standards. Design: Electronic literature searches PubMed, EBSCO (Medline), ProQuest, and ScienceDirect databases from January 2011 to October 2020. There was sixteen studies reviewed included in this systematic study were experimental, randomized controlled trials, or systematic reviews (which are also experimental designs, randomized controlled trials). The study focused on non-invasive interventions performed on post-stroke dysphagia patients. Results: Interventions in dysphagia found, namely: The use of food thickeners against the risk of aspiration resulted in the patient's swallowing ability significantly increased by 71.9% (p <0.01); Chin down intervention combined with thickening fluid provides a solution to improve the nutritional needs of patients dysphagia post-stroke; Tongue training interventions, swallowing training and speech therapy; Tongue stretching exercises that have a positive effect on tongue motility and oromotor function in post-stroke dysphagia patients; Intervention of Tongue resistance training that increases the strength of the tongue and reduces fluid residue in the vallecular; and early screening of dysphagia by nurses using formal guidelines to manage dysphagia patients thereby reducing chest infections and mortality. Conclusion: Nurses should not diagnose dysphagia, but can identify post-stroke dysphagia to determine the interventions necessary for nutrition management, hydration, and aspiration prevention. Interventions include early dysphagia screening within 24 hours after stroke, thickening nutrition according to nutritionist recommendations, laryngeal elevation exercises, peripheral stimulation, posture regulation, and education on eating and drinking.
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Noë, Sofie, Ann Goeleven, Hilde Brouwers, Tom Meurrens, Alexander De Cock, Daphne Kos, and Kris Vanhaecht. "Training for Caregivers and Compliance with Dysphagia Recommendations in a Tertiary Multiple Sclerosis Rehabilitation Center." International Journal of MS Care 23, no. 5 (March 19, 2021): 223–28. http://dx.doi.org/10.7224/1537-2073.2020-019.
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Abstract Background: Dysphagia is common in persons with multiple sclerosis (MS). Speech and language therapists give dysphagia recommendations to persons with MS and caregivers. Nonadherence to these recommendations can increase the risk of aspiration. We investigated current compliance with dysphagia recommendations among caregivers and kitchen staff and assessed improvement in compliance by increasing knowledge through tailored training. Methods: An observational cohort study was conducted over 4 weeks during which the compliance of the caregivers and kitchen staff in a rehabilitation center was monitored. A questionnaire was used to assess reasons for noncompliance. A 2-hour training session was provided for all caregivers and kitchen staff to improve their knowledge and skills. The compliance rate was observed again 1 and 6 months after the training. Compliance was defined by whether recommendations were followed. Results: Results showed a significant improvement after training for overall compliance by caregivers (from 58% to >81%, P < .001). This improvement was still observed 6 months later (80%). After training, significant differences were found in compliance with the following recommendations (P ≤ .001): consistency of soup, consistency of liquids, food preparation, alertness, speed, amount, posture, and supervision. Recommendation for utensils did not improve (P = .44). Compliance with diet modifications made by the kitchen staff improved significantly (from 74% to >86%, P = .002), and even more during follow-up (to >95%, P = .009). Conclusions: Dysphagia training tailored to the needs of caregivers to improve knowledge significantly improves compliance with dysphagia recommendations and the quality of care.
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Melgaard, Dorte, Albert Westergren, Conni Skrubbeltrang, and David Smithard. "Interventions for Nursing Home Residents with Dysphagia—A Scoping Review." Geriatrics 6, no. 2 (May 21, 2021): 55. http://dx.doi.org/10.3390/geriatrics6020055.
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Oropharyngeal dysphagia is common in nursing home residents. The objective of this scoping review was to summarize and disseminate the findings from the literature on interventions for dysphagia in nursing home residents. Searches were conducted in four databases. The criteria for including the studies were nursing home residents, dysphagia, interventions, original research, published in English, Danish, Norwegian, or Swedish with no restriction placed regarding publication date. Excluded were literature reviews, editorial comments, conference abstracts, protocols, papers not available in full text, and studies with a mixed population, for example, geriatric patients and nursing home residents and where the results were not separated between the groups. A total of 14 papers were included and analyzed. The included papers represented interventions focusing on feeding intervention, oral hygiene, caregiver algorithm, stimulation (taste and smell), teaching the residents what to eat, mobilization of the spine, exercises/training, and positioning. This scoping review identifies sparse knowledge about interventions affecting nursing home residents’ dysphagia. But the results indicate that multi-component interventions, including staff training, training of residents, and/or next of kin, might be successful. This scoping review clarifies that there is a need for well-designed studies that uncover which specific interventions have an effect in relation to nursing home residents with dysphagia and can serve as a guide for designing multi-component person-centered intervention studies. Future studies should implement high evidence study designs, define the measures of dysphagia, and quantify the severity of dysphagia, its underlying diseases, and comorbidities.
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Li, Honghong, Yong He, Xiaohuang Zhuo, Zongwei Yue, Xiaoming Rong, Yike Li, Yi Li, et al. "Establishment and Validation of a Predictive Model for Radiation-Associated Aspiration Pneumonia in Patients with Radiation-Induced Dysphagia after Nasopharyngeal Carcinoma." Behavioural Neurology 2022 (August 19, 2022): 1–10. http://dx.doi.org/10.1155/2022/6307804.
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Introduction. Radiotherapy for patients with head and neck cancers raises their risk of aspiration pneumonia-related death. We aimed to develop and validate a model to predict radiation-associated aspiration pneumonia (RAP) among patients with dysphagia after radiotherapy for nasopharyngeal carcinoma (NPC). Materials and Methods. A total of 453 dysphagic patients with NPC were retrospectively recruited from Sun Yat-Sen Memorial Hospital from January 2012 to January 2018. Patients were randomly divided into training cohort ( n = 302 ) and internal validation cohort ( n = 151 ) at a ratio of 2 : 1. The concordance index (C-index) and calibration curve were used to evaluate the accuracy and discriminative ability of this model. Moreover, decision curve analysis was performed to evaluate the net clinical benefit. The results were externally validated in 203 dysphagic patients from the First People’s Hospital of Foshan. Results. Derived from multivariable analysis of the training cohort, four independent factors were introduced to predict RAP, including Kubota water drinking test grades, the maximum radiation dose of lymph node gross tumor volume (Dmax of the GTVnd), neutrophil count, and erythrocyte sedimentation rate (ESR). The nomogram showed favorable calibration and discrimination regarding the training cohort, with a C-index of 0.749 (95% confidence interval (CI), 0.681 to 0.817), which was confirmed by the internal validation cohort (C-index 0.743; 95% CI, 0.669 to 0.818) and the external validation cohort (C-index 0.722; 95% CI, 0.606 to 0.838). Conclusions. Our study established and validated a simple nomogram for RAP among patients with dysphagia after radiotherapy for NPC.
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Curtis, James A., Avery E. Dakin, and Michelle S. Troche. "Respiratory–Swallow Coordination Training and Voluntary Cough Skill Training: A Single-Subject Treatment Study in a Person With Parkinson's Disease." Journal of Speech, Language, and Hearing Research 63, no. 2 (February 26, 2020): 472–86. http://dx.doi.org/10.1044/2019_jslhr-19-00207.
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Purpose Airway protective disorders are common in Parkinson's disease (PD), yet effective methods to rehabilitate these life-threatening impairments are limited. This study examined the effects of two skill-based treatments aimed at improving swallowing and cough in a severely dysphagic person with PD: respiratory–swallow coordination training (RSCT) and voluntary cough skill training (VCST). It was hypothesized that (a) RSCT would improve respiratory–swallow coordination and swallowing safety and efficiency and (b) VCST would improve reflex and voluntary cough effectiveness. Method An 81-year-old man with midstage PD and severe dysphagia was recruited for study participation. The study utilized a multiple-baseline ABACA experimental design with a 2-month delayed retention assessment. Measures of respiratory–swallow coordination, swallowing safety and efficiency, and cough effectiveness were collected at each assessment using respiratory inductive plethysmography, flexible endoscopic evaluations of swallowing, and spirometry. Data were analyzed descriptively using baseline corrected tau and standard mean difference effect sizes ( d ). Results Large effect sizes were observed immediately following RSCT for respiratory–swallow coordination ( d = 9.17), penetration–aspiration ( d = 12.88), vallecular residue ( d = 1.75), piriform residue ( d = 4.15), and overall dysphagia severity ( d = 1.83). Large effect sizes were also observed immediately following VCST for single voluntary cough ( d = 4.30), sequential voluntary cough ( d = 3.28), and reflex cough ( d = 5.58). Improvements were maintained 2 months later for all outcome measures except single voluntary cough. Discussion This is the first study to examine the effects of RSCT and VCST in a person with PD. Robust improvements in respiratory–swallow coordination and swallowing safety and efficiency were achieved following four sessions of RSCT, and significant improvements in reflex and voluntary cough strength were seen following four sessions of VCST. Future work is needed to study these treatments in larger cohorts of people with PD.
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Milazzo, Mario, Andrea Panepinto, Angelo Maria Sabatini, and Serena Danti. "Tongue Rehabilitation Device for Dysphagic Patients." Sensors 19, no. 21 (October 26, 2019): 4657. http://dx.doi.org/10.3390/s19214657.
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Dysphagia refers to difficulty in swallowing often associated with syndromic disorders. In dysphagic patients’ rehabilitation, tongue motility is usually treated and monitored via simple exercises, in which the tongue is pushed against a depressor held by the speech therapist in different directions. In this study, we developed and tested a simple pressure/force sensor device, named “Tonic Tongue (ToTo)”, intended to support training and monitoring tasks for the rehabilitation of tongue musculature. It consists of a metallic frame holding a ball bearing support equipped with a sterile disposable depressor, whose angular displacements are counterbalanced by extensional springs. The conversion from angular displacement to force is managed using a simple mechanical model of ToTo operation. Since the force exerted by the tongue in various directions can be estimated, quantitative assessment of the outcome of a given training program is possible. A first prototype of ToTo was tested on 26 healthy adults, who were trained for one month. After the treatment, we observed a statistically significant improvement with a force up to 2.2 N (median value) in all tested directions of pushing, except in the downward direction, in which the improvement was slightly higher than 5 N (median value). ToTo promises to be an innovative and reliable device that can be used for the rehabilitation of dysphagic patients. Moreover, since it is a self-standing device, it could be used as a point-of-care solution for in-home rehabilitation management of dysphasia.
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Nagami, Shinsuke, Shinya Fukunaga, and Atsushi Toda. "Trends and practices in dysphagia rehabilitation training methods." Journal of allied health sciences 9, no. 2 (October 1, 2018): 134–41. http://dx.doi.org/10.15563/jalliedhealthsci.9.134.
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Hägg, Mary, and Matti Anniko. "Lip muscle training in stroke patients with dysphagia." Acta Oto-Laryngologica 128, no. 9 (January 2008): 1027–33. http://dx.doi.org/10.1080/00016480701813814.
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Speyer, Renée, Adriana Sandbekkbråten, Ingvild Rosseland, and Jennifer L. Moore. "Dysphagia Care and Management in Rehabilitation: A National Survey." Journal of Clinical Medicine 11, no. 19 (September 27, 2022): 5730. http://dx.doi.org/10.3390/jcm11195730.
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Dysphagia care and management may differ between countries and healthcare settings. This study aims to describe the management and care of dysphagia in rehabilitation centres and health houses across Norway. Two national surveys were developed targeting either managers or healthcare professionals. Both surveys focused on staff and client populations; screening and assessment of dysphagia; dysphagia management and interventions; staff training and education; and self-perceived quality of dysphagia care. A total of 71 managers and clinicians from 45 out of 68 identified rehabilitation centres and health houses in Norway completed the surveys. The resulting overall response rate was 72.1%. Significant differences in dysphagia care and management were identified between rehabilitation services across Norway. Rehabilitation centres and health houses often had neither a speech therapist among their staff nor had access to external healthcare professionals. Screening was most frequently performed using non-standardised water swallows and only limited data were available on non-instrumental assessments. None of the respondents reported having access to instrumental assessments. Dysphagia interventions mainly consisted of compensatory strategies, including bolus modification, with very infrequent use of rehabilitative interventions, such as swallow manoeuvres. Although almost half of all respondents perceived the overall quality of care for clients with eating and swallowing problems as good, lack of awareness of dysphagia and its symptoms, consequences and options for treatment may have influenced quality ratings. There is a need to raise awareness of dysphagia and provide training opportunities for healthcare professionals in both screening and assessment, and dysphagia care and management.
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Afrida, Afrida. "EFFECT OF INGESTING TRAINING TOWARDS DYSPHAGIA IN STROKE’ PATIENTS IN HAJI HOSPITAL AND MAKASSAR CITY HOSPITAL." Indonesian Contemporary Nursing Journal (ICON Journal) 2, no. 1 (February 13, 2018): 13. http://dx.doi.org/10.20956/icon.v2i1.3580.
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Introduction: Stroke is a loss of brain function caused by the cessation of blood supply to the brain. One of the most common clinical disorders of stroke is ingesting or dysphagia. This study aims to identify the effect of ingesting exercise to stroke patients with dysphagia in the General Hospital of Haji General Hospital of Makassar City. Method: The design of this study was pre experimental with One Group Pre-Post Test Design. Samples in this study were all stroke patients with dysphagia with Convenience Sampling technique, obtained 20 respondents. Rehabilitation of ingesting exercise is done three times a day at breakfast, lunch, and dinner for seven days in a row. Evaluation of respondents' ingesting status was done on the first day before exercise and last day after practicing exercise. Result: Bivariate results showed that there was an influence between stroke patients with dysphagia and ingesting exercises (p <0.001). Conclusion: It is further recommended that nurses perform structured ingesting exercises as self-care nursing intervention in dealing with stroke patients who have dysphagia.
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Ershov, V. I., A. A. Borzdyko, and V. V. Silkin. "The treatment effi cacy of disturbed swallowing function in patients with ischemic stroke and neurogenic dysphagia." Russian neurological journal 26, no. 3 (July 21, 2021): 51–57. http://dx.doi.org/10.30629/2658-7947-2021-26-3-51-57.
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The aim. To evaluate the effi cacy of swallowing recovery of patients with ischemic stroke carried out with the use of training rehabilitation method using special nutrient mixtures as part of combination therapy. Material and methods. The study included 65 patients (35 men and 30 women, aged 45 to 80 years) with dysphagia in the acute period of ischemic stroke. Thirty patients (control group) were treated with special binding compounds as part of a combination therapy. Thirty fi ve patients (comparison group) did not use the mixture. The dynamics of the recovery function of swallowing using the Penetration–Aspiration Scale (PAS) and the Fiberoptic Endoscopic Dysphagia Severity Scale (FEDSS), as well as the transition from tube to independent feeding were studied. Results. The training method of rehabilitation using special nutritional mixtures is eff ective assessed with PAS and FEDSS in patients with ischemic stroke and neurogenic dysphagia (p < 0.05). The most pronounced eff ect was achieved in the group of patients with pseudobulbar syndrome. In patients with bulbar syndrome no statistically signifi cant diff erences were observed in the dynamic assessment of the severity of dysphagia on the PAS and FEDSS scales. The application of the training method leads to a signifi cantly better transition from tube to independent feeding. Conclusion. The training method of rehabilitation using special nutritional mixtures is eff ective in patients with ischemic stroke and neurogenic dysphagia and leads to a signifi cantly better transition from tube to independent feeding.
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McKenna, Victoria S., Bin Zhang, Morgan B. Haines, and Lisa N. Kelchner. "A Systematic Review of Isometric Lingual Strength-Training Programs in Adults With and Without Dysphagia." American Journal of Speech-Language Pathology 26, no. 2 (May 17, 2017): 524–39. http://dx.doi.org/10.1044/2016_ajslp-15-0051.
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Purpose This systematic review summarizes the effects of isometric lingual strength training on lingual strength and swallow function in adult populations. Furthermore, it evaluates the designs of the reviewed studies and identifies areas of future research in isometric lingual strength training for dysphagia remediation. Method A comprehensive literature search of 3 databases and additional backward citation search identified 10 studies for inclusion in the review. The review reports and discusses the isometric-exercise intervention protocols, pre- and postintervention lingual-pressure data (maximum peak pressures and lingual-palatal pressures during swallowing), and oropharyngeal swallowing measures such as penetration-aspiration scales, oropharyngeal residue and duration, lingual volumes, and quality-of-life assessments. Results Studies reported gains in maximum peak lingual pressures following isometric lingual strength training for both healthy adults and select groups of individuals with dysphagia. However, due to the variability in study designs, it remains unclear whether strength gains generalize to swallow function. Conclusion Although isometric lingual strength training is a promising intervention for oropharyngeal dysphagia, the current literature is too variable to confidently report specific therapeutic benefits. Future investigations should target homogenous patient populations and use randomized controlled trials to determine the efficacy of this treatment for individuals with dysphagia.
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Shim, Hee Youn, Ernest Xuan Hao Tan, Mark Yuxuan Chng, Fang Ming Lim, Huai Zhi Goh, Eng Keng Soh, Lakhaphat Aigu Lin, and Celia Ia Choo Tan. "GS7-9 Development of a Dysphagia Rehabilitation Training (DRT) Device(GS7: Rehabilitation Biomechanics II)." Proceedings of the Asian Pacific Conference on Biomechanics : emerging science and technology in biomechanics 2015.8 (2015): 190. http://dx.doi.org/10.1299/jsmeapbio.2015.8.190.
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Heber, N., J. Petry, J. Schomaker, C. Wippich, C. Beushausen, and H. Grötzbach. "Update Dysphagie:." Neurologie & Rehabilitation 28, no. 1 (February 2022): 16–24. http://dx.doi.org/10.14624/nr2201002.
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Zusammenfassung Hintergrund: Ziel: Eine systematische Suche nach aktuellen, internationalen RCTs und Leitlinien zur Behandlung von Erwachsenen mit einer neurogenen Dysphagie soll einen aktuellen Überblick über diejenigen therapeutischen Möglichkeiten geben, die evidenzbasiert effektiv sind. Zudem sollen Evidenzen für eine optimale Therapieintensität und -frequenz bei Dysphagietherapie zur Verfügung gestellt werden. Methode: Es wurde eine systematische Literaturrecherche durchgeführt, die sich auf den Zeitraum von 2016 bis 2021 bezog. Ermittelte RCTs wurden mit der CASP-Checkliste initial nach ihrer Güte bewertet. Es wurde außerdem ein Punktesystem entwickelt, um die RCTs besser miteinander vergleichen zu können. Ergebnisse: Insgesamt entsprachen acht Leitlinien und 33 RCTs den im Voraus definierten Ein- und Ausschlusskriterien. Anhand der Leitlinien können Maßnahmen der funktionellen Dysphagietherapie (FDT), die Edukation von Betroffenen und Angehörigen, ein Atemtraining sowie eine Mund- und Zahnpflege als effektive therapeutische Maßnahmen empfohlen werden. Die Ergebnisse aus der Analyse der RCTs ergaben heterogene Angaben zu den Therapiemethoden und der Therapiefrequenz. Insbesondere kompensatorische, restituierende und adaptive Maßnahmen der FDT führen zu signifikanten Fortschritten. Das Atemtraining und die transkranielle elektrische Stimulation stellen sinnvolle Ergänzungen zur konventionellen Dysphagietherapie dar. Heterogene Ergebnisse ergaben sich für die Anwendung der neuromuskulären elektrischen Stimulation (MNES). Schlussfolgerung: Für die Therapie der neurogenen Dysphagien können klare Empfehlungen ausgesprochen werden. Allerdings ist es zurzeit nicht möglich, homogene Empfehlungen für die Therapieintensität und -frequenz zu geben. Abstract Aims: A systematic search for current, international RCTs and guidelines for the treatment of adults with neurogenic dysphagia will provide an up-to-date overview of those therapeutic options that are evidence-based and effective. In addition, evidence for optimal therapy intensity and frequency for dysphagia therapy will be made available. Methods: A systematic literature search was conducted covering the period from 2016 to 2021. To further differentiate the RCTs found, they were initially evaluated according to their quality using the CASP checklist. For better comparability of the RCTs, a scoring system was created by the working group. Results: In total, eight guidelines and 33 RCTs met the predefined inclusion and exclusion criteria. Based on the guidelines, methods of functional dysphagia therapy (FDT), education of affected persons and their relatives, respiratory training, and oral and dental care can be recommended as effective therapeutic measures. The results from the analysis of RCTs provide heterogeneous information on therapy methods as well as their therapy frequency. In particular, compensatory, restorative, and adaptive measures of FDT lead to significant progress. Respiratory training and transcranial electrical stimulation are useful adjuncts to conventional dysphagia therapy. Heterogeneous results emerged for the use of neuromuscular electrical stimulation (MNES).
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Dhufaigh, Niamh Ní, Marie Haughey, and Cliodhna Gillen. "170 Admissions to a Stroke Unit in an Irish Rehabilitation Hospital: A Review from Speech and Language Therapy." Age and Ageing 48, Supplement_3 (September 2019): iii1—iii16. http://dx.doi.org/10.1093/ageing/afz102.36.
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Abstract Background Communication disorders and dysphagia are debilitating sequelae associated with stroke. Speech and Language Therapy (SLT) has a pivotal role in stroke rehabilitation, and in improving outcomes. The research into dysphasia, dysphagia, and dysarthria post-stroke is extensive. In comparison, the research into cognitive-communication difficulties post-stroke is still emerging. Cognitive-communication difficulties (CCDs) are communication impairments resulting from underlying cognitive deficits due to neurological impairments1. The aim of this audit was to review SLT referrals in an Irish Stroke Rehabilitation Unit. Methods Single-centre retrospective review of all stroke admissions from January to December 2018. Communication outcomes were assessed using the Functional Independence Measure and Functional Assessment Measure (FIM+FAM)2 a 7-point disability rating scale. Standard Bayesian statistics were employed for analysis. Results SLT received referrals for 66% (n=41) of all stroke admissions (n=62). Mean age was 68 years (SD+/-14), compared with 70 years (SD+/-14) for patients not referred. 65% were female and 35% male. Patients requiring SLT had significantly longer length of stay (p=0.0072). 83% of referrals were for communication, 12% dysphagia, and 5% inappropriate. Of communication referrals, primary diagnoses were as follows: 17.5% dysarthria (n=6), 26.5% dysphasia (n=9) and 56% CCD (n=19). Patients with dysphasia showed greater improvement in FIMFAM scores (x̄=1.3) than those with CCD (x̄=0.9) or dysarthria (x̄=0.7). Patients with CCD comprised the largest cohort who required SLT on discharge (68%). Conclusion CCDs are highly prevalent and represented the largest subtype of communication disorders in this cohort. FIMFAM scores appear useful in assessing CCDs however they display insufficient sensitivity in capturing change within this population. This audit highlights the need for further interdisciplinary research, education and training into cognitive-communication difficulties with post-stroke populations.
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Werstuck, Michele Macdonald, and Cindy Steel. "Dysphagia Identification and Assessment in Adults in Primary Care Settings—A Canadian Study of Dietitians." Canadian Journal of Dietetic Practice and Research 82, no. 2 (June 1, 2021): 84–89. http://dx.doi.org/10.3148/cjdpr-2021-002.
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Dysphagia affects up to 35% of older adults living in the community and is considered a significant risk factor for malnutrition and aspiration. Early intervention is important, yet dietitian referrals for dysphagia management in primary care are disproportionately low considering the prevalence of dysphagia and its risk factors. As little is known about dietitian’s current dysphagia identification and assessment practices in Canada, an online survey was developed. Registered dietitians practicing in primary care were invited to participate. Of the 70 surveys completed, nearly 75% do not have a dysphagia screening process where they practice, and only 8% reported performing noninstrumental, clinical swallowing assessment (CSA). Lack of competency or skills required to complete dysphagia screening and assessment was the most reported barrier. Many respondents were unsure or did not believe CSA fell within their scope of practice, and over 70% reported needing hands-on dysphagia screening and assessment training. Current practices in primary care could be placing individuals with dysphagia, and those at risk, in jeopardy of being overlooked. Initiatives to increase dysphagia awareness, create screening processes, and increase awareness of dietitian’s scope of practice are needed to enable primary care dietitians to develop competency in dysphagia screening and assessment.
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YONG XINYI, DEBORAH, AFFIZAL AHMAD, and MALARVINI VESUALINGAM. "Medical Officers’ Awareness, Involvement and Training in Dysphagia Management." Jurnal Sains Kesihatan Malaysia 16, no. 1 (January 15, 2018): 7–16. http://dx.doi.org/10.17576/jskm-2018-1601-02.
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Shen, Shih Chieh, Yuval Nachalon, Derrick R. Randall, Nogah Nativ-Zeltzer, and Peter C. Belafsky. "High elevation training mask as a respiratory muscle strength training tool for dysphagia." Acta Oto-Laryngologica 139, no. 6 (April 29, 2019): 536–40. http://dx.doi.org/10.1080/00016489.2019.1605196.
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Bui, Trang, Ingrid Parry, Pauline W. Ng, Kathleen S. Romanowski, Tina L. Palmieri, David Greenhalgh, and Soman Sen. "67 Transient Dysphagia After Burn Injury in Children: An Under-identified Problem." Journal of Burn Care & Research 43, Supplement_1 (March 23, 2022): S46. http://dx.doi.org/10.1093/jbcr/irac012.070.
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Abstract Introduction Severely burn injured pediatric patients are at risk of dysphagia (difficulty swallowing) due to prolonged intubation or tracheostomy placement. To improve the early identification and treatment of dysphagia, we implemented a swallowing assessment protocol. We hypothesized that the swallowing assessment protocol is effective for identifying and treating dysphagia after prolonged intubation. Methods Between October 2016 and December 2020, pediatric burn patients with facial burn injuries, prolonged mechanical ventilation, tracheostomy, inhalation injury and/or anoxic events were placed on the swallowing protocol. The protocol included a Transitional Swallow Screen (TSS) performed within 24 hours after extubation or decanulation by an advanced practice swallow occupational therapist. If signs of dysphagia were noted, recommendations on diet consistency and treatment for positioning and feeding were implemented. Regular reassessments continued until the patient was determined to have regained premorbid swallowing function. Data on patient demographics, burn characteristics, dysphagia, treatment and outcome were collected. Descriptive statistics were used to describe the population, treatments and outcome. Results A total of 33 pediatric burn patients were included. Mean age was 8.1±5.9 years and TBSA was 48.1±26.8%. Median time from injury to swallow assessment was 45 (21-81) days. The majority of patients suffered from flame burns (70%). Almost all of the patients were intubated (97%) and 85% underwent a tracheostomy. Patients had a facial burn (73%), inhalation injury (24%) or anoxic injury (15%). Transient dysphagia was diagnosed in 79% of patients. Subsequent therapeutic procedures as a result of the TSS included: neurologic re-education (30%), swallow therapy exercises (55%), desensitization (42%), and patient/ family training and supervision (79%). All patients eventually returned to normal swallow and regular diet. This occurred at an average of 72.5+46.7 days post injury and 8.2+18.0 days post swallow assessment. Conclusions Pediatric patients with substantial burn injury may not only be at risk for aspiration but also have other forms of dysphasia that require intervention. Implementation of a swallowing protocol can identify patients who required further therapeutic intervention and can guide the recovery of safe swallowing and functional oral intake.
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Burkhead, Lori M. "Applications of Exercise Science in Dysphagia Rehabilitation." Perspectives on Swallowing and Swallowing Disorders (Dysphagia) 18, no. 2 (June 2009): 43–48. http://dx.doi.org/10.1044/sasd18.2.43.
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Abstract Dysphagia clinicians are charged with improving strength, skill, and endurance in order to rehabilitate oropharyngeal swallowing. The obvious method is exercise training. Dysphagia clinicians often use trial-and-error and experience to develop effective regimens. This article is intended to invoke broader and more accurate perspectives from our colleagues in exercise science.
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Humbert, Ianessa A. "Point/Counterpoint: Electrical Stimulation for Dysphagia: The Argument Against Electrical Stimulation for Dysphagia." Perspectives on Swallowing and Swallowing Disorders (Dysphagia) 20, no. 4 (December 2011): 102–8. http://dx.doi.org/10.1044/sasd20.4.102.
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Surface electrical stimulation for dysphagia is still a controversial subject. Some studies tout the benefits of using electrical stimulation (e-stim) for improving a disordered swallow. It is important to ensure that the discussion about e-stim is balanced. In this article, I discuss selected counterpoints, including e-stim's intended use, the objective findings of scientific findings, and whether speech-language pathology training in the area of swallowing anatomy and physiology adequately prepares clinicians to use e-stim for dysphagia. Overall, clinicians are urged to take into account all sides of this debate and make educated decisions about whether it should be a part of their clinical practice.
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Zhao, Weiwei, Chuanguang Ju, Daozhen Wang, and Huifen Shen. "Clinical observation of effects of ultrashort wave therapy combined with acupuncture and rehabilitation training in the treatment of patients with dysphagia after stroke." Journal of Neurorestoratology 7, no. 3 (2019): 136–42. http://dx.doi.org/10.26599/jnr.2019.9040014.
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Aim:The present study aimed to assess the clinical effects of ultrashort wave therapy combined with acupuncture and rehabilitation training on patients with dysphagia after stroke.Method:A total of 126 patients with stroke with dysphagia were randomly divided into an acupuncture group (control group: 63 patients) and a comprehensive rehabilitation training group (treatment group: 63 patients). The control group received rehabilitation training and acupuncture, whereas the treatment group received ultrashort wave therapy in addition to rehabilitation training and acupuncture (comprehensive rehabilitation training). The curative effect was evaluated using water-drinking test scores and swallowing quality of life scale (SWAL-QOL) scores before and after intervention. Additionally, the incidence of aspiration pneumonia was assessed in the two groups.Results:The water-drinking test scores in both groups were significantly better after 4 weeks of intervention than before intervention (P < 0.01); however, the improvement degree was significantly greater in the treatment group than in the control group (P < 0.01). The SWAL-QOL scores in both groups were significantly higher after intervention than before intervention (P < 0.05); however, the improvement degree was significantly greater in the treatment group than in the control group (P < 0.05). Moreover, the incidence of aspiration pneumonia was significantly lower in the treatment group than in the control group (P < 0.05).Conclusion:Comprehensive rehabilitation training can greatly improve dysphagia after stroke and can effectively reduce the incidence of aspiration pneumonia.
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McCulloch, Emaley, Audra Cuckler, Elise Valdes, and M. Courtney Hughes. "Effectiveness of Online Training and Supervisor Feedback on Safe Eating and Drinking Practices for Individuals With Developmental Disabilities." Intellectual and Developmental Disabilities 58, no. 2 (April 1, 2020): 111–25. http://dx.doi.org/10.1352/1934-9556-58.2.111.
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Abstract Dysphagia is common in individuals with developmental disabilities. Little research exists on the impact of trainings aimed at improving Direct Care Staff's (DCS) use of safe eating and drinking practices. This article presents two studies using pre-and postexperimental design, evaluating online training to improve DCSs' knowledge and ability to identify nonadherence to diet orders. A pilot study (n = 18) informed improvements to the intervention. The follow-up study (n = 64) compared those receiving training with those receiving training plus supervisor feedback. There was no significant difference between groups after training. Both groups increased in knowledge and identification of nonadherence to diet orders. Online training may be an effective tool for training DCS in safe eating and drinking practices.
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Khoja, Manal Abdullah. "Registered nurses’ knowledge and care practices regarding patients with dysphagia in Saudi Arabia." International Journal of Health Care Quality Assurance 31, no. 8 (October 8, 2018): 896–909. http://dx.doi.org/10.1108/ijhcqa-06-2017-0106.
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Purpose The purpose of this paper is to assess the knowledge and practices of nursing staff caring for patients with dysphagia to determine any needs for further education programmes. Design/methodology/approach A self-administered questionnaire with close-ended questions was completed by nurses at a tertiary hospital in Saudi Arabia to measure the depth of their dysphagia knowledge. Findings From 316 potential participants, a sample of 174 nurses completed the questionnaire. The results revealed that the participants had partial theoretical and practical knowledge about nursing care for patients with dysphagia. Of interest, 78 per cent of the nurses reported that they had received less than 1 h of training in dysphagia, and only 4 per cent were aware of speech and language pathologists’ role in dysphagia management. Practical implications As the medical professionals who have the most contact with the patients, nurses have a central role in the care of patients with dysphagia. This study provides information that will guide strategies for in-service nurse education dysphagia programmes. Originality/value The estimated Saudi prevalence of dysphagia is high due to increased incidence of medical conditions commonly associated with dysphagia, such as stroke, cerebral palsy and traumatic brain injuries from traffic accidents. Nurses play a pivotal role in caring for these patients. However, little is known about the level of care patients with dysphagia require in Saudi hospital settings.
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Florea, Cristina, Christine Bräumann, Christine Mussger, Stefan Leis, Larissa Hauer, Johann Sellner, and Stefan M. Golaszewski. "Therapy of Dysphagia by Prolonged Pharyngeal Electrical Stimulation (Phagenyx) in a Patient with Brainstem Infarction." Brain Sciences 10, no. 5 (April 28, 2020): 256. http://dx.doi.org/10.3390/brainsci10050256.
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Dysphagia after stroke impacts quality of life and is a risk factor for respiratory infections. Patients frequently require prophylactic measures including nasogastric tube or percutaneous endoscopic gastrostomy. Until recently, therapy for dysphagia was limited to training with a speech and language specialist. Intraluminal pharyngeal electrical stimulation (PES) is a new technique that stimulates the pharyngeal sensory afferents to the higher swallowing center in cortex. The clinical trials published to date involved stimulation for 10 minutes over three days. We present a case of brainstem infarction with severe dysphagia in a 53-year-old woman with preserved cognitive functions. For airway protection, she had a surgical tracheotomy. The initial swallowing training achieved slight improvements, but stagnated after three months so PES was tried. Under good PES tube tolerance, a prolonged and repeated stimulation protocol was administered, with the main purpose of relieving her of the tracheal tube. Although the swallowing improved, she stayed tube-dependent with minimal attempts with puréed food during therapy, and could not be decannulated. Further studies are required to assess the value of this promising approach for the treatment of dysphagia.
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Cohen, Audrey K. "Creating a Swallow Screening Program at Mass General Hospital: A Model for Development and Implementation." Perspectives on Swallowing and Swallowing Disorders (Dysphagia) 18, no. 4 (December 2009): 123–28. http://dx.doi.org/10.1044/sasd18.4.123.
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Abstract The Massachusetts General Hospital-Swallow Screening Tool (MGH-SST) is a two-part dysphagia screening tool for use by trained staff working with acute neuroscience patients. It was developed in 2004 for use on our neuroscience inpatient units using factors sensitive to aspiration risk. The MGH-SST provides early detection of those at risk for aspiration, guides the decision whether a patient can safely eat or drink, and acts as a trigger for appropriate speech--language pathology (SLP) consult for a comprehensive swallow evaluation. A staff education module was developed including a training video with clinical examples to simulate disordered clinical features, as well as a competency assessment. The MGH-SST was validated using trained nurses with patients with a broad range of neurological and neurosurgical injuries, comparing the MGH-SST results to an instrumental dysphagia assessment, fiberoptic endoscopic evaluation of swallowing (FEES). It was found to be a valid and effective screening to identify patients at risk for dysphagia. Elements critical to the success of a dysphagia screening program include multi-disciplinary collaboration, administrative support, comprehensive training to ensure reliable and consistent administration, and continuous performance measurements.
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Curtis, James A., Zeina N. Seikaly, and Michelle S. Troche. "Respiratory–Swallow Coordination Training Improves Swallowing Safety and Efficiency in a Person With Anoxic Brain Injury." American Journal of Speech-Language Pathology 29, no. 4 (November 12, 2020): 1965–75. http://dx.doi.org/10.1044/2020_ajslp-20-00095.
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Purpose The aim of this study was to assess the effects of respiratory–swallow coordination training (RSCT) on respiratory–swallow coordination (RSC), swallowing safety (penetration/aspiration), and swallowing efficiency (pharyngeal residue) in a person with anoxic brain injury. Method A 68-year-old man with anoxic brain injury, tachypnea, and severe dysphagia was recruited to participate in a prospective AABAA single-subject experimental design. RSC, swallowing safety, and swallowing efficiency were measured at each assessment using respiratory inductive plethysmography and flexible endoscopic evaluations of swallowing. Data were analyzed descriptively using Cohen's d effect size. Outcome measures were compared pre-RSCT to post-RSCT, and pre-RSCT to a 1-month retention assessment. Results Improvements in RSC were observed immediately post-RSCT ( d = 0.60). These improvements were maintained upon retention assessment 1 month later ( d = 0.60). Additionally, improvements in swallowing safety ( d = 1.73), efficiency ( d = 1.73), and overall dysphagia severity ( d = 1.73) were observed immediately post-RSCT and were maintained upon retention assessment 1 month later ( d = 1.73). Conclusions Clinically meaningful improvements in RSC were observed following four sessions of RSCT, which were subsequently associated with large improvements in swallowing safety and efficiency. RSCT may be an efficacious, clinically feasible skill-based exercise for people with anoxic brain injury, suboptimal RSC, and dysphagia. Future work is needed to expand these findings in a larger cohort of people with dysphagia.
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Kamal, Rahayu Mustaffa, Elizabeth Ward, and Petrea Cornwell. "Dysphagia training for speech-language pathologists: Implications for clinical practice." International Journal of Speech-Language Pathology 14, no. 6 (September 14, 2012): 569–76. http://dx.doi.org/10.3109/17549507.2012.713394.
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O'Donoghue, Cynthia R., and Sarah E. Hegyi. "Dysphagia Management in the Schools: Concepts in Training and Competency." Perspectives on Swallowing and Swallowing Disorders (Dysphagia) 18, no. 3 (October 2009): 103–8. http://dx.doi.org/10.1044/sasd18.3.103.
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Abstract As the demands to care for children with swallowing and feeding disorders continue to evolve for school-based speech-language pathologists (SLPs), avenues to establish, maintain, and monitor competency are imperative. Optimally, these approaches should delineate dysphagia protocols and practices at school, district, and state levels that are grounded in evidence. Key foundational components to improving services for children, while minimizing the liabilities for SLPs, include legislated scope of practice within school licensure regulations, published guidelines and standard of practice protocols, documented yearly competencies, and established monitoring for knowledge and skill levels. This article outlines the Commonwealth of Virginia's approaches to these goals as a preliminary model to address these logistical issues. Although a concept not reported previously in the school-based swallowing and feeding literature, a continuum of knowledge and skills is considered. This continuum emphasizes acquired skills do not mean “competency” for life. Competency is dynamic; SLPs will advance or regress in their performances based on personal interests, continuing education, and clinical experiences.
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Li, Chih-Ming, Tyng-Guey Wang, Hsiao-Yu Lee, Hsueh-Pei Wang, Shang-Heng Hsieh, Michelle Chou, and Jia-Jin Jason Chen. "Swallowing Training Combined With Game-Based Biofeedback in Poststroke Dysphagia." PM&R 8, no. 8 (August 2016): 773–79. http://dx.doi.org/10.1016/j.pmrj.2016.01.003.
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Bastian, Jalinda, and Joselyn Eitemiller. "Poster 90: Intensive Swallowing Training for Elderly People With Dysphagia." PM&R 2 (September 2010): S45—S46. http://dx.doi.org/10.1016/j.pmrj.2010.07.122.
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Ito, Hiroyuki, and Takakuni Kato. "Effectiveness of Physical Training in the Treatment of Dynamic Dysphagia." Japan Journal of Logopedics and Phoniatrics 38, no. 4 (1997): 385–89. http://dx.doi.org/10.5112/jjlp.38.385.
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Tredinnick, Gerlind, and Naomi Cocks. "Effectiveness of dysphagia training for adult learning disabilities support workers." British Journal of Learning Disabilities 42, no. 2 (April 7, 2013): 125–32. http://dx.doi.org/10.1111/bld.12018.
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Wey, Jing-Hwa, Jin-Er Lee, Kwang-Hwa Chang, Yen-Nung Lin, and Wen-Kuei Chung. "Dysphagia in a Young Man." Case Reports in Neurology 12, no. 3 (November 9, 2020): 410–15. http://dx.doi.org/10.1159/000507242.
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This case report presents oropharyngeal dysphagia due to oromandibular and cervical dystonia, a rare consequence of aseptic meningitis. A 19-year-old male who was diagnosed with aseptic meningitis visited the rehabilitation outpatient clinic for a sense of foreign body in his throat and odynophagia. Repetitive involuntary movements of his facial, tongue, and laryngeal muscles accompanied by lateroanterior torticollis were observed. Videofluoroscopic swallowing study showed inefficient bolus formation due to repetitive rolling of his tongue and vallecular stasis without penetration or aspiration. Dysphagia and odynophagia had brought the patient significant weight loss and frustration. We provided swallowing training to improve the efficiency and safety of swallowing. The patient’s symptoms improved gradually along with body weight gain and emotional stability. Acute-onset oropharyngeal dysphagia is devastating for young adults. A multidisciplinary approach is mandatory for optimal outcome. We share our experience as a team work and emphasize the rehabilitation aspect.
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Speyer, Renée, Reinie Cordier, Anna-Liisa Sutt, Lianne Remijn, Bas Joris Heijnen, Mathieu Balaguer, Timothy Pommée, Michelle McInerney, and Liza Bergström. "Behavioural Interventions in People with Oropharyngeal Dysphagia: A Systematic Review and Meta-Analysis of Randomised Clinical Trials." Journal of Clinical Medicine 11, no. 3 (January 28, 2022): 685. http://dx.doi.org/10.3390/jcm11030685.
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Objective: To determine the effects of behavioural interventions in people with oropharyngeal dysphagia. Methods: Systematic literature searches were conducted to retrieve randomized controlled trials in four different databases (CINAHL, Embase, PsycINFO, and PubMed). The methodological quality of eligible articles was assessed using the Revised Cochrane risk-of-bias tool for randomised trials (RoB 2), after which meta-analyses were performed using a random-effects model. Results: A total of 37 studies were included. Overall, a significant, large pre-post interventions effect size was found. To compare different types of interventions, all behavioural interventions and conventional dysphagia treatment comparison groups were categorised into compensatory, rehabilitative, and combined compensatory and rehabilitative interventions. Overall, significant treatment effects were identified favouring behavioural interventions. In particular, large effect sizes were found when comparing rehabilitative interventions with no dysphagia treatment, and combined interventions with compensatory conventional dysphagia treatment. When comparing selected interventions versus conventional dysphagia treatment, significant, large effect sizes were found in favour of Shaker exercise, chin tuck against resistance exercise, and expiratory muscle strength training. Conclusions: Behavioural interventions show promising effects in people with oropharyngeal dysphagia. However, due to high heterogeneity between studies, generalisations of meta-analyses need to be interpreted with care.
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Drulia, Teresa, and Alexis Hodge. "Clinical Practice Patterns of Speech-Language Pathologists Delivering Dysphagia Services to Persons with COPD: Analysis of Survey Outcomes." Seminars in Speech and Language 42, no. 05 (November 2021): 363–83. http://dx.doi.org/10.1055/s-0041-1735846.
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AbstractSwallowing impairments co-occur with chronic obstructive pulmonary disease (COPD) leading to aspiration, disease exacerbations, and malnutrition. This pilot survey study aimed to identify current clinical practice patterns for swallowing evaluation and treatment in persons with COPD. A 35-question Qualtrics survey was deployed to medical speech-language pathology (SLP) social media sites and professional boards; flyers were distributed at a professional conference. Forty-eight SLPs completed the study. SLPs routinely include a clinical swallow examination (96%), videofluoroscopic swallowing study (79%), adjunctive respiratory measures (respiratory rate [83%], and pulse oximetry [67%], respiratory–swallow pattern [77%]) but less frequently include fiberoptic endoscopic evaluation of swallowing (23%). Self-reported advanced clinical experience and expert respiratory analysis skills were associated with adjunctive respiratory measure (respiratory rate, pulse oximetry) inclusion during assessment. Compensatory strategy training (77%) is a preferred treatment for dysphagia in COPD; however, respiratory–swallow pattern training and expiratory muscle strength training are increasing in use. SLPs self-report a comprehensive, individualized patient-centered care approach with inclusion of adjunctive respiratory-focused methods in dysphagia evaluation and treatment practice in persons with COPD. Advances in the identification of the integral role of respiratory function in swallowing integrity may be translating to clinical practice methods for dysphagia management in persons with COPD.
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Varindani Desai, Rinki, and Ashwini Namasivayam-MacDonald. "Practice Patterns of Speech-Language Pathologists Managing Dysphagia in Dementia: A Cross-Sectional Survey in the United States." Perspectives of the ASHA Special Interest Groups 5, no. 6 (December 17, 2020): 1631–46. http://dx.doi.org/10.1044/2020_persp-19-00152.
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Purpose The purpose of this study was to describe the practice patterns of speech-language pathologists (SLPs) managing dysphagia in persons with dementia (PWD) in the United States. We wanted to investigate if clinicians are (a) adequately prepared to manage dysphagia in PWD, (b) confident in their ability to manage dysphagia in PWD, (c) performing comprehensive dysphagia assessments in PWD, and (d) using evidence-based techniques to manage dysphagia in PWD. Method A web-based survey comprising 32 questions was developed, field-tested, and distributed to members of the American Speech-Language-Hearing Association's Special Interest Groups 13 and 15, as well as members of online SLP forums. Two hundred fifty-one responses were obtained and analyzed using descriptive methods. Results Respondents were experienced SLPs working primarily in acute care and skilled nursing facility settings. Their confidence in assessment and treatment was found to significantly increase with years of experience ( p < .001). The majority indicated more continuing education opportunities need to be offered related to managing dysphagia in PWD. Most reported using assessments that have not been validated for PWD. Clinical swallow examinations were utilized more frequently than instrumental exams to inform treatment planning. There was variability in the treatment techniques used to manage dysphagia in PWD, with a focus on use of compensatory strategies and providing caregiver training. Respondents listed several barriers to managing dysphagia in PWD and stated influences on their clinical decision making. Conclusions While some trends emerged regarding dysphagia practice patterns among SLPs managing PWD in the United States, a lack of consensus regarding best practices was apparent. The establishment of formal diagnostic standards, the elucidation of the underlying mechanisms of different types of dementia, and the development of evidence-based treatments for managing dysphagia in PWD could help improve SLP management of dysphagia in dementia and reduce the significant burden of this disease.
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Pelletier, Cathy A. "What Do Certified Nurse Assistants Actually Know About Dysphagia and Feeding Nursing Home Residents?" American Journal of Speech-Language Pathology 13, no. 2 (May 2004): 99–113. http://dx.doi.org/10.1044/1058-0360(2004/012).
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The purpose of this study was to examine certified nurse assistants' (CNAs') knowledge of dysphagia and how to feed nursing home residents using nonparticipatory structured feeding observation, critique of staged feeding behaviors on film, and semistructured interview in a triangulation methods design. Content analysis of the data confirmed previous studies that suggested CNAs lack knowledge about dysphagia and how to feed residents. A surprising result was the lack of accurate, comprehensive information in CNA texts and classrooms about dysphagia and how to manage challenging feeding behaviors. Speech-language pathologists are uniquely trained to improve CNA communication skills and provide accurate information to nursing colleagues. Specific recommendations of how to improve CNA feeding training programs are provided.
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Wilson, Jennifer J., Amanda K. Simmons, and Jillian H. McCarthy. "Pediatric Dysphagia: Survey Results Describing Speech-Language Pathologists' Education and Experience." Perspectives of the ASHA Special Interest Groups 5, no. 1 (February 21, 2020): 236–45. http://dx.doi.org/10.1044/2019_persp-19-00016.
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Purpose Evaluation and treatment of pediatric dysphagia, swallowing difficulties occurring during childhood, is in the speech-language pathologists' (SLPs) scope of practice; however, little is known regarding the education SLPs receive during their graduate work and afterwards to effectively assess, treat, and manage this diagnosis. Method An 11-question survey was developed to examine the experience and opinions of SLPs related to the type and extent of pediatric dysphagia education and training they have and/or should have received during their graduate education. The survey was disseminated to SLPs across the United States via social media and e-mail Listservs. Results Survey results from 134 participants across the country, with varying clinical backgrounds, indicated a lack of pediatric dysphagia education during graduate school. SLPs reported overcoming these insufficiencies through gaining work experience and pursuing continuing education units on pediatric dysphagia. SLPs overwhelmingly (> 95% of respondents) recommended a full course or unit focusing on pediatric dysphagia for master's students in speech-language pathology. Survey results found a statistically significant increase in the likelihood of completion of a pediatric dysphagia unit or course for students graduating in the last 10 years; however, this positive trajectory shows a modest increase in the availability of coursework to prepare pediatric SLPs to evaluate and treat the growing pediatric dysphagia population. Conclusions Some positive changes in SLP education can be inferred from these results; however, there is still additional work to be done to equip pediatric SLPs to provide adequate care for a growing population with pediatric dysphagia.
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Edmiaston, Jeff, Lisa Tabor Connor, Lynda Loehr, and Abdullah Nassief. "Validation of a Dysphagia Screening Tool in Acute Stroke Patients." American Journal of Critical Care 19, no. 4 (July 1, 2010): 357–64. http://dx.doi.org/10.4037/ajcc2009961.
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Background Although many dysphagia screening tools exist, none has high sensitivity and reliability or can be administered quickly with minimal training. Objective To design and validate a swallowing screening tool to be used by health care professionals who are not speech language pathologists to identify dysphagia and aspiration risk in acute stroke patients. Methods In a prospective study of 300 patients admitted to the stroke service at an urban tertiary care hospital, interrater and test-retest reliabilities of a new tool (the Acute Stroke Dysphagia Screen) were established. The tool was administered by nursing staff when patients were admitted to the stroke unit. A speech language pathologist blinded to the results with the new tool administered the Mann Assessment of Swallowing Ability, a clinical bedside evaluation, with dysphagia operationally defined by a score less than 178. Results The mean time from admission to screening with the new tool was 8 hours. The mean time between administration of the new tool and the clinical bedside evaluation was 32 hours. For the new tool, interrater reliability was 93.6% and test-retest reliability was 92.5%. The new tool had a sensitivity of 91% and a specificity of 74% for detecting dysphagia and a sensitivity of 95% and a specificity of 68% for detecting aspiration risk. Conclusions The Acute Stroke Dysphagia Screen is an easily administered and reliable tool that has sufficient sensitivity to detect both dysphagia and aspiration risk in acute stroke patients.
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Miller, Ruth, and Karen Krawczyk. "Dysphagia Training Programmes: ‘Fixes that Fail’ or Effective Inter-Disciplinary Working?" International Journal of Language & Communication Disorders 36, s1 (January 2001): 379–84. http://dx.doi.org/10.3109/13682820109177915.
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Davis, Lori, and Karen Copeland. "Effectiveness of Computer-Based Dysphagia Training for Direct Patient Care Staff." Dysphagia 20, no. 2 (June 2005): 141–48. http://dx.doi.org/10.1007/s00455-005-0007-z.
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