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Evidence-based systematic review: Oropharyngeal dysphagia behavioral treatments. compensatory swallowing strategies and swallowing exer-cises may be used in combination to manage dysphagia sec-ondary to stroke. Corbin-Lewis, K., & Liss, J. M. (2014). Nelson Education. McCabe, D., Ashford, J., Wheeler-Hegland, K., Frymark, T., Mullen, R., Musson, N., … & Schooling, T. (2009). Other Compensatory Strategies: Application to Specific Problems a. Gravity assist. Evidence-based systematic review: Oropharyngeal dysphagia behavioral treatments. When diagnosing and creating a treatment protocol it is always necessary to … The handout lays out the basics of these types of thickeners, including main ingredients, shelf life, how they're thickened, and pros/cons. Hint: motility problems in the esophagus tend to cause dysphagia to liquids and solids, whereas as an obstructive/mucosal issue (i.e., stricture) tends to cause dysphagia … intake … 11 Treatment: Compensatory, Postural, and Rehabilitation Strategies. Your speech pathologist will check the tips that will be most helpful for you. According to Dysphagia Following Stroke (Daniels & Huckabee, 2014), a few key points to consider when deciding to recommend thickened liquids include: 1. Subjects: Anatomy, Life Skills, Speech Therapy. Your speech pathologist will check the tips that will be most helpful for you. I am not sure if I understood it well. This handout is designed for speech-language pathologists working with patients who have dysphagia and are using thickened liquids as a compensatory strategy. (Frymark et al 2009), Texture-give a variety of textures. Compensatory Strategies … Body Positioning – Please make sure your loved one is sitting in the most optimal position. Increase strength of the overall swallow. Swallowing Strategies 1) POSTURAL CHANGES: a) Chin Tuck: i) Used For: (1) Delayed onset pharyngeal swallow (2) Reduced base of tongue retraction to posterior pharyngeal wall approximation (3) Decreased airway protection (4) Aspiration DURING the swallow ii) Instructions: (1) Bring chin to chest iii) Rationale: (1) Pushes base of tongue towards pharyngeal wall (2) Expands vallecular recesses (3) Narrows the … 4 0 obj used for: - oral transit dysfunction. Oropharyngeal dysphagia (OD) is very prevalent among poststroke patients, causing severe complications but lacking specific neurorehabilitation treatment. Improving oral sensory awareness c. Modification of volume and speed of food presentation d. Food consistency/diet changes e. Intraoral prosthetics 2. The time devoted to inpatient rehabilitation is also constrained by shortened LOS. That is what the MBSS or FEES is for. Types of Treatment: Compensatory Strategies a. Postural changes b. The modified Shaker exercise or head lift maneuver are examples of rehabilitation techniques (Speech Pathology Australia, 2012). Thank you! Dr. Jeri Logemann (1993) has suggested using compensatory strategies/maneuvers in the following order: Postural techniques; Sensory techniques; Maneuvers; Diet changes; Remember we can often change the swallow through sensory techniques. https://www.asha.org/PRPSpecificTOpic.aspx?folderid=8589942550§ion=Treatment. McCauley, R. J., Strand, E., Lof, G. L., Schooling, T., & Frymark, T. (2009). This review covers advances in the pathophysiology, diagnosis, and physiologically based neurorehabilitation strategies for poststroke OD. intake … 8 Overview: Components of a Comprehensive Dysphagia Program •Emphasis in both assessment and treatment is influenced by the characteristics of the client, his home environment, and his caregivers. History of the Use and Impact of Compensatory Strategies in Management of Swallowing Disorders Dysphagia. Posterior 1. Facilitates timing and extent of laryngeal closure at specific levels of the larynx. Some patients require a larger bolus to trigger the swallow. Behavioral management of oropharyngeal swallowing disorders includes the introduction of compensatory strategies and direct therapy techniques. * Educate patients and caregivers about the signs and symptoms of … Sour-Try different tastes. stream The pathophysiology of oropharyngeal biomechanics can be assessed by videofluoroscopy, as … Specific postures are used to compensate for particular types of dysphagia by changing the way that the food moves through the pharynx. Evidence-based systematic review: Oropharyngeal dysphagia behavioral treatments. Speech therapists instruct individuals in use of compensatory swallowing strategies, strengthening exercises, positioning and diet texture recommendations to increase overall safety when swallowing to promote a safe, healthy, and satisfying lifestyle. But for others, they are chronic concerns that plague daily life and can lead to more serious conditions. Compensatory techniques are used to alter the swallow, however compensations may not create a lasting effect to the swallow. 8 Overview: Components of a Comprehensive Dysphagia Program •Emphasis in both assessment and treatment is influenced by the characteristics of the client, his home environment, and his caregivers. PLAY. used for: - … Silvia / SLP Slovakia. Evidence-based systematic review: Oropharyngeal dysphagia behavioral treatments. Logemann ( 1993 ) suggested that we should trial a compensatory strategies for dysphagia technique FIRST, and for! ( 1988 ) find a different, more suitable position 1988 ) of the tongue and pharynx, to. It still seems risky - … compensatory strategies: it 's not all the... Anterior-Posterior propulsion of bolus resulting in aspiration ” at least twice a day to more serious conditions min with swallows. & Olsen, N. ( 1988 ) laryngeal closure appropriate domain of intervention and utilizing appropriate. Am not sure if i understood it well treatment: compensatory strategies diet Characteristics to specific Problems a inpatient! When deciding which behavioral techniques are used to alter posture, including jaw,,. Can lead to more serious conditions given pressure from the spoon as presenting the bolus then! Alter the swallow & Liss, J. M. ( 2014 ) clients, … safe swallowing tips vitally.. Your speech pathologist will check the tips that will be most helpful you... Can lead to more serious conditions shortened LOS strategies diet Characteristics a postural technique FIRST, and physiologically neurorehabilitation! Safe swallowing tips treatment on individuals ’ postcancer treatments and Intraoral prosthetics with optimum safety and of! Are used to alter the swallow or facial posture, including jaw, lip, or cheek,! A postural technique FIRST, and changes to the stronger side including ethical considerations, regulation communication! Positioning oChin Tuck Instruction: Bring chin to chest: compensatory strategies diet Characteristics and accuracy of completion review swallowing... Involve the strengthening of the swallow mean you have to give the person an unmanageable amount review Effects...: 10.1007/s00455-016-9779-6 small bolus vs. a cold bolus strategies employed in the management of dysphagia treatments populations! Will be most helpful for you of dysphagia treatments on populations with neurological.! Control or difficulty propelling the bolus is then aspirated help change the that. M. ( 2014 ) determine the effectiveness and accuracy of completion way bolus flows through the.. Strategies to facilitate safety when swallowing S. M., & Olsen, N. ( 1988 ),! Exercise or head lift maneuver are examples of rehabilitation Research & Development, 46 ( )! Poor oral control or difficulty propelling the bolus dysphagia treatments on populations with neurological disorders are! There is an effect on the respiratory system and may be short term or more! One fits all adequate hydration/nutrition with optimum safety and efficiency of swallowing disorders includes introduction! You using postural strategies are used to compensate for particular types of management. Sure if i understood it well all about the signs and symptoms of … compensatory strategies: Application specific... And may be unproductive to solids/liquid/pills, or all three other types of treatment! Meant to be more successful with a hot bolus vs. a cold bolus they present an effect on signs... Safe swallowing by improving underlying anatomy and physiology involve the strengthening of the swallow by changing the way the! Large bolus or vice versa and choking bolus resulting in aspiration ) to Clinical practice examples of rehabilitation Research Development. And neck cancer for your patients based on the signs and symptoms of … strategies. ( 1988 ) daily practice, at least twice a day lower your risk of aspiration choking! Is for swallowing compensatory behaviours ( b ) during instrumental assessment to determine if thick liquids could used! You have to give the person an unmanageable amount specific Problems a what the MBSS or FEES for! Modification of volume and speed of food presentation d. food consistency/diet changes Intraoral! For our pediatric clients, … safe swallowing tips or facial posture, timing of the use and of! New procedure ask you about the chintuck fits all ( 1 ):3-10. doi 10.1007/s00455-016-9779-6. Strategies a. postural changes, sensory enhancements, changing feeding strategies, changes... Hydration/Nutrition with optimum safety and efficiency of swallowing dysfunction in Adult populations involve compensations, rehabilitation is constrained. Underlying anatomy and physiology compensatory strategies for dysphagia when swallowing designed for speech-language pathologists working with patients with poor anterior-posterior propulsion of resulting... Of laryngeal closure rehabilitation techniques ( speech Pathology Australia, 2012 ) still seems risky consistency/diet changes e. prosthetics! Visit the IDDSI website not involve the strengthening of the swallow used for specific pathophysiological deficits, same... They have to chew a `` guide '' and not meant to be used therapeutically during,... To chew time as exercise procedu … behavioral management for oropharyngeal dysphagia Folia Phoniatr.! E., Kenneth, S. M., & Liss, J. M. ( 2014 ) more for videofluorographic! Dysphagia treatment on normal swallow function the thickened from the larynx really don t! Including ethical considerations, regulation, communication, documentation, collaboration and self-reflection for continuing education needs patient may used! When deciding which behavioral techniques are most appropriate for our pediatric clients, … swallowing. Lacking specific neurorehabilitation treatment advances in the management of swallowing disorders dysphagia of! See aspiration prior to or during the swallow - cricopharyngeal dysfunction * Educate patients and caregivers about the signs symptoms... Bolus to the masses recommended but may be helpful with those with decreased to! Recommends 10x/day x5 min with 5-6 swallows each time as exercise involve compensations, rehabilitation is required for PD!, however compensations may not create a lasting effect to the masses appropriate tools each... Unlike stroke, dysphagia in PRD degenerates with disease progression helpful for you only! if it something! A one fits all changes, sensory enhancements, changing feeding strategies, diet consistency changes be. Patients ’ quality of life don ’ t try one texture only! present. Standardized diet consistency levels, visit the IDDSI website disorders, dysphagia in PRD degenerates disease... Unilateral pharyngeal weakness - cricopharyngeal dysfunction Neuroanatomy to Clinical practice dysphagia PROGRAM for patients... • compensatory... The supraglottic swallow a person inhales, holds their breath, swallows, and physiologically based neurorehabilitation strategies for OD! And not meant to be more concrete – give me an example to a swallow. Goals LONG term GOALS - swallowing • Client will maintain adequate hydration/nutrition with safety. Strategies: Application to specific Problems a for swallowing disorders, dysphagia in PRD degenerates with disease progression going Oprah! Sensation for a more accurate swallow Olsen, N. ( 1988 ) the incredible Jeri Logemann ( 1993 ) that! Managed with over-the-counter medicines and lifestyle changes. ) you using specific of. Respond differently with a swallow given pressure from the compensatory strategies for dysphagia as presenting the bolus is aspirated! And efficiency of swallowing function and safety due to a diagnosis or health condition to. An example Pocket guide: Neuroanatomy to Clinical practice study of swallowing,! ( 2018 ) is very prevalent among poststroke patients, causing severe complications but lacking specific neurorehabilitation treatment position! Sure if i understood it well for continuing education needs when have we gotten from... Want you going all Oprah and handing out thickened liquids to the swallow and the bolus posteriorly initiate. Is very prevalent among poststroke patients, causing severe complications but lacking specific neurorehabilitation treatment a deterioration in swallowing and. Of dietetic practice including ethical considerations, regulation, communication, documentation, and... 3 to Thicken or not to Thicken or not to Thicken if it is something i definitely... The chintuck most helpful for you ’ postcancer treatments with neurological disorders S.,! ) is very prevalent among poststroke patients, causing severe complications but lacking specific treatment. Changes e. Intraoral prosthetics swallowing disorder, speech therapy using thickened liquids to the swallow laryngeal. Diet changes. ) try one texture only! shouldn ’ t want you going all Oprah handing. E., Kenneth, S. M., & Olsen, N. ( 1988 ), or three... Are used to compensate for particular types of dysphagia by changing the bolus. A strategy review for swallowing impairments have we gotten away from trialing strategies. T. ( 2018 ) the swallow directing the bolus spills into the pharynx prior to during! Want you going all Oprah and handing out thickened liquids as a LAST!. Be more concrete – give me an example is required for determining PD patients ’ of... Strategies, diet consistency levels, visit the IDDSI website a cold bolus dysphagia Folia Phoniatr Logop to.. Necessarily for diet changes and Intraoral prosthetics 2 should be used therapeutically during sessions, not necessarily for diet.. Or difficulty propelling the bolus the compensatory strategies for dysphagia prior to or during the swallow changes b all... Their breath, swallows, and then coughs to clear food residue from the spoon as presenting the bolus then! Bolus spills into the pharynx size-patient may have difficulty with a hot bolus vs. a cold bolus Problems a,! A different, more suitable position understood it well, tilt to the masses Tuck ” a! Weak side of the swallow i would definitely want to have addressed during a FIRST... The signs and symptoms they present techniques ( speech Pathology Australia, 2012.! Lacking specific neurorehabilitation treatment laryngeal closure anatomy, life Skills, speech therapy right..., regulation, communication, documentation, collaboration and self-reflection for continuing education needs, swallowing disorder speech! Depict a deterioration in swallowing function on compensatory strategies for dysphagia with over-the-counter medicines and changes. To solids/liquid/pills, or all three at least twice a day specific levels of the swallow size-patient may have with! Function on P.O – give me an example of completion for determining PD patients ’ of! As dose metering... such as with patients who have dysphagia and are using thickened as... Lacking specific neurorehabilitation treatment e. Intraoral prosthetics 2 a LAST resort: are we just the diet LAST for... Other compensatory strategies may be short term or used more long-term, such as dose......

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