11.1 - Treatment of Dysphagia Flashcards
What are the two different strategies that are used to treat dysphagia?
Compensatory strategies
Rehabilitation
What are swallowing compensation strategies?
3
Changing viscosities
Changing postures
Swallowing strategies
What is swallowing rehabilitation?
2
Swallowing maneuvers (Masako, Mendelsohn, Shaker, Supraglottic, Super Supraglottic)
They improve swallowing physiology
What five things do we need to consider before settling on a dysphagia treatment?
Options
Physiology
Risks vs. benefits
Outcomes (Qol, etc.)
Compliance (will pt. be able to)
What are seven physiology-based impairments we can treat?
Oral stage deficits
Swallow initiation
VP closure
BoT to PPW retraction
Hyolaryngeal excursion
Airway protection
UES opening
What strategies can improve Oral Stage Deficits?
Strengthening exercises (CSL, IOPI, Therabite)
What strategies can improve Swallow Initiation?
Thermal/tactile stimulation
What strategies can improve VP Closure?
CTAP
What strategies can improve BoT to PPW Retraction?
2
Masako
Effortful swallows
What strategies can improve Airway Protection?
2
Supraglottic Maneuver
Super Supraglottic maneuver
What strategies can improve UES Opening?
Mendelsohn
What substances can be injected into the VFs?
3
Teflon
Collagen
Fat
What are five additional techniques that can be used to treat dysphagia?
Pitch gliding exercises.
Myofascial release (massage)
Expiratory Muscle Strength Training
Free-water protocol
LSVT
What is Pitch gliding?
What does it improve? (2)
Gliding from a low pitch to high pitch on sustained phonation.
//
Pharyngeal muscles
Airway protection
What is Myofascial Release?
3
Type of massage used by Physical therapists that has been recently used by SLP as well
Similar to circumlaryngeal massaging.
Targets tightness in muscles
Who is Myofascial Release beneficial for?
Individuals with fibrosis
How does Expiratory Muscle Strength Training (EMST) help with swallowing?
(4)
Improved respiratory pressure
Improved strength of cough
Improved sub-mental activity (muscles under the chin)
Better airway protection
How does LSVT improve swallowing?
3
Increases sub-glottal pressure.
Improve VF and laryngeal vestibule closure
May improve pharyngeal transit too.
What is the Free-Water Protocol?
3
Water continues to be allowed
No water is given during meals or for 30 minutes after eating (thickened liquids used during meals)
No medications given with water
What is the idea behind the Free-Water Protocol?
2
Aspirating water is a benign event
Good hydration is important for oral care and quality of life
