Compensatory Strategies Flashcards
What is the purpose of compensatory strategies?
immediate but typically transient effect on efficiency or safety of swallow by changing the flow and gravitational direction of the bolus.
When would you NOT use compensatory strategies AND rehabilitative exercises?
degenerative, late-stage diseases
Which compensatory strategy is the last resort option?
diet modifications
What are the levels of solid modified diets?
regular, dysphagia advanced (no hard, crunchy, sticky, dry foods), mechanical soft, puree
What are the two types of postural strategies?
body posturing, pharyngeal posturing
What are the types of pharyngeal posturing?
chin tuck, head rotation, head tilt
What does a chin tuck do?
widens vallecula and slows flow to prevent bolus from entering airway; pushes tongue base backward toward pharyngeal wall; narrows laryngeal entrance
Which physiological problems would a chin tuck help?
delayed pharyngeal swallow, posterior spillage; reduced tongue base retraction, residue in vallecula; reduced airway closure, can help eliminate aspiration
What does a head rotation do?
twists the pharynx and closes off the side to which the person is rotated; provides external pull on the PES and facilitates opening
Which physiological problems would a head turn help?
unilateral pharyngeal wall paralysis or paresis; reduced laryngeal closure (pushes weaker vocal fold to midline, helping vocal folds to adduct; reduced PES opening
what does a head tilt do?
uses gravity to pull food to stronger side
Which physiological problems would a head tilt help?
unilateral oral impairment (head tilt toward stronger side); unilateral pharyngeal impairment, with head tilted toward stronger side
What does a neck extension do?
uses gravity to drain food from oral cavity
which physiological problems would a neck extension help?
reduced tongue control
What is a 3-second sweep?
after bolus is in mouth, bolus mentally counts to 3 prior to posterior transfer of bolus.
Which physiological problems good for 3-second sweep?
delayed swallow initiation
What is a lingual sweep?
using tongue to clear residue from oral recess
What are the types of bolus control strategies?
3-second sweep, lingual sweep, alternating solids and liquids, dry swallows, tactile thermal stimulation, bolus placement, modification of bolus size, adaptions in rate of intake, slurp and swallow
What is tactile thermal stimulation?
stroking the anterior faucial arches with cold things… increases oral sensory awareness, heightens sensation which should result in faster swallow response; should not be used as a rehabilitative strategy
What are some volitional airway protection strategies?
supraglottic swallow, super supraglottic swallow, vocal quality checks
what is a supraglottic swallow?
pt takes breath and holds it firmly while swallowing the bolus. after the swallow they cough, swallow, cough.
what is a supraglottic swallow?
pt takes breath, holds tightly. swallow hard, with great effort. after swallowing , cough hard and swallow again.
