Therapy Technique

Question 0

What head positions are useful in therapy?

Answer 0

For: poor anterior bolus transit but good airway protection
What: throw head backwards into extension
Why: propels bolus backward

For: reduced laryngeal closure
What: rotate head to damaged side, chin down
Why: increases vocal cord closure by applying extrinsic pressure

For: unilateral oral and pharyngeal weakness
What: tilt head and neck to stronger side
Why: keeps material on stronger side in the oral cavity and through the pharynx

Or
What: turn the head to the weaker side
Why: closes the pyriform sinus on the affected side and directs material down the more normal side

For: delayed swallow
What: head flexed, chin tuck
Why: widens the vallecular for food to collect there giving time for the swallow to trigger, narrows airway entrance, pushes epiglottis posteriorly

Question 1

What should we consider when deciding on a therapy approach?

Answer 1

Any associated medical problems? Cognitive difficulties

Clients motivation and fatigue

Is dysphagia progressive?

How frequently therapy can be provided

Who can support therapy, postures and strategies?