Swallow Strong Device

Swallow Strong

Have you seen the Swallow Strong device yet?  If you haven’t, you’re definitely missing out.

Much like the Iowa Oral Performance Instrument  (IOPI), the Swallow Strong was developed to not only measure lingual strength, but to use visual feedback for treatment.

The Swallow Strong, formerly called the MOST (Madison Oral Strength Trainer) was used in the research for IPRO (Isometric Progressive Resistive Oropharyngeal therapy).

Where the IOPI uses a tongue bulb to measure strength and use resistance, the Swallow Strong uses a mouthpiece that fits in the palate with five sensors (anterior, medial, poster and 2 lateral) to work the different parts of the tongue.

Swallow Strong Mouthpiece

The Swallow Strong also uses a tablet to record data, set limits and provide visual feedback during lingual exercises and during assessment of lingual strength.

What’s the big deal about the Swallow Strong?  It just won an award for “Most Innovative” by LINK LTC, a Long-Term Care organization.

Make sure to check out the award winning Swallow Strong!  It’s definitely worth a look!

ISO-SED

A huge thanks to Jolie Parker for sending me an ISO device for this blog post!!

I am always trying to find an exercise that is fairly easy for my patients.  A great exercise is the Shaker.  The guidelines for repetitions are provided!  Not many exercises come with instructions for reps.  The Shaker focuses on the suprahyoid muscles and assists with UES opening, reducing pyriform sinus residue.

The problem with the Shaker is that it is very difficult to complete.

One thing I do know about exercise is that by adding resistance, you are adding “weight” to the exercise.  Now, most people don’t run to the gym to lift “air weights”.  They left weights and then add to the weight to increase muscle and strength.

I recently wrote a post about an article for CTAR or Chin Tuck Against Resistance.  Another great article to read is about an exercise called Jaw Opening Against Resistance.  CTAR is very similar to the Shaker, however the patient remains seated upright and use a device for the resistance.

Initially, I used the Neckline Slimmer as resistance.  The Neckline Slimmer is a tiny little device with a spring inside.  You push down using your chin on the top until you can no longer push.  The bottom portion of the device is on your chest so you are doing a chin tuck.  The spring offers resistance.  The spring is also interchangable and comes in low, medium and high resistance.

Neckline Slimmer

The trouble with the Neckline Slimmer, which was created to help people eliminate a double chin, doesn’t last as long as I long as I would like it to last.  It also can be a little painful for my elderly patients, who are very thin especially.   The plate that rests against the chest often hurt the patient.

Now, if you are on Facebook and “like” anything dysphagia-related, you have probably seen the ISO device.  This is a device created for the CTAR and JOAR exercises!  It is a larger device with padding on both the chest piece and the chin piece.  The device is made from a flexible polycarbonate and is easy to hold and to use.

isosed

A video demonstrating use of the ISO Swallowing Exercise Device (ISO SED) can be viewed here.

The ISO SED can be purchased for $99, however can be used with multiple patients as it has chin pad covers.  The ISO was used with considerably more ease than the Neckline Slimmer, is more durable and less painful.

If you are interested in checking out the ISO SED, you can find more information here.

Clark, H.M. (2005).  Therapeutic exercise in dysphagia management:  Philosophies, practices and challenges.  Perspectives in Swallowing and Swallowing Disorders, 24-27.

Burkhead L.M., Sapienza C.M., Rosenbek J.C. (2007).  Strength training exercise in dysphagia rehabilitation:  Principles, procedures and directions for future research.  Dysphagia; 22:  251-265.

Clark, Heather M. “Neuromuscular Treatments for Speech and SwallowingA Tutorial.” American Journal of Speech-Language Pathology 12.4 (2003): 400-415.

Wada, Satoko, et al. “Jaw-opening exercise for insufficient opening of upper esophageal sphincter.” Archives of physical medicine and rehabilitation 93.11 (2012): 1995-1999.

Yoon, Wai Lam, Jason Kai Peng Khoo, and Susan J. Rickard Liow. “Chin tuck against resistance (CTAR): new method for enhancing suprahyoid muscle activity using a Shaker-type exercise.” Dysphagia 29.2 (2014): 243-248.

Course Alert-Evidence Based Practice

critical_thinking_skills

Image from:http://thecollaboratory.wdfiles.com/local–files/philosophy-of-thought-and-logic-2011-2012/critical_thinking_skills.jpg

Northern Speech Services has a new course called:  Evidence-Based Practice In Adult Dysphagia Management: What The Evidence Says About Commonly Selected Rehabilitation Interventions.  This is a webinar by Ianessa Humbert, Catriona Steele and Phoebe Macrae.

I took this course over the weekend.  It was GREAT!  It starts with approximately 35 minutes of review of the anatomy and physiology by Dr. Humbert.  The second section is close to 2 hours and discusses 4 compensations/exercises including:  chin tuck, Mendelsohn Maneuver, Shaker and the Effortful Swallow.  Evidence for each of the 4 techniques is discussed and a look at critically appraising techniques/exercises for dysphagia.  A case study is provided for each.

This course only looks at 4 exercises/compensations, however it also breaks down the critical assessment for each, allowing the viewer to apply the same principle to any exercise/compensation.

I would definitely recommend this course to anyone working with patients with dysphagia.

Dysphagia Awareness Month

I was beyond excited that June is Dysphagia Awareness Month.  I have been planning this post for weeks in my head and then life stepped in and said, “not today.”  That “not today” lasted over a week.

To begin the summer, I ended up getting really sick.  In fact, I was sick to the point the thought of food made me worse.  Needless to say, to write about swallowing and food was not my top priority at that time!!

How are you celebrating dysphagia?  To me, the best way to celebrate is to educate.

So many people have no idea what dysphagia is.  It is imperative that we educate the public.  You never know when that ONE person you talk to may need the information.  When I check into a hotel for a continuing education event and they ask me why I’m staying, you’d better believe I tell them what I’m there for and then tell them a little about dysphagia.  People ask all the time what I do for a living.  Take that moment to tell them a little about dysphagia.

Request to speak at a local health fair.  People are there for health information.  Take advantage of educating the people regarding dysphagia, what is it, who it can affect, signs and symptoms.  The presentation can be as little as five minutes.  You can also provide information about dysphagia at the health fair.  Some county fairs will have hospital booths providing information.  Ask if you can provide information about dysphagia.

Ask to write a guest blog post or start your own blog.  When I started blogging, there were basically no dysphagia blogs.  There are plenty of speech blogs but the dysphagia blogs tend to be on the low side.  You can use a blog to share information about therapy, review journal articles or just to educate the public.

Start a journal club.  Let’s face it, we live in an evidence-based world.  Embrace it.  Learn as much as you can from the evidence to make educated decisions for your patients with dysphagia.

Take a good quality course this month.  Ianessa Humbert has a new course coming in September.  This promises to be a challenging course allowing SLPs to become better at critical thinking in dysphagia assessment and treatment.  Northern Speech Services has great courses available.  Courses are also on sale through June 14!  SpeechPathology.com also offers a wide variety of courses.  CIAO is another company offering some good, quality continuing education courses.  What courses would you recommend for a GREAT quality learning experience?

Make the most of Dysphagia Awareness Month, not just in June, but all year long!

A Course You DON’T Want to Miss!!

The best tool that you can ever have to be a better clinician is between your ears. It is not in a device or a certification. At our course, we aim to hand you the manual to the swallowing-clinician part of your brain (teach you to fish rather than giving you fish) So that you can critically appraise ANYTHING that comes your way! Plus we will have exhibitors (BRACO, IOPI, AMPCARE, TIMS, and Beldev medical) for you to ask tough questions to! 
http://www.eventbrite.com/e/critical-thinking-in-dysphagia-management-blazing-a-new-clinical-trail-tickets-16227227073?aff=eac2