Course Alert-MBSImP

mbsimp

If you are a clinician working with patients with dysphagia, the Modified Barium Swallow Impairment Profile is an very thorough course.  The MBSImP targets modified barium swallow studies, however the anatomy learned through the course is amazing.

After taking the course, I wrote a review, which you can find here.

The MBSImP is taught by Dr. Bonnie Martin-Harris and available through Northern Speech Services.

The course seems a little costly, but at $600 for 2.1 CEUs it is a great value!

Carbonated Beverages

carbonated

Carbonated beverages have hit the dysphagia world by storm.  Much of the recent dysphagia research has focused on the sensory portion of the swallow and how sensory drives the swallowing process.  Part of the sensory process is carbonated beverages.  One of the common misconceptions at this time is that carbonated beverages act as a nectar thick liquid.

Carbonation is a sensory option for dysphagia rehabilitation.   It’s effective through a process called chemesthesis, where the “bubbly” or “fizzy” of the carbonated beverage acts as a Trigeminal irritant.  The Trigeminal Nerve or Cranial Nerve V is one of the major swallowing nerves.  The Trigeminal Nerve has bare nerve endings making it more susceptible to sensory or afferent input.

Rather than acting as a nectar thick liquid, the carbonated beverage actually increases the sensory stimulation for the swallow.  Sensory input (afferent drive) drives the motoric output (efferent drive).

Research of carbonated beverages shows:

No significant effect on oral transit time, pharyngeal transit time, initiation of pharyngeal swallow or pharyngeal retention.  Carbonated beverages sis however decrease penetration/aspiraiton with 5 & 10 ml swallows.  (Saravou & Walshe).

Carbonated thin liquid significantly decreased the incidence of spillover, delayed pharyngeal response and laryngeal penetration compared to non-carbonated thin liquids.  (Newman et al).

Drinks containing chemical ingredients that activate sour and heat receptors alter swallowing physiology greater than water.  (Krival & Bates).

It is likely that sour and carbonated beverages reflect a more organized activation of the submental muscles because of more effective afferent input to the Nucleus Tractus Solitarius.  (Miura, et al).

One of the important issues to consider when looking at research involving carbonated beverages is that the researchers in these studies do not use Coke, Pepsi or Sprite.  They use Ginger Brew, Club Soda or carbonated citrus.

It is vital, as with any other compensation or technique to view the effects of carbonated beverages.  As with other strategies, you may not see the same effect in every patient and sometimes, the strategy you choose may make the swallow worse.

Krival K, Bates C. Effects of Club Soda and Ginger Brew on Linguapalatal Pressures in Healthy Swallowing. Dysphagia (2012). 27: 228-239.

Newman, et al. Carbonated Thin Liquid Significantly Decreases the Incidence of Spillover, Delayed Pharyngeal Response and Laryngeal Penetration Compared to Non-Carbonated Thin Liquids. Dysphagia 2001: 16: 146-150.

Saravou K, Walshe M. Effects of Carbonated Liquids on Oropharyngeal Swallowing Measures in People with Neurogenic Dysphagia. Dysphagia(2012) 27: 240-250.

Miura, Yutaka, et al. “Effects of taste solutions, carbonation, and cold stimulus on the power frequency content of swallowing submental surface electromyography.” Chemical senses 34.4 (2009): 325-331.

CEU Allied Health-Company Alert

money

If you are looking for a course that is different from the others and affordable, you may want to try CEU Allied Health.

The company is owned by Dr. Eric Blicker and offers a variety of courses.   The price of each course will not cause you to have to take a small loan or sell a family member.  All posted courses are under $30 and most courses are more than an hour in time.

Check out this fairly new company for your CEU requirements!

What’s Important

Woman-Pulling-Hair-out

We all have those days no matter which setting we work, which population we serve or what our area of specialty may be.

The CNA tells you that speech isn’t really a therapy, they need to talk to a real therapist, like a physical therapist.

Physical or Occupational Therapy gets the majority of minutes because of billing issues.

The doctor tells you no on a request for a patient that REALLY needs speech services.

The teacher becomes upset and tells you the time that you both agreed on for the students, that you scheduled EVERYONE else around, no longer works with their schedule.

The days you question your choice of profession and wonder what else you might be good at doing…..

Always remember, we don’t do it for the people that made our day not so great.  We do it for the patients, students, families, caregivers that need our support.  That is what matters at the end of the day.

Books to Read-Clinical Anatomy and Physiology of the Swallow Mechanism

swallowing mechanism

This book is a great read to help understand the anatomy and physiology of the swallowing system.  It breaks the information down into an easy-to-read format.  This is a book that I used extensively when studying for for BCS-S exam and still have the book to reference when I question anatomy or physiology.  Definitely worth the money (although you may want to look for it used).

Clinical Anatomy and Physiology of the Swallow Mechanism by Kim Corbin-Lewis, Julie M. Liss and Kellie L. Sciortino

Upcoming Articles!!

One thing I love about the Dysphagia journal, is not only the great research it provides me 4 times a year.  I love the abstracts for the upcoming (now past) Dysphagia Research Society (DRS) conference.  

This year was no exception for exciting new research to come!

Some titles that I am very excited to look into:

  • The Effects of Taste Concentration on SEMG in Swallowing-(Spoiler:  High concentraion sour stimuli elicit higher amplitudes and longer durations on SEMG).  
  • Esophageal Screening as an Adjunct to the Videofluoroscopic Study of Swallowing.  
  • Sour Bolus Facilitates Spontaneous Swallow in Parkinson’s Disease
  • Effects of Age and Sensation on the Anticipatory Stage of Swallowing
  • Physiological Factors Related to Aspiration Risk:  A Systematic Review
  • Pharyngeal Tactile Stimulation Using A Nylon Thread for Enhancing Pharyngeal Sensory Perception

These are just a few of the exciting titles that have caught my attention.  

If you are interested in the Dysphagia journal or the Dysphagia Research Society conference at a discount, make sure to join the Dysphagia Research Society!

books