Author: Tiffani Wallace-SLP and Certified Nutrition Coach
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Lingual Strengthening in Dysphagia Therapy: What the Research Really Says
Lingual strengthening is an emerging focus in dysphagia therapy, emphasizing the tongue’s crucial role in proper swallowing. Research shows that resistance-based exercises enhance tongue strength, swallow safety, and overall quality of life. Various devices, from advanced tools to simple tongue depressors, can be effectively utilized depending on budget and resources.
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Exercise in Dysphagia Therapy: Let’s Get Functional
Recent—and not-so-recent—dysphagia literature has made one thing very clear: exercise physiology belongs in swallowing rehab. Researchers like Lazarus, Robbins, Burkhead, and Clark have emphasized that understanding the muscles involved in swallowing—and how they actually function—is key to designing exercises that work. Spoiler alert: just having someone swallow applesauce with a side of hope isn’t enough.…
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Chin Tuck Against Resistance (CTAR): A Powerhouse Exercise for Suprahyoid Strengthening
Discover how the Chin Tuck Against Resistance (CTAR) exercise supports swallowing rehabilitation, strengthens the suprahyoid muscles, and offers a more accessible alternative to the Shaker exercise.
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Pudding with a Straw: A Functional Swallowing Exercise with Real Resistance
Looking for a simple but effective exercise to strengthen the entire swallowing mechanism using resistance? So was I. Over the years, I’ve tried many different exercises with my patients. One of my go-to favorites—though it earns me a few side-eyes from coworkers—is an unusual yet highly effective technique I call: Pudding with a Straw Yes,…
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Compensatory Techniques
Compensatory strategies aid individuals facing swallowing difficulties, such as aspiration or mastication issues, by altering swallowing mechanics. Techniques include specific maneuvers and postures designed to improve swallow efficacy. While some strategies offer short-term solutions, others may provide lasting benefits, warranting assessment for effectiveness during instrumental evaluations.
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Advocating for Instrumental Assessment
Many speech-language pathologists (SLPs) forgo instrumental assessments for dysphagia due to lack of access and facility policies. This can lead to misdiagnosis and increased healthcare costs. Advocating for instrumental evaluations is crucial, as they can reduce unnecessary dietary modifications and rehospitalizations, ultimately improving patient outcomes and saving money.
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What the Heck is the MBSImP?
The Modified Barium Swallow Impairment Profile (MBSImP™) standardizes the interpretation of Modified Barium Swallow Studies (MBSS) through a clear, evidence-based protocol. Developed by Dr. Bonnie Martin-Harris, it focuses on assessing and treating dysphagia by quantifying impairments, guiding rehabilitation, and enhancing clinical understanding of swallowing dysfunction.
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Laryngeal Palpation in Swallowing Evaluations: Feel It to Believe It?
As the patient swallows, the SLP feels for hyolaryngeal movement to judge the speed and completeness of elevation. It’s a technique that’s been around for a while—but how reliable is it?
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Cervical Auscultation
Cervical Auscultation (CA) uses a stethoscope to listen to swallow sounds, aiding in assessing swallowing and airway function. However, a systematic review reveals insufficient reliability and validity for diagnosing dysphagia in adults and children. CA should not be a stand-alone diagnostic tool, as sound patterns do not consistently correlate with physiological events.
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Go With the (Peak) Flow
Insurance companies prioritize objective data, making it vital to incorporate measures like Peak Expiratory Flow (PEF) in Clinical Swallow Evaluations (CSE) to assess cough strength and airway protection. PEF demonstrates a strong correlation with aspiration risks, thereby enhancing dysphagia management through reliable and quick assessments, allowing for better documentation and therapy tracking.
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Dysphagia Ramblings 