The clinician's place for dysphagia awareness, evidence-based practice and information.
The First Thing.... When I assess a patient with dysphagia, my first plan of attack is to teach the patient about oral care and start an oral care plan with that patient! Aspiration Aspiration is defined as the inhalation of either oropharyngeal or gastric contents into the lower airways, that is, the act of taking [...]
Inspiratory Muscle Strength Training Inspiratory strength training works on the muscles of inspiration the diaphragm, the intercostals. Inspiration involves contractions of the diaphragm and external intercostals, which increase intrathoracic volume and decreased volume in pressure. Respiration is a recoil from inspiration. Exhalation involves relaxation of the inhalation muscles, recruitment of abdominal and internal intercostals to force [...]
My dining room story.... I can't even count how many times I have started work in a new building or started a new PRN job and been told meal times so that I can go sit with patients during their meals for their therapy time. It's easy, right. I go sit in the dining room [...]
Research Research by Dr. Lazarus and Dr. Robbins has focused heavily on lingual strengthening. Many of these research articles have proven to us that lingual strengthening using resistance such as an IOPI does increase not only tongue strength and at times, tongue mass, but also improves the overall swallow. This same research has also shown us that using [...]
Recent and some previous dysphagia literature emphasizes the use of exercise physiology. Researchers such Lazarus et. al, Robbins et.al, Burkhead et. al and Clark have published the need for incorporating exercise physiology into dysphagia therapy. They emphasize the need to understand the muscles involved in the swallowing mechanism, understand their function so that you can [...]
Way back in 2014...... Way back in 2014, an article was published describing Chin Tuck Against Resistance. When we look at patients with dysphagia from Pharyngoesophageal Segment (PES) dysfunction, we look at strengthening the suprahyoid muscles. These muscles assist in hyolaryngeal excursion and therefore play a part in esophageal opening. Isokinetic vs. Isometric CTAR vs [...]
Picture from: www.busymomboutique.com Looking for an exercise. Haven't you always wanted a very simple exercise [...]
Congratulations Sarah.coletti1@gmail.com and slpbrooke@gmail.com!! You both win a copy of the Dysphagia Pocketguide!! Email me at dysphagiaramblings@gmail.com with your name and address and I will get the books to you. Congratulations!!!
The 1998 Paper Leder, Cohn and Moller investigated the incidence of aspiration following extubation in critically ill trauma patients. The study looked at 20 patients who required oropharyngeal intubation for at least 48 hours. All FEES were completed around 24 hours following extubation. Remember, aspiration is when the bolus enters the airway, below the level [...]
The many colors of FEES You've maybe witnessed a FEES exam. It can sometimes be quite colorful. Often, green food coloring is used during the exam. This helps to make the bolus "stand out" in the pharynx. You may also see blue food coloring used or even white food coloring or naturally white foods such [...]