https://doi.org/10.1044/sasd11.1.9, Fujiu-Kurachi, M., Fujiwara, S., Tamine, K., Kondo, J., Minagi, Y., Maeda, Y., Hori, K., & Ono, T. (2014). In clinical settings, SLPs typically use one of two types of instrumental evaluation: the videofluoroscopic swallowing study (VFSS) or the flexible endoscopic evaluation of swallowing (FEES), sometimes also called fiber-optic endoscopic evaluation of swallowing. Swallow while squeezing your throat as hard as you can (pretend that you're swallowing a whole grape) Repeat to fatigue (or in sets of 5-10 swallows, as appropriate) You can also prompt patients to press their tongue hard against their palate . (2004). https://doi.org/10.3109/17549507.2015.1024171, Layne, K. A., Losinski, D. S., Zenner, P. M., & Ament, J. concerns regarding the safety and efficiency of swallow function, contribution of dysphagia to nutritional compromise, contribution of dysphagia to pulmonary compromise, contribution of dysphagia to concerns for airway safety (e.g., choking), the need to identify disordered swallowing physiology to guide management and treatment, the need to assist in the determination of a differential medical diagnosis related to the presence of dysphagia, the presence of a medical condition or diagnosis associated with a high risk of dysphagia, previously identified dysphagia with a suspected change in swallow function; and, the presence of a chronic degenerative condition with a known progression or the recovery from a condition that may require further information for the management of oropharyngeal function. vocal . The Effect of Voluntary Pharyngeal Swallowing Maneuvers on - Springer Kangaroo - Effortful Swallow. Steele, C., Greenwood, C., Ens, I., Robertson, C., & Seidman-Carlson, R. (1997). https://doi.org/10.1161/01.STR.0000190056.76543.eb, McCabe, D., Ashford, J., Wheeler-Hegland, K., Frymark, T., Mullen, R., Musson, N., Hammond, C. S., & Schooling, T. (2009). Patients and caregivers may not agree with clinical recommendations and may feel that these recommendations do not provide the best quality of life for their loved one. The SLP educates involved parties on possible health consequences and documents all communication with the patient and caretakers (Horner et al., 2016). Objective data highlights progress for patients and therapists to see while also guiding treatment plans. Effects of chin-up posture on the sequence of swallowing events. American Speech-Language-Hearing Association, preferred providers of dysphagia services, Flexible Endoscopic Evaluation of Swallowing, International Dysphagia Diet Standardisation Initiative [IDDSI], Alternative Nutrition and Hydration in Dysphagia Care, ASHA Guidance to SLPs Regarding Aerosol Generating Procedures, End-of-Life Issues in Speech-Language Pathology, Flexible Endoscopic Evaluation of Swallowing (FEES), International Dysphagia Diet Standardisation Initiative (IDDSI), Perspectives of the ASHA Special Interest Groups, Royal College of Speech and Language Therapists: Statement on Thickened Fluids, The Impact of Prescribed Medication on Swallowing: An Overview, Videofluoroscopic Swallowing Study (VFSS), https://doi.org/10.1016/j.archger.2012.04.011, https://doi.org/10.1097/MCG.0000000000000624, https://doi.org/10.1007/s12603-019-1191-0, https://doi.org/10.1007/s00455-015-9637-y, https://doi.org/10.1007/s00455-016-9737-3, https://doi.org/10.1513/AnnalsATS.201606-455OC, https://doi.org/10.1007/s00455-001-0065-9, https://doi.org/10.1034/j.1600-0404.2002.10062.x, https://doi.org/10.1001/archotol.133.6.564, https://doi.org/10.1111/j.1365-2788.2008.01115.x, https://doi.org/10.1111/j.1468-3148.2005.00250.x, https://doi.org/10.1191/0961203302lu195cr, https://doi.org/10.1044/1058-0360(2009/08-0088), https://doi.org/10.1016/S0303-8467(02)00053-7, https://doi.org/10.1001/archneur.1992.00530360057018, https://doi.org/10.1016/j.jcrc.2014.07.011, https://doi.org/10.1044/1058-0360(2011/10-0067), https://doi.org/10.1001/archotol.130.2.208, https://doi.org/10.1016/j.jstrokecerebrovasdis.2009.01.009, https://doi.org/10.1016/j.jcomdis.2013.04.001, https://doi.org/10.1007/s00455-013-9471-z, https://doi.org/10.1007/s00455-013-9464-y, https://doi.org/10.1044/2020_AJSLP-19-00063, https://doi.org/10.1016/j.clnu.2007.08.006, https://doi.org/10.1016/j.pmr.2008.07.001, https://doi.org/10.1016/j.physbeh.2017.03.018, https://doi.org/10.1044/2016_AJSLP-15-0041, https://doi.org/10.1016/j.jmu.2013.10.008, https://doi.org/10.1016/j.apmr.2006.04.019, https://doi.org/10.1016/j.parkreldis.2011.11.006, https://doi.org/10.1007/s00455-004-0013-6, https://doi.org/10.1007/s00455-017-9852-9, https://doi.org/10.3109/17549507.2015.1024171, https://doi.org/10.1001/archinte.159.17.2058, https://doi.org/10.1002/(SICI)1097-0347(199709)19:6<535::AID-HED11>3.0.CO;2-4, https://doi.org/10.1097/CCM.0b013e31829caf33, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3740808/, https://doi.org/10.1001/archotol.131.9.762, https://doi.org/10.1161/01.STR.0000190056.76543.eb, https://doi.org/10.1682/JRRD.2008.08.0092, https://doi.org/10.1044/1092-4388(2005/089), https://doi.org/10.1007/978-0-387-22434-3_13, https://doi.org/10.1007/s00455-017-9863-6, https://www.swallowingdisorderfoundation.com/about/swallowing-disorder-basics/, https://www.nidcd.nih.gov/health/statistics/quick-statistics-voice-speech-language, https://doi.org/10.1097/MOO.0000000000000491, https://doi.org/10.1007/s00455-015-9657-7, https://doi.org/10.1007/s00520-019-04920-z, https://doi.org/10.1007/s00455-014-9551-8, https://doi.org/10.1044/leader.FTR5.09072004.8, https://doi.org/10.1016/j.apmr.2006.11.002, https://doi.org/10.1016/j.otc.2013.08.008, http://europepmc.org/abstract/MED/20645565, https://doi.org/10.1007/s00455-017-9855-6, https://doi.org/10.1111/j.1532-5415.2010.03227.x, https://doi.org/10.1016/0003-9993(93)90035-9, https://doi.org/10.1016/j.jpor.2012.02.001, https://doi.org/10.1007/978-0-387-22434-3_8, https://doi.org/10.1056/NEJM199104253241703, https://doi.org/10.1016/S0016-5085(99)70573-1, https://doi.org/10.1007/s00455-020-10137-8, https://doi.org/10.1007/s00455-013-9488-3, https://doi.org/10.1097/PHM.0000000000001397, https://doi.org/10.1592/phco.19.11.974.31575, https://doi.org/10.1111/j.1365-2982.2008.01208.x, https://doi.org/10.1016/j.otc.2013.08.002, https://doi.org/10.1007/s40141-014-0061-2, https://doi.org/10.1044/leader.FTR3.08082003.4, www.asha.org/Practice-Portal/Clinical-Topics/Adult-Dysphagia/, Connect with your colleagues in the ASHA Community. Respiration and Swallowing Precautions: May increase nasal regurgitation. Gastroenterology, 117(1), 233254. We investigated the acute effects of effortful swallowing maneuver on HRV. Physiology & Behavior, 174, 155161. Causes of dysphagia among different age groups: A systematic review of the literature. Neurogastroenterology & Motility, 21(4), 361369. For further information please see ASHAs resource on the Videofluroscopic Swallowing Study. It is not contraindicated for patients with cardiovascular disease or stroke. Dysphagia, 4(1), 3942. https://www.asha.org/policy/, American Speech-Language-Hearing Association. Archives of Gerontology and Geriatrics, 56(1), 19. Squeezing hard with their tongue and throat A. Introduction. (2001). For further information on the modified Evans blue dye test, please see the, recommendations for additional assessment to determine whether, and the degree to which, swallowing anatomy and/or physiology may be impaired; and. https://doi.org/10.1001/archneur.1992.00530360057018, DiBardino, D. M., & Wunderink, R. G. (2015). Other studies have such findings as follows: Not all signs and symptoms are seen in all types of dysphagia, and the evidence supporting the predictive value of these signs and symptoms is mixed. Deglutition disorders as a consequence of head and neck cancer therapies: A systematic review and meta-analysis. Clinicians modify bolus size particularly for patients that require a greater volume to adequately stimulate a swallow response (increase bolus size) or for patients that require multiple swallows per bolus (decrease bolus size). Dysphagia: Clinical management in adults and children. Although this technique may increase swallow safety and/or efficiency during the swallow, there is no lasting benefit or improvement in physiology. Archives of OtolaryngologyHead & Neck Surgery, 130(2), 208210. Current Opinion in Otolaryngology & Head and Neck Surgery, 26(6), 382391. Knowledge, skills, and clinical experience related to the evaluation and management of individuals with swallowing and swallowing problems may be acquired on the graduate or postgraduate level, in formal coursework, and/or via continuing education. After being educated about the risks and benefits of a particular recommendation (e.g., oral vs. non-oral means of nutrition, diet level, rehabilitative technique), if a patient (or their decision-maker) chooses an alternate course of action, the SLP makes recommendations and offers treatment as appropriate. Dysphagia in the elderly: Management and nutritional considerations. However, clinicians were not concerned about the possible effects of this rehabilitation protocol on cardiac events. Archer, S. K., Smith, C. H., & Newham, D. J. The prevalence of dysphagia among adults in the United States. (2000). Secondly, the effects of the EPG as an exercise are unknown as our study was conduced on healthy subjects without dysphagia. SLPs may also make recommendations regarding continuing per os (P.O.) A., Michou, E., MacRae, P. R., & Crujido, L. (2012). Roden, D. F., & Altman, K. W. (2013). combines voluntary airway protection with strength building of effortful swallow (tilts aryteoinds anteriorly, closes the true and false VF) voice quality check. The VFSS is also known as the modified barium swallow study (MBSS) and is a radiographic procedure used to gain further information regarding dysphagia. International Journal of MS Care, 2(1), 4050. Some maneuvers require following multistep directions and may not be appropriate for patients with cognitive impairments. https://doi.org/10.1044/2016_AJSLP-15-0041, Hsiao, M. Y., Wahyuni, L. K., & Wang, T.-G. (2013). Jonsen, A. R., Siegler, M., & Winslade, W. J. The purpose of the instrumental examination is to enable the SLP to perform the following tasks: Implementation of any instrumental procedure requires the SLP to have advanced knowledge and specific skills in order to. B., Yoo, S. J., Chang, M. Y., Lee, S. W., & Park, J. S. (2017). INTRODUCTION. Gaidos, S., Hrdlicka, H. C., & Corbett, J. Clinical Neurology & Neurosurgery, 104(4), 345351. Bryant proposed that visual monitoring of the sEMG signal could be used to guide performance of effortful swallows and the Mendelsohn maneuver. The effortful swallow achieves overload through high effort. The primary goals of dysphagia intervention are to. https://doi.org/10.1002/(SICI)1097-0347(199709)19:6<535::AID-HED11>3.0.CO;2-4, Macht, M., Wimbish, T., Bodine, C., & Moss, M. (2013). https://doi.org/10.1007/BF02493526, Via, M. A., & Mechanick, J. I. Improved Pharyngoesophageal Segment Opening. https://doi.org/10.1111/j.1532-5415.2010.03227.x, Shanahan, T. K., Logemann, J. SLPs may work with these patients and caregivers to develop compensatory strategies that will allow the patients to eat an oral diet for as long as they desire. https://doi.org/10.1016/j.jpor.2012.02.001, Skoretz, S. A., Flowers, H., & Martino, R. (2010). The patient, with their proxy, then chooses to accept or reject use of alternative nutrition and hydration following a shared decision making, informed consent discussion. An inspection of the oral mechanism, cranial nerve assessment, and other observations such as.
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