Oral motor control exercises b. (A Compensatory Strategy Review for Swallowing Disorders Part 3) Are you absolutely certain that you should be thickening your patient’s liquids? Many elderly patients need that increased sensation for a more accurate swallow. Compensatory strategies have an immediate, but temporary effect on swallow safety; rehabilitative strategies may promote a long-term effect and change the physiology of the swallow. This handout gives tips to help lower your risk of aspiration and choking. Behavioral management of oropharyngeal swallowing disorders includes the introduction of compensatory strategies and direct therapy techniques. When diagnosing and creating a treatment protocol it is always necessary to … Postural strategies are used to help change the way bolus flows through the swallowing mechanism. May 13, 2020 - How to do a strategy review for swallowing disorders, dysphagia, and more for the medical SLP. Evidence-based systematic review: Oropharyngeal dysphagia behavioral treatments. Evidence-based systematic review: Oropharyngeal dysphagia behavioral treatments. (1993). I am not sure if I understood it well. Provide a list of the exercises you recommend. intake … ), Viscosity-May trial thicker consistencies to determine if there is an effect on the swallow. Journal of Rehabilitation Research & Development, 46(2). Compensatory Strategies … Body Positioning – Please make sure your loved one is sitting in the most optimal position. Super-Supraglottic swallow strategy Take a deep breath and hold tightly, swallow hard or with greater force than usual, after swllow, pt should cough prior to inhalation For: pts with dysphagia secondary to oral-pharyngeal carcinoma for those with compromised airway protection and overall pharyngeal weakness 58 Broadly speaking, therapy can be differentiated into compensatory and rehabilitative strategies. << /Length 5 0 R /Filter /FlateDecode >> Dear Tffany, I´d like to ask you about the term: “posterior loss of bolus resulting in aspiration”. DYSPHAGIA PROGRAM FOR PATIENTS ... • Attempt compensatory strategies. Postural - chin tuck. Safe Swallowing Tips . Some patients require a larger bolus to trigger the swallow. Subjects: Anatomy, Life Skills, Speech Therapy. I really don’t want you going all Oprah and handing out thickened liquids to the masses. It’s basically premature spillage. While most compensatory strategies do not cause long-term effects to the swallowing system, some can be used as exercise to create a lasting effect to swallowing. Adequate … Rehabilitation: Connecting exercises to specific deficits; Collaboration with registered dietitian; Sarcopenia, failure to thrive, frailty; Collaboration with the entire team (e.g., RN, OT, PT, physicians/NPs/PAs) and making appropriate referrals (e.g., GI, ORL, … Posterior: rarely recommended but may be helpful with those with decreased ability to propel the bolus posteriorly to initiate swallow. In the supraglottic swallow a person inhales, holds their breath, swallows, and then coughs to clear food residue from the larynx. Compensatory Strategies Postural Adjustments- head tilt 1. This review covers advances in the pathophysiology, diagnosis, and physiologically based neurorehabilitation strategies for poststroke OD. Oropharyngeal dysphagia (OD) is very prevalent among poststroke patients, causing severe complications but lacking specific neurorehabilitation treatment. Any compensatory strategy should be viewed during instrumental assessment to determine the effectiveness and accuracy of completion. Below is a list of common compensatory swallowing strategies. Reduced Airway Closure, Reduced Laryngeal Elevation, & Aspiration --Compensatory Strategies work best because other types of exercises may put further stress and work on the respiratory system and may be unproductive. McCoy, Y., & Wallace, T. (2018). Patient Education Speech Pathology Services The tips checked below will lower your risk for aspiration (getting food or liquid in your lungs) and choking: Special swallowing strategies: _____ _____ … It doesn’t mean you have to give the person an unmanageable amount. Categories. Model each, then have the patient demonstrate it back to you. 32. A. 2). Compensatory strategies include postural changes, sensory enhancements, changing feeding strategies, diet changes and intraoral prosthetics. A very succinct and useful resource . Swallowing compensatory strategies may be spontaneously adopted, such as dose metering ... such as by performing swallowing compensatory behaviours (B). Increase strength of the overall swallow. Compensatory techniques are used to alter the swallow, however compensations may not create a lasting effect to the swallow. Compensatory strategies can be used to alter posture, timing of the swallow, laryngeal closure. Post was not sent - check your email addresses! 1. Dysphagia, 2(4), 216-219. Compensatory strategies provide a scaffold to a safer swallow by reducing the complexity of the swallowing task (Huckabee and Hughes 2013). Wheeler-Hegland, K., Frymark, T., Schooling, T., McCabe, D., Ashford, J., Mullen, R., … & Musson, N. (2009). It is something I would definitely want to have addressed during a FEES/MBS first but it still seems risky. Dysphagia - Compensatory strategies. Encourage daily practice, at least twice a day. Dysphagia - Compensatory strategies. Part II–impact of dysphagia treatment on normal swallow function. 4 0 obj But for others, they are chronic concerns that plague daily life and can lead to more serious conditions. Wish List. �B�Z�s�͒1䰇�楍l ��w��Awz�bL7�����Xk��]Y�y�9ɀ%���r|P�C��n�d.e���&hR Epub 2017 Jan 28. Recognizing the appropriate domain of intervention and utilizing the appropriate tools within each category are vitally important. Many times compensatory and rehabilitative techniques are used con- currently when treating children with dysphagia. Part V–Applications for clinicians and researchers. Evidence-based systematic review: Oropharyngeal dysphagia behavioral treatments. Part II–impact of dysphagia treatment on normal swallow function. Supraglottic and Super supraglottic swallows: These are useful strategies for people with airway protection problems, although they are a bit laborious to use through an entire meal. Compensatory Strategies (use during meal) SpeechRamblings.weebly.com ’ Impact’on’Swallowing’ Exercise’ Procedure’ Rationale/Notes’ Cryotherapy. That is what the MBSS or FEES is for. Advances in treatment include improvements in compensatory strategies but are mainly focused on (1) peripheral stimulation strategies and (2) central, noninvasive stimulation strategies with evidence of their clinical benefits. Use with oral containment issues (posterior loss of bolus resulting in aspiration). DYSPHAGIA GOALS LONG TERM GOALS - SWALLOWING • Client will maintain adequate hydration/nutrition with optimum safety and efficiency of swallowing function on P.O. McCauley, R. J., Strand, E., Lof, G. L., Schooling, T., & Frymark, T. (2009). It should be noted that this is simply a "guide" and not meant to be used as a one fits all. Logemann recommends 10x/day x5 min with 5-6 swallows each time as exercise. Use with reduced pharyngeal contraction (pharyngeal residue, aspiration after swallow). Journal of Rehabilitation Research & Development, 46(2). Dr. Jeri Logemann (1993) has suggested using compensatory strategies/maneuvers in the following order: Postural techniques; Sensory techniques; Maneuvers; Diet changes; Remember we can often change the swallow through sensory techniques. Do not immediately trial thickened liquids and change a diet without first trialing other strategies that may allow a patient to safely swallow thin liquids. 8 Overview: Components of a Comprehensive Dysphagia Program •Emphasis in both assessment and treatment is influenced by the characteristics of the client, his home environment, and his caregivers. Part IV–impact of dysphagia treatment on individuals’ postcancer treatments. Improving oral sensory awareness c. Modification of volume and speed of food presentation d. Food consistency/diet changes e. Intraoral prosthetics 2. Oropharyngeal dysphagia (OD) is very prevalent among poststroke patients, causing severe complications but lacking specific neurorehabilitation treatment. When the bolus spills into the pharynx prior to the swallow and the bolus is then aspirated. History of the Use and Impact of Compensatory Strategies in Management of Swallowing Disorders. Helps patient keep bolus in the oral cavity. C and D depict a deterioration in swallowing function and safety due to a diagnosis or health condition known to affect swallowing . Part V–Applications for clinicians and researchers. Use with patients with poor anterior-posterior propulsion of bolus such as with glossectomy. Unfortunately, there is a paucity of evidence for dysphagia therapy, which has been highlighted in a Cochrane review 57 as well as an American Gastroenterology Association technical review. While most compensatory strategies do not cause long-term effects to the swallowing system, some can be used as exercise to create a lasting effect to swallowing. Silvia / SLP Slovakia. 2. A Compensatory Strategy Review for Swallowing Disorders; Blog; Books; MBSimp Physiological Impairment Review; Podcast; The Step-by-Step Guide to Advocating for Access to Instrumentation; … "���t��z/lD4��*�b�Bd F����A� {D��]*@�� ���"�0��������t@�d��Iԙ��cLV���d��vrΝ��Ɨ��N�U� [�5��e���B�SkJ_��|g�����4Mu�[S/8d����X�-�22ڜ��͂C�^H��)��C�X��6)�r;>�2�W�L�2f������B}�«5?�rmk]4Q*ʒ�7�5�d}�v������eT��S�;Z��ϽB5�&mnk��T׆M�2O-3��,��RWoyX�Jw͌���� ��ܿ?�����+Kr�ŷ��P�,����g2�x&�9M¹.3C�bS We have a few more tools in our toolbox that we can explore first before we resort to the Oprah thickened liquids method and you discharge everyone on your caseload so that you can get to … 11 ) Myth: People with dysphagia with patients with head and neck cancer would want! 32 ( 1 ):3-10. doi: 10.1007/s00455-016-9779-6 oral motor exercises on speech • Attempt compensatory strategies a! Laryngeal closure, Viscosity-May trial thicker consistencies to determine if there is an effect the! 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