DYSPHAGIA
Dysphagia (difficulty swallowing) is the unsafe and/or inefficient movement of foods and/or liquids from the mouth to the stomach.
Diagnostic tests for dysphagia:
- Modified barium swallow study – the patient eats or drinks food or liquid with barium in it and the swallowing process is viewed on an x-ray
- Endoscope assessment – using a lighted scope inserted through the nose, the swallow can be viewed on a screen.
In our clinic we provide clinical swallowing evaluation. An instrumental assessment of swallowing is necessary to properly identify disordered swallowing physiology in order to guide management and treatment. Our clinic uses outside providers for completing instrumental exams.
The following technology and tools are available in our clinic to help patients strengthen weakened muscles in the mouth and throat; improve timing and coordination of the swallow; and enhance airway protection.
BiSSkiT (Biofeedback in Strength and Skill Training)
is a training protocol and accompanying software program for rehabilitation of swallowing impairments. It is based on, and dependent on, surface electromyography (sEMG) as a hardware platform
http://www.canterbury.ac.nz/rosecentre/products/bisskit-software/
Tongueometer
aids in evaluating tongue and lip strength for swallowing function enabling the best treatment plans. The IOPI gauges the strength and endurance of the tongue by measuring the maximum amount of pressure that an individual can produce by pressing a tongue bulb against the roof of the mouth. The peak pressure generated by the tongue is then displayed on the unit’s display screen. Individuals with a swallowing disorder secondary to tongue and lip weakness may benefit from the IOPI.
MDTP (McNeill Dysphagia Treatment)
is a swallowing program that focuses of the progressive stengthening, development and refinement of the muscular components of the swallowing process. Positive outcomes from MDTP are seen in two to three weeks of intensive therapy.
VOICE
Voice problems can result from structural changes in the voice mechanism (e.g., vocal nodules), neurological problems (e.g., vocal fold paralysis) or from improper or inefficient use of the vocal mechanism (e.g., muscle tension dysphonia).
Voice assessment:
In our clinic we provide clinical and acoustic voice assessments. The laryngeal endoscopic imaging exams (e.g., videostroboscopy) are completed by outside medical providers (i.e., ENTs).
LSVT (Lee Silverman Voice Treatment)
is an effective speech treatment for people with Parkinson’s disease and other neurological conditions.
Myofascial Release
is one style of manual therapy that uses slow, still, prolonged stretching through clothing or directly on the skin to facilitate change in the patient. It can be used for individuals with voice and swallowing problems resulting from head/neck cancer, various dysphagia, dysarthria, trismus/TMJ disorders.
APHASIA
Aphasia is an impairment of language, affecting the production or comprehension of speech and the ability to read or write. Aphasia is usually caused by a stroke or brain injury with damage to one or more parts of the brain that deal with language. It may also be caused by a brain tumor, brain infection, or dementia such as Alzheimer’s disease.
PROMPT (Prompts for Restructuring Oral Muscular Phonetic Targets)
is a tactile-kinesthetic approach that uses touch cues to a patient’s articulators (jaw, tongue, lips) to manually guide them through a targeted word, phrase or sentence. PROMPT is an effective treatment for improving various speech/communication disorders such as acquired apraxia of speech, aphasia and dysarthria.