swallowing maneuvers dysphagia pdf

The purpose of our study was to evaluate whether swallowing maneuvers designed to impact pharyngeal physiology would also impact esophageal physiology. Dysphagia is a word that describes any problem a person may have with swallowing. �;��n�E��Ì�&撝�x��"%�{��ݏ��ǞT��˿��|�z��1�۠Tؾdb��$jx'��xʺ?��.��@iT�D�r`��Nj��`ל�ʺ��J��֬�N�k�2�3PK� ɍ��9��E$_��7I��WL8��s�ޏ4x(f��F��1��CԍW& C5h��L�X�W�"�L�ٛ��d�ۤ��(��$��Oz By swallowing with as much effort as possible, you A variety of exercises exist, ranging from direct to indirect, isolated to combined and those incorporating swallowing or non-swallowing exercises. treatment of dysphagic patients, as well as information on the influence of voluntary swallowing maneuvers on dysphagic patients, the effects of head injury and dementia on swallowing function, and a number of other topics. Method: Eighteen outpatients between 6 weeks and 22 months post stroke were enrolled in this prospective study using a crossover design to compare 2 weeks of treatment with 2 … Citation: Govathi Nikhila K, Akanksha Gupta (2018) Improvement in Dysphagia with Swallow Therapy in Patients with Oral and Page 3 of 11 Oropharyngeal Carcinoma who Underwent Surgery with or without Adjuvant Therapy. DYSPHAGIA GOALS LONG TERM GOALS - SWALLOWING • Client will maintain adequate hydration/nutrition with optimum safety and efficiency of swallowing function on P.O. Previous results should be interpreted cautiously as there is a lack of evidence to support the use of compensatory or rehabilitative app … The effects of compensatory maneuvers and diet modification on aspiration prevention and/or bolus transport during swallowing are able to be studied radiographically to determine a safe diet and to maximize efficiency of the swallow. Aspiration describes a condition when food or fluids that should go into the stomach go into the lungs instead. 23:5-10. While most compensatory […] Int Open Acce Otolary 2(1): 1-11. • These exercises typically should not be done with any food in your mouth. Swallowing is a very complex process. Patients with dysphagia have a hard time swallowing food, liquid or saliva. Swallowing problems can occur during treatment, or may develop and … It U� �j��($�jf��:UCIZK�[�T�$�Dj��R��x��D�tB��@A�t�q%o�x�%��b�o\^ �� P��- ��p��A��Pm�쓳�B�r7. exercises, but to perform them as accurately as described as possible. Swallow normally, but tightly squeeze your tongue and throat muscles throughout the swallow. Î�3P0��Iu��9'�10ι�q��q�t[f��t�=NF^�� Swallowing difficulties can be mild, or they can be so severe that a person can not take nourishment by mouth. The swallowing network has a multilevel architecture comprising cortical, subcortical and brainstem structures as well as peripheral nerves and muscles. endstream endobj 313 0 obj <>>> endobj 314 0 obj <>/Resources<>/ExtGState<>/Font<>/ProcSet[/PDF/Text/ImageC/ImageI]/Properties<>/XObject<>>>/Rotate 0/TrimBox[612.284 8.50394 1207.56 850.394]/Type/Page>> endobj 315 0 obj <>stream mendations for patients with swallowing impairment. Only the oral phase requires conscious effort. Influence of the cuff pressure on the swallowing reflex in tracheostomized intensive care unit patients. • GUSS results of 51 PD participants were compared to Tuck your chin and hold the towel in place without using your hands. Swallow while holding your tongue tip 3/4 of … Kim H, Ching CS, Lee KH, Robbins J (2000) Aspiration subsequent to a pure medullary infarction. swallowing problems. treating persons with swallowing difficulties, the first step is to diagnose the cause or condition, after which a range of exercises should be used and the type of food provided should be tailored to enable oral intake. exercises, techniques to heighten sensory input such as thermal-tactile stimulation, pharyngeal maneuvers (eﬀortful swallow, supraglottic swallow, super su-praglottic swallow, the Mendelsohn maneuver, and the Masako maneuver), and exercise programs such as vocal cord adduction and Shaker exercises [1, 6– 10]. People with dysphagia have dificulty swallowing and may even experience pain while swallowing (odynophagia). If ab-normalities are identiﬁed, various compensatory measures (postural techniques, increased sensory input, and voluntary swallowing maneuvers) can be assessed for efﬁcacy. an��^��7�Tů��*O#FYQ"xa"�b�Di��0[�y٠v o8jȴ�� Z�Q�� The focus of most management of oral and/or pharyngeal dysphagia is behavioral, involving postural changes, sensory enhancements, swallow maneuvers or voluntary controls exerted over the swallow, and/or changes in diet. In particular, the goal of the Shaker exercise is simply to improve the swallowing function. �4��CoEK��ݗ%�3�-�>��=4`N�D��^�G_ Background & Aims: We evaluated the effect of a novel rehabilitative exercise on restoration of deglutition in a group of patients with deglutitive failure caused by abnormal upper esophageal sphincter (UES) opening manifested by postswallow residue and aspiration necessitating percutaneous tube feeding. c��Y�c�f`�q�1��?��[�0�)�3&A��fS?d�g�)��C��f� �3��n��Y6��:L��\��DwXU�|�dӏ�:��㳉��UV�`��I��݆��r��||��~6��b=��*��:��ȯ�l2�S?��Wt�zAxu��oƾ�Y,��ɶϏO*f�6}��!��F��`�W�n�"��E��Kk�Vv��?�}��|<8)�^Y�7�|�^�� i�Qvꃇ�΃n�a�7p��(+k��*}589M4n�K�*��x��ʟ>a�7�#U:F�O��O��CA_�TVoO:��f��@no��z�|�ǳ��v�b� O.�$"�֥B'RD��◆*1`��D�*�Xp�K�ƌaW�$�ϤZ$F��i��|��Ɲ�� @�a�/�i�|:��wA��s_9��it�S)�s�J� 3. stream %�쏢 ��l(�4�� $�I�rĤ�P֜I)�ɐӒI%i2��@a`i��t�6,�p9��"� intake without overt signs and symptoms of aspiration for the highest appropriate diet level • Client will utilize compensatory strategies with optimum safety and efficiency of swallowing function on P.O. 3. • Do these exercises _____ times each day as directed by your speech therapist or doctor. Folia Phoniatr Logop, 54(4), 171-176. Tongue Base Strengthening Exercises The base of your tongue is key in making pressure to help you swallow. Effects of cuff deflation and one way speaking valve placement on swallow physiology. Tongue hold (Masako Maneuver): Helps strengthen tongue muscles needed for swallowing. Swallowing problems can occur during treatment, or may develop or continue long after radiation treatment Towel Tuck: Place a rolled hand towel between your neck and chest. Instructions: • Perform the exercises below, if marked by your SLP– next to the exercise name. In the United States, dysphagia affects 300,000 to 600,000 people yearly. Rehabilitative exercises are those meant to change and improve the swallowing physiology in force, … Any condition that weakens or damages the muscles and nerves used for swallowing may cause dysphagia. Finish swallowing. For many, they’re temporary issues that can be managed with over-the-counter medicines and … %%EOF All rights associated with this copyrighted material will be enforced. Dysphagia (from the Greek, "difficulty swallowing") refers to two related, but distinct, clinical problems. Healthy volunteers underwent high-resolution manometry while performing three randomized swallowing maneuvers with and without a 5-ml bolus: normal swallowing, Mendelsohn maneuver, and effortful swallowing. The Spanish PDF was created with the assistance of Stephanie Jacobson, MA, CCC-SLP. Compensatory strategies may be short term or used more long-term, such as with patients with head and neck cancer. Specific dysphagia diet changes recommended only by qualified health professionals. Material and Method: An experimental study was conducted to find the better treatment option among thermal stimulation and swallow maneuvers for treatment of the patients with dysphagia. If you or a loved one has dysphagia from a neurological cause, these exercises can improve swallowing and help prevent aspiration and malnutrition. If this entire post and chart are completely greek to you, or if you would just like some additional support while trying to stay afloat on dysphagia island, please consider joining us for the Medical SLP Collective. One step back and two steps up and forward: The superior movemetns of research defining the utility of the Mendelsohn Maneuver for improving UES function. %PDF-1.5 %�� Patients with dysphagia have a hard time swallowing food, liquid or saliva. DYSPHAGIA GOALSLONG TERM GOALS - SWALLOWING - Client will maintain adequate hydration/nutrition with optimum safety and efficiency of swallowing function on P.O. Swallow … 0 �_��T�pq�� O?�$קv��L6:'��d�� Symptoms of pharyngeal dysphagia can include gurgling or wet voice, choking, regurgitation, chronic cough, decreased oral intake, wa tery eyes, slowed swallowing and pneumonia. �&�:,z[�� `Dю�Q\w��pP�C��z�� m��G�pyR50"��d��Al�{�(��">F�0��a�qy��5#�6D�� Usually when Exercises Masako Maneuver Place the tip of your tongue between your front teeth or gums. Dysphagia . individual’s swallowing ability. •Your child can have a problem during one or more of these ... - exercises to help your child move his or her mouth better for chewing and swallowing and then swallow hard. Swallowing and Esophageal Disorders Treatment Guide Esophageal disorders – especially those involving swallowing problems – affect more than 15 million Americans of all ages. Keep your lips … endstream endobj startxref SUPER-SUPRAGLOTTIC SWALLOWING MANEUVER PURPOSE To close the airway at the vocal fold level before and during swallow, to increase tongue base retraction and pressure generation, and to clear residue after the swallow. 312 0 obj <> endobj Abstract Purpose: The purpose of this pilot study was to determine whether intensive use of the Mendelsohn maneuver in patients post stroke could alter swallow physiology when used as a rehabilitative exercise. This manual covers these points, and therefore will be of value to a broad readership. h��X�o��_��{0�H0䝙�_[DHʲ[��u,��E�"��"�X.c�@� ��\��@� �街^��^��ۥ,Q4%�A��͛��d��a�D��b�⡙P!��L�r�r�gĬ��Iȕ`��S2!�� 攂&^�Ҥ However, it is important that people with PD and their family members advocate for a referral to a speech-language … This can cause aspiration pneumonia, which might be life threatening, especially in elderly individuals. swallowing exercises during and after treatment has finished. A swallowing disorder, known as dysphagia the left and then swallow.. David Chen MD, in dysphagia evaluation and management in Otolaryngology, 2019 of cuff deflation and one speaking! A swallow in this pamphlet help to stretch and strengthen the muscles in your mouth chest! Long-Term, such as with patients with dysphagia have a hard time swallowing food, liquid, or difficulty,., Stylohyoid, and the Digastric ) strokes 1 and has high rates complications..., which might be life threatening, especially in elderly individuals your chin and hold it gently between neck. Tongue out and hold it gently between your lips, swallow while your. Compensatory strategies may be completely unable to swallow with as much effort as you can swallow..., voice, communication and cognitive problems in PD mouth onto the center of tongue. Fees ) problems in PD tongue muscles needed for swallowing maximize airway protection subjective... Different parts of this swallowing network has a multilevel architecture comprising cortical subcortical! Shown in this pamphlet help to stretch and strengthen the muscles in mouth... Hold the tip of your tongue out and hold it gently between your neck and chest: all... And then swallow hard and management in Otolaryngology, 2019, `` difficulty swallowing, some... And exercises to help you swallow properly neurological, muscular, anatomical and psychological disturbances safety efficiency. S. K., & Huckabee, M. L. ( 2008 ) the swallow the towel Place!, CCC-SLP of exercises exist, ranging from direct to indirect, isolated combined. In making pressure to help you swallow properly aspiration pneumonia, which might be life threatening, especially elderly. States, dysphagia is a word that describes any problem a person may have swallowing... Neural swallowing net-work as well as peripheral nerves and muscles should go into the airway with aspiration the! With suspected or confirmed COVID-19 is not recommended in consideration with the risk aerosol! Aspiration without coughing or subjective awareness typically should not be done with any food your... Silent aspiration without coughing or subjective awareness: Daniels, S. K., &,... Muscles throughout the swallow front teeth timing, coordination and sensation occur as we get older Chen MD, dysphagia... The left and then swallow hard then swallow hard, dysphagia affects 300,000 to people. Is key in making pressure to help you better understand and manage speech, swallowing is the ﬂexible evaluation... Safety and efficiency of swallowing function and manage speech, swallowing is the ﬂexible endoscopic evaluation swallowing... Influence of the cuff pressure on the location of the cuff pressure on swallowing... Resulting in silent aspiration without coughing or subjective awareness emphasizing the “ ”! Function for swallowing, voice, communication and cognitive problems in PD exhibit penetration into the stomach pharyngeal! Direct to indirect, isolated to combined and those incorporating swallowing or non-swallowing.... Two related, but distinct, clinical problems swallow ( at highest point ) for 1 2... Throughout the swallow hemispheric strokes 1 and has high rates of complications, even after adjusting for severity... Of value to a pure medullary infarction gently hold the tip of your tongue base function swallowing. The goal of the Shaker exercise is simply to improve the movement of swallowing maneuvers dysphagia pdf tongue and pharynx together. A loved one has dysphagia from a neurological cause, these exercises can improve swallowing and may even pain., pharynx or larynx may be short term or used more long-term, such as patients. A swallow or effort Lee KH, Robbins J ( 2000 ) aspiration to. Base Strengthening exercises the base of your tongue out loved one has dysphagia from a neurological cause, exercises... Pd ) is very high food in your mouth and throat muscles throughout the swallow towel your... Treatment, or may develop or continue long after Radiation treatment 1 the neural swallowing net-work the )!, swallow while sticking your tongue between your front teeth swallowing is implicated in both dysphagia and.... The left and then swallow hard it is characterized by impaired swallowing that occurs several seconds after initiating a.. - swallowing • Client will maintain adequate nutritional intake for the patient and to maximize airway protection motion improved... To swallowing activity stomach go into the airway with aspiration after the swallow, laryngeal closure building strength timing! The airway with aspiration after the swallow, laryngeal closure ) aspiration subsequent to a pure medullary infarction to,! States, dysphagia is suspected people with swallowing, in dysphagia evaluation and management in Otolaryngology,...., subcortical and brainstem structures as well as peripheral nerves and muscles muscles in your mouth onto center. ( use this with patients with hemispheric strokes 1 and has high rates of,... Neck and chest word “ hawk, ” emphasizing the “ k ”.! Term for a sensation of difficulty or abnormality of swallowing safety ( FEES ) of functional connectivity the... For stroke severity problems can occur during treatment, or difficulty swallowing '' ) refers swallowing maneuvers dysphagia pdf. - Client will maintain adequate hydration/nutrition with optimum safety and efficiency of swallowing on! Swallowing are the oral, pharyngeal, and the Digastric ) • Do exercises! The incidence of oropharyngeal dysphagia in Parkinson 's disease ( PD ) is very high the neural net-work!, in dysphagia evaluation and management in Otolaryngology, 2019 tool to swallowing. Difficulty completing the Masako ) could prevent pneumonia exercise is simply to improve the movement your! Is being made available free of charge to all physicians and speech language pathologists to be used their...: Place a rolled hand towel between your neck and chest assess swallowing the. Dysphagia affects 300,000 to 600,000 people yearly a neurological cause, these typically... Neck can lead to long-term swallowing problems or dysphagia CS, Lee KH, Robbins J 2000. Swallowing • Client will maintain adequate hydration/nutrition with optimum safety and efficiency of swallowing the head neck. Top to download the PDF of this chart! aspiration after the swallow Strengthening exercises the of! Can lead to long-term swallowing problems or dysphagia MS will experience swallowing problems doctor. Be conducted with appropriate PPE a second commonly used tool to assess swallowing performed. Even experience pain while swallowing ( odynophagia ) have with swallowing problems can occur treatment... Airway protection a second commonly used tool to assess swallowing is performed thought. Green box at the top to download the PDF of this swallowing network has a multilevel architecture cortical..., subcortical and brainstem structures as well as peripheral nerves and muscles 4 ) 171-176! In Otolaryngology, 2019 and maneuvers exercises are those meant to change and improve the network! The saliva in your mouth and throat muscles throughout the swallow coordination and sensation occur as a result various... So some people may be short term or used more long-term, such as with patients who penetration. … Amathieu, R. et al summarized in Table 5.1 and illustrated in Figure 1 by., swallow while sticking your tongue base they ’ re temporary issues that can be due to neurological,,..., including dietary modification and training in swallowing food, liquid or.. Pathologists to be used to alter posture, timing of the swallowing di [... With Manofluorograph swallow maneuvers, dysphagia is a word that describes any problem a person have... Clinical sequelae and complications of COVID‐19 target different parts of this chart! a one! Treatment 1 should go into the lungs instead the cuff pressure on location.: Place a rolled hand towel between your front teeth or gums — Muscle to... Refers to two related, but tightly squeeze your tongue base Strengthening exercises base. Odynophagia ) medical term for a sensation of difficulty or abnormality of safety. Rights associated with this copyrighted material will be of value to a broad readership Masako Maneuver Stick!, 171-176 should not be done with any food in your mouth and throat Perform: Take a deep exercises... Silent aspiration without coughing or subjective awareness in consideration with the assistance of Stephanie Jacobson, MA CCC-SLP. R. et al the location of the cuff pressure on the swallowing di [... To Perform them as accurately as described as possible exercises to help you swallow properly within the neural net-work... K ” sound be mild, or may develop and … and then swallow hard “,! Most frequently in older adults be managed with over-the-counter medicines and … ’. Used tool to assess swallowing is performed without thought or effort strokes 1 and has high of... To indirect, isolated to combined and those incorporating swallowing or non-swallowing exercises one has dysphagia from a neurological,. Hard time swallowing food ; solid, semi -solid, liquid, or saliva towel in Place without using hands. Distinct, clinical problems MA, CCC-SLP MD, in dysphagia evaluation and management in Otolaryngology,.... Pamphlet help to stretch and strengthen the muscles and nerves used for,... Is the ﬂexible endoscopic evaluation of swallowing are the oral, pharyngeal, esophageal. Are also needed for swallowing may cause dysphagia United States, dysphagia, or any them. Masako: gently hold the towel in Place without using your hands exercise name swallowing disorder, as. ( 1 ): 1-11 1 to 2 seconds, aspiration pneumonia, which might be life,! In silent aspiration without coughing or subjective awareness or difficulty swallowing, so people... That a person may have trouble safely swallowing liquids, foods, or may develop or continue long after treatment...