Dysphagia Quiz 7👅

I forgot Quiz 5 was take home

Neural Plasticity principle

The brain's ability to adapt in response to new experiences, like injuries or training.

Use It or Lose It principle

One of the 10 neural plasticity principles. If a neural pathway isn't being used, it will start to degrade. Example: Keeping a patient on NPO for too long makes their swallowing worse over time.

Use It and Improve It principle

One of the 10 neural plasticity principles. Practicing a skill improves it, as opposed to just maintaining it. Ex: A patient who is working towards a specific goal will find better results than a patient just working generally.

Plasticity Is Experience Specific principle

One of the 10 neural plasticity principles. All training has to match the target behavior.

Repetition Matters principle

One of the 10 neural plasticity principles. You need consistent, repeated practice to get neural change.

Intensity Matters principle

One of the 10 neural plasticity principles. Low intensity training is unhelpful, but high intensity training is harmful (excitotoxicity).

Time Matters principle

One of the 10 neural plasticity principles. Starting training earlier is best. Continuous training is also more helpful versus intermittent training.

Salience Matters principle

One of the 10 neural plasticity principles. The brain learns better when the task is relevant.

Age Matters principle

One of the 10 neural plasticity principles. Younger nervous systems respond better to training.

Transference principle

One of the 10 neural plasticity principles. Plasticity in one set of neural circuits can promote plasticity in related circuits.

Interference principle

One of the 10 neural plasticity principles. Plasticity in one circuit can undo plasticity in another circuit.

Behavioral Plasticity

A change in swallowing performance that occurs without clear neural changes.

Neural Plasticity (in swallowing)

Actual measurable change in brain organization in response to swallowing intervention. Much harder to demonstrate than behavioral plasticity. Only a small number of swallowing interventions show evidence of this.

Sensory Interventions (dysphagia)

Treatments that stimulate sensory input to change swallowing. Example: bolus modifications (temperature, taste).

Motor With Swallow Interventions

Swallowing exercises that are performed DURING an actual swallow. Example: Mendelsohn maneuver

Motor Without Swallow Interventions

Exercises that strengthen or train the swallowing muscles WITHOUT actually swallowing. Example: head-lift exercises (Shaker)

Compensatory Interventions (neural plasticity)

Postural adjustments like chin tuck, do not produce neural plastic changes on their own

Lingual Strengthening

A motor-without-swallow exercise. Patients use progressive resistance training for the tongue.

Shaker Exercise (head-lift exercise)

A motor-without-swallow exercise. Patient lies flat and repeatedly lifts just their head off the ground, trying to see their toes without elevating their shoulders. Strengthens the suprahyoid muscles.

LSVT (Lee Silverman Voice Treatment)

A program originally designed for Parkinson's disease. Also improves swallowing, an example of transference in neural plasticity.

EMST (Expiratory Muscle Strength Training)

A motor-without-swallow exercise. Patient exhales against a resistance load. Builds strength in the suprahyoid muscles, used for Parkinson’s patients.

Overload Principle

An exercise science concept: training needs to exceed what body is used to. You need to push past baseline.

Progressive Resistance

An exercise science concept: as strength improves, training must also become harder to match.

Specificity (exercise science)

It’s important to pair muscle-strengthening exercises with actual swallowing tasks

Deconditioning (dysphagia)

Loss of muscle strength which comes from disuse, disease, or normal aging.

Head Turn Strategy

a type of Compensation technique. Patient tucks the chin toward the chest to narrow the throat and reduce the risk of bolus entering the airway (not really effective in patients with dementia or Parkinson's disease).

Tongue-Hold Maneuver (Masako)

A rehabilitative technique where the patient holds the tip of their tongue between their teeth while swallowing, which causes the back of the throat to move forward more. Meant to strengthen muscles. Should NOT be done with actual food or liquid. Evidence is weak and it carries some risk

Frazier Water Protocol

Protocol that allows patients to drink water between meals. Excessive oral care is important. Does not significantly increase the risk of lung infection (most of the time).

Super-Supraglottic Swallow Strategy

A compensatory strategy. Patient holds their breath while straining, swallows, then coughs gently. The extra effort causes even better airway protection than the regular supraglottic swallow. Should NOT be used in patients with heart disease.

Supraglottic Swallow strategy

a Compensatory strategy. Patient holds their breath, swallows, and coughs to clear any residue from vocal folds. This works because the glottis (space between vocal folds) closes horizontally when someone holds their breath

Effortful Swallow

A compensatory strategy. Patient swallows as hard as possible, which builds up more pressure in the throat leaving less leftover residue behind

Mendelsohn Maneuver

A swallowing technique where the larynx is held at its peak position during the swallow to improve coordination.