Intervention Strategies for Swallowing Disorders

What are the three types of intervention strategies for swallowing disorders?

Compensatory strategies, therapy techniques, swallow maneuvers

What is the purpose of compensatory strategies in swallowing therapy?

To reduce symptoms without changing physiology, specifically to control bolus flow.

What is the chin tuck maneuver and when is it beneficial?

The chin tuck decreases the distance from the base of the tongue to the posterior pharyngeal wall, making the valleculae wider and increasing pharyngeal pressure. It is good for premature spillage, delayed pharyngeal response, decreased base of tongue retraction, and decreased airway closure.

How does the chin up maneuver assist in swallowing?

The chin up maneuver uses gravity to drain food from the oral cavity, making it beneficial for patients with decreased lingual control but intact pharyngeal responses.

What is the head turn maneuver and its purpose?

The head turn involves turning to the affected/weak side to close off that side and direct food down the stronger side, which is beneficial for unilateral pharyngeal weakness.

What is the head tilt maneuver and when is it used?

The head tilt involves tilting to the strong side to keep the bolus in the stronger side of the oral cavity and pharynx, beneficial for unilateral oral and pharyngeal weakness.

What are the benefits of lying down or side-lying during swallowing?

Lying down helps keep the bolus on the posterior pharyngeal wall, preventing it from falling into the airway. Lying on the stronger side helps keep any residue on the stronger side.

What is the purpose of sensory stimulation in swallowing therapy?

To increase the speed of the pharyngeal response and trigger a pharyngeal swallow, often using cold, sour pressure.

How can the bolus be modified to assist with swallowing?

By using larger volumes, slower presentations, alternating liquid and solid, or dry swallowing between bolus swallows.

What is the Masako Maneuver and its purpose?

The Masako Maneuver aims to increase anterior movement of the pharyngeal wall by holding the tongue out while swallowing.

What does the Shaker Exercise aim to achieve?

The Shaker Exercise increases anterior movement of the hyolaryngeal complex to enhance upper esophageal segment opening.

What is the Mendelsohn Maneuver designed to improve?

The Mendelsohn Maneuver increases hyolaryngeal elevation for better airway protection and upper esophageal sphincter opening.

What is the purpose of the supraglottic swallow?

To voluntarily close the vocal folds before and during swallowing to prevent aspiration.

What is the super-supraglottic swallow and its goal?

The super-supraglottic swallow aims to voluntarily close the laryngeal vestibule to prevent aspiration.

What is the extended supraglottic swallow used for?

To facilitate oral transit and airway protection for those with severely reduced oral transit.

What is the effortful swallow and its purpose?

The effortful swallow aims to increase base of tongue and pharyngeal wall movement by swallowing as hard as possible.

What is neuromuscular electrical stimulation and its purpose in swallowing therapy?

Neuromuscular electrical stimulation enhances muscle function by stimulating peripheral nerves to contract muscles.

What are the two methods of applying neuromuscular electrical stimulation?

Applied superficially on the skin (transcutaneously) or directly into the muscle (intramuscularly).

Who benefits from neuromuscular electrical stimulation?

Patients with central nervous system deficits but intact peripheral nervous system.

What is the role of bolus modification in swallowing therapy?

To adjust the characteristics of the bolus to improve swallowing safety and efficiency.

What are the key components of the chin tuck maneuver?

Decreases distance from the base of the tongue to the posterior pharyngeal wall, widens valleculae, and increases pharyngeal pressure.

What are the indications for using the head turn maneuver?

It is indicated for patients with unilateral pharyngeal weakness.

What is the significance of the lying down position during swallowing?

It helps prevent aspiration by keeping the bolus on the posterior pharyngeal wall.