The Use Of A Myofunctional Device In An Aged Care Population For Oral Care And Swallowing: A Feasibility Study, Hollie-Ann L. Shortland, Gwendalyn Webb, Anne E. Vertigan, Sally Hewat

International Journal of Orofacial Myology and Myofunctional Therapy

Purpose: Poor oral health is a known predictor of aspiration pneumonia in vulnerable populations such as the elderly and chronically ill. This study examined the feasibility of using myofunctional devices during a 5-week intervention for the management of oral care and dysphagia for residents in a residential aged-care facility.

Method: Feasibility was determined through evaluation of study recruitment and retention rates, adherence to intervention, and resident and staff acceptability of the intervention. Thirteen residents, ages 74–99, participated in the intervention and 10 care staff completed feedback on post-intervention questionnaires.

Results: Enrolment and retention rates were 61.9% and 92.3%, respectively. Adherence …

Speech-Language Pathology Graduate Student Clinicians’ Self-Perceived Competency In Dysphagia Management, R. Jordan Hazelwood, Erin D. Bouldin, Indigo R. Burford, Emily A. Steffen

Teaching and Learning in Communication Sciences & Disorders

Speech-language pathologists (SLPs) are the preferred healthcare providers for managing the direct clinical care of patients with dysphagia. By assessing self-perceived competency during academic training, SLP graduate student clinicians may increase their understanding of their skills in dysphagia management. We modified the Dysphagia Competency Verification Tool (DCVT) to use a 5-point ordinal scale to explore how SLP graduate student clinicians’ self-perception of competency in dysphagia management changes over time and to determine the impact of clinical practicum experiences. Seventy-two SLP graduate student clinicians rated their self-perceived competency for four DCVT domains. We used Generalized Estimating Equations (GEE) models to analyze …

Speech-Language Pathologists' Skills And Knowledge In Dysphagia Management In Long-Term Care Facilities, Madelyn Griffin

Honors Theses

An increasing amount of current research indicates the prevalence of oral and pharyngeal dysphagia in all age groups, with a higher number of cases present in the geriatric population. Dysphagia is common in age-related diseases such as Parkinson’s disease, Alzheimer’s disease, and Dementia. The purpose of this study was to investigate the knowledge and skills of speech- language pathologists (SLPs) working in long-term care, in the area of oral and pharyngeal dysphagia. Participating SLPs responded to a survey asking to self-identify their knowledge/skills in oral and pharyngeal dysphagia. The findings from this study revealed the variety of expertise of SLPs …

Mental Practice Of Lingual Resistance And Cortical Plasticity In Older Adults: An Exploratory Fnirs Study, Erin Kamarunas, Sarah Szynkiewicz, Lindsay Griffin, Teresa Drulia, Kelsey Murray

International Journal of Orofacial Myology and Myofunctional Therapy

Purpose: Mental practice using motor imagery (MP) improves motor strength and coordination in the upper and lower extremities in clinical patient populations. Its effectiveness as a rehabilitation tool for patients with lingual weakness is not yet well understood, nor are the underlying mechanisms within the context of swallow or lingual MP. Using previously published data on a lingual and MP exercise program, the objective of this study was to explore how MP of lingual exercise affects cortical activation in healthy older adults over time and how neural changes correlate with functional oral pressure outcomes.

Method: A prospective randomized controlled study …

Speech Language Pathologists (Slps) Enactment Of Dysphagia Education And Counselling In Tbi Inpatient Rehabilitation., Stephanie Muir-Derbyshire

Electronic Thesis and Dissertation Repository

Abstract

Background

Traumatic brain injury (TBI) incidence rates are rising significantly across all age groups, often requiring complex and expensive medical care. Common causes of TBI include motor-vehicle accidents, violence, sport injuries and falls. For some individuals, inpatient rehabilitation (IPR) is used as a care pathway to provide intervention(s) for the physiological, psychological, neurobehavioural and cognitive-communication sequelae of a TBI.Many patients with a TBI will also experience dysphagia, an impairment or disorder of deglutition (swallowing). Dysphagia affects hydration, nutritional intake, respiration and can significantly impact an individual’s quality of life. It has been identified as a contributing factor in the …

The Influence Of Side-Lying Position On Oropharyngeal Swallow Function In At-Risk Infants: An Exploratory Study, Julian White

Dissertations, 2020-current

Speech-Language Pathologists (SLP) are the primary healthcare providers responsible for the evaluation and treatment of infant feeding and swallowing disorders. At-risk infants, such as those born prematurely or with certain medical conditions, are more prone to swallowing impairments (i.e., dysphagia). Dysphagia in at-risk infants can have severe consequences such as chronic respiratory symptoms, pneumonia, progressive lung disease, undernutrition, and death. Therefore, it is important to have methods of examining an infant’s swallow functioning that are both safe and accurate. A leading method of evaluating infant swallowing is the Modified Barium Swallow Study (MBS). The works contained within this dissertation document …

Simulation-Based Training Improves Student Assessment Of Oral Feeding Skills In Preterm Infants, Courtney K. Broadfoot, Julie M. Estis

Teaching and Learning in Communication Sciences & Disorders

Advancements in medical technology have contributed to increased rates of preterm birth. Prematurity places infants at high risk for feeding difficulties, however. Early identification and assessment of preterm infant dysphagia is critical to maximize nutrition and hydration, feeding safety, and growth and development. The purpose of this study was to assess the ability of a simulation-based training toolto increase non-health care and entry-level clinical student sensitivity to signs of feeding distress in preterm infants. Data were collected from 60 students (20 masters-level Speech-Language Pathology, 20 undergraduate nursing, 20 undergraduate non-health care) in a pre-test/post-test design. All participants completed a …

Comparing In Vivo Versus Simulation Training For Transnasal Endoscopy Skills, Laura L. Wolford, George W. Wolford

Teaching and Learning in Communication Sciences & Disorders

Fiberoptic endoscopic evaluations of swallowing (FEES) is as important of a swallowing evaluation as the videoflouroscopic swallow study, but far fewer speech-language pathologists are competent in its use (Ambika, Datta, Manjula, Warawantkar, & Thomas, 2019; Brady & Donzelli, 2013; Pisegna & Langmore, 2016). One hurdle in FEES training is the necessity of practicing transnasal endoscopy on volunteers. The primary aim of this study was to compare the learning effectiveness of practicing transnasal endoscopy via simulation with practice in vivo for a student’s first passes of the endoscope. The end goal of this study was to determine the most cost-effective and …

The Impact Of Active Learning In A Speech-Language Pathology Swallowing And Dysphagia Course, Rebecca H. Affoo, Justin L. Bruner, Angela M. Dietsch, Ciara E. Nellenbach, Theresa M. Jones, Mark E. Lehman

Teaching and Learning in Communication Sciences & Disorders

The signature pedagogy in Speech-Language Pathology (SLP) higher education programs has been criticized for its instructor-centric lecture format and emphasis on the lower tiers of Bloom’s taxonomy (simply memorizing knowledge) at the expense of helping students develop the clinical problem-solving skills required for a lifetime of practice and learning. The purpose of this study was to examine the responses of a cohort of graduate speech-language pathology students to an active learning-oriented swallowing and dysphagia course design. A potential relationship between student perceptions of the active learning pedagogy and academic performance was also explored. The results suggest that active learning positively …

The Impact Of Temporal Resolution On Clinical Decision-Making For Individuals With Dysphagia, Shauna Corinne Murray

Speech and Hearing Sciences ETDs

INTRODUCTION: Dysphagia, or a disordered swallow, affects up to 1 in 25 individuals in the United States. The gold standard for assessing dysphagia is the videofluoroscopic evaluation of swallowing (VFES). This allows the clinician to observe the swallow anatomy in motion via an X-ray movie, which historically was recorded at 30 frames per second. In recent years VFES have been performed at less frames per second due to radiation concern. This project investigates the effect of using lower temporal resolutions on assessment of video-fluoroscopic swallow studies.

METHODS: In this investigation, 30 swallow studies, all acquired at 30 frames per second, …

Participant Accuracy And Impact Of Biofeedback On A Skilled Swallowing Task, Caris Giessler

Senior Honors Projects, 2010-2019

Biofeedback is as a visual way to self-assess muscle contraction, particularly during rehabilitative exercises. Speech language pathologists and otolaryngologists have investigated the use of visual biofeedback in swallowing therapy, especially for volitional swallowing rehabilitative exercises such as the effortful swallow, which requires the patient to maximally swallow with all their strength. In contrast to the effortful swallow, “effortful skilled swallowing” is the ability to swallow with a specific and precise amount of effort, which is an emerging topic in dysphagia research. Dysphagia, also known as disordered swallowing, can be an organic congenital disorder treated via feeding tubes, or an acquired …

The Impact Of Master’S Level Education On The Assessment And Intervention Of Pediatric Swallowing, Andrea Seagren

All Graduate Plan B and other Reports, Spring 1920 to Spring 2023

Purpose: Pediatric swallowing disorders is increasing in prevalence as medical advancements are made. This increase raises the need for more speech-language pathologists (SLPs) to be involved in the assessment and intervention of pediatric swallowing. However, discrepancies exist in the amount and level of education being provided during academic coursework in the area of pediatric swallowing.

Method 1: The investigation had a two-tier approach. Part one included a survey specifically targeting SLPs who graduated within the most recent accreditation standards (2014 to present) and masters level students in their second year of graduate school (n=100). Part two explored academic courses offered …

Inspiratory Muscle Recruitment During Swallow And A Comparison Across Airway Behaviors., Allison V. English

Electronic Theses and Dissertations

During swallow, a negative esophageal pressure is present that, along positive pressure from the tongue, which works to move the bolus through the pharynx into the esophagus. This negative esophageal pressure is thought to be produced via recruitment of chest wall inspiratory muscles (diaphragm and parasternal). This current study aimed to examine respiratory muscle recruitment across behaviors which have known inspiratory muscle activity (eupnea, augmented breath and cough) and compare to swallow. It was hypothesized that there would be no significant difference in amplitude and muscle recruitment over 75 ms between swallow and eupnea, but cough and augmented breath would …

Dysphagia Practice Patterns Of Virginia Speech-Language Pathologists, Molly Kathleen Dailey

Theses & Honors Papers

Currently, there are a variety of screening tools, clinical, and instrumental assessments used by speech-language pathologists (SLPs) to diagnose dysphagia and plan for treatment. Anecdotal reports and empirical evidence suggest that dysphagia assessment and treatment practice patterns vary considerably across patient populations, work settings, and clinicians. Understanding the SLP assessment and treatment practices across settings and factors that may influence their decisions will help inform future directions in dysphagia education, training, and clinical practice components. These findings will enable the provision of quality care that will ultimately lead to positive patient health outcomes. Thus, this survey study was designed to …

Pediatric Feeding Disorder: Consensus Definition And Conceptual Framework, Praveen S. Goday, Susanna Y. Huh, Alan Silverman, Colleen T. Lukens, Pamela Dodrill, Sherri S. Cohen, Amy Delaney, Mary B. Feuling, Richard J. Noel, Erika Gisel, Amy Kenzer, Daniel B. Kessler, Olaf Kraus De Camargo, Joe Browne, James A. Phalen

Speech Pathology and Audiology Faculty Research and Publications

Pediatric feeding disorders (PFDs) lack a universally accepted definition. Feeding disorders require comprehensive assessment and treatment of 4 closely related, complementary domains (medical, psychosocial, and feeding skill-based systems and associated nutritional complications). Previous diagnostic paradigms have, however, typically defined feeding disorders using the lens of a single professional discipline and fail to characterize associated functional limitations that are critical to plan appropriate interventions and improve quality of life. Using the framework of the World Health Organization International Classification of Functioning, Disability, and Health, a unifying diagnostic term is proposed: “Pediatric Feeding Disorder” (PFD), defined as impaired oral intake that is …

The Impact Of Dysphagia And Gastrostomy On Quality Of Life In Caregivers Of Patients With Amyotrophic Lateral Sclerosis, Emily Clare Sither Goggin

Theses and Dissertations--Communication Sciences and Disorders

There is little research studying the relationship between caregiver quality of life and gastrostomy, a palliative intervention recommended to manage dysphagia and malnutrition in patients diagnosed with Amyotrophic Lateral Sclerosis (ALS). To facilitate a more comprehensive assessment of treatment effectiveness and to better guide patients and their families, this study investigated the relationship between gastrostomy, caregiver strain, and patient disease-related factors. Patients with bulbar-onset ALS and their caregivers were recruited regardless of their decision to accept or decline future gastrostomy. Caregivers completed the Modified Caregiver Strain Index (MCSI) to assess levels of caregiver strain as an index of quality of …

Efficacy Of Electrical Stimulation Intervention In Treating Adults With Dysphagia: A Systematic Review, Virginia N. Cheng, Jenna N. Dalton, Kathryn R. Howrigan

Communication Sciences and Disorders: Systematic Review Publications

Purpose: Dysphagia is a term used for a swallowing disorder resulting from problems with the oral cavity, pharynx, esophagus, or gastroesophageal junction. Dysphagia can have significant impacts on an individual’s quality of life and statistics suggest that nearly 15 million adults in the United States present with swallowing disorders. Common medical complications associated with dysphagia are malnutrition, dehydration, aspiration pneumonia, and even death. Traditional dysphagia treatment (TDT) for adults currently consists of diet modification, compensatory strategies involving postural adjustments, and swallowing exercises to strengthen musculature. The objective of this systematic review is to determine whether electrical stimulation (ES) improves swallowing …

Effectiveness Of Prophylactic Lingual Strengthening Exercises For Patients With Head And Neck Cancer A Systematic Review, Cassidy Pickens

Theses and Dissertations--Communication Sciences and Disorders

Radiation treatment for head and neck cancer has devastating effects on swallowing ability. Prophylactic swallowing exercises are often recommended. However, the evidence for these exercises is equivocal and information regarding critical components of an exercise program is lacking. The purpose of this systematic review was to examine the evidence regarding lingual strengthening exercises as a component of a prophylactic swallowing program.

Let's Talk About Dementia: The Effects Of Dementia On Communicative Functions, Mary Kate Hoeve

Honors Projects

A general outline and presentation designed for a seminar setting aimed toward an audience of medical staff in skilled nursing facilities. The purpose of this training is to educate frequent communication partners of those with dementia about effective communication tactics, as well as, a brief definition of dementia. Additionally, a small portion is dedicated to dysphagia. The possible role of a speech-language pathologist in dementia care is also discussed throughout the training.

Advantages Of Percutaneous Endoscopic Gastrostomy Tube Placement In Patients With Head And Neck Cancer Who Receive Radiation As Part Of Their Treatment, Nevin Thul

Speech and Hearing Sciences ETDs

The use of percutaneous endoscopic gastrostomy tubes as an intervention strategy in head and neck cancer was investigated in this retrospective chart review. Twenty-five veterans met the inclusion criteria and were categorized into two groups – use of prophylactic percutaneous endoscopic gastrostomy and absence of percutaneous endoscopic gastrostomy tube placement. Medical charts were reviewed and data extracted included weight, swallow function, swallow exercise compliance, and physical and social quality of life for 2 years post-treatment. Month-to-month data were compared across the two groups with respect to weight, swallow function, swallow exercise compliance, and physical and social quality of life scores. …

Establishing Effective Amplitude Criterion For Transcranial Direct Current Stimulation, Lindsey Michele Schwenger

Senior Honors Projects, 2010-2019

My honors project will document and reflect on my experiences as a member of a research team that is studying transcranial direct current stimulation (tDCS) as a treatment for dysphagia, or difficulty swallowing, which affects a vast, diverse group of individuals. There is substantial need for more efficient and effective rehabilitation strategies used to restore abilities and reduce the risks associated with dysphagia. Recent studies have addressed these risks by exploring tDCS as a treatment for central nervous system damage caused by stroke, traumatic brain injury, and Parkinson's disease. Research has recently been conducted to test its effectiveness, but has …

Swallow And Breathing Coordination Following Suprahyoid Muscle Injury., Bradley Kimbel

Electronic Theses and Dissertations

Swallowing motility disorders (dysphagia) are a major complication following radiation treatment for head and neck cancer, affecting ~50% of those treated. One reason for this is that radiation causes muscle damage, provoking sensorimotor pathologies. Previous work has suggested that injury may cause discoordination between breathing and swallowing behaviors. We sought to determine if muscle injury provokes changes in this behavior. We hypothesized that acute suprahyoid muscle damage would alter cross-behavior excitability, causing destabilization of the respiratory-swallow pattern. Swallowing was evoked in anesthetized spontaneously breathing cats via injection of a 3cc bolus of water into the oropharyngeal cavity. A suprahyoid injury …

A New Surgical Approach For O-C2 Fusion, Solving The Problem Of Dysphagia., M. Kathryn Mcclure

Electronic Theses and Dissertations

The fusion of the second cervical vertebrae to the occipital bone (O-C2 fusion) for head stabilization can result in postoperative dysphagia and dyspnea, negatively impacting the patient’s quality of life. Currently, the O-C2 angle is used for head placement, which may not place the head neutrally. We hypothesize that aligning the external auditory meatus with midline of the C2 will reduce oropharyngeal stenosis, reducing dysphagia. One male patient with poor swallow quality of life who required a revision of a previous O-C2 surgery was evaluated via videofluoroscopy and completed the standard swallow quality of life questionnaire (SWAL-QOL) before and after …

Transitioning Adults From A Tube-Feeding To An Oral Feeding In Long-Term Care Facilities, Patricia D. Mejorado

Theses and Dissertations

The objective of this investigation is to gain information regarding the transition of adults from a tube feeding to an oral feeding in long-term care facilities. Twelve surveys were administered to the speech language pathologist population from the UTRGV and UTPA communication sciences and disorders alumni via email invitation. The survey consisted of questions regarding: years practiced in long-term care facilities, interdisciplinary collaboration, protocol and/or algorithms for transitioning patients from a tube feeding to an oral feeding, documentation programs, access to meal intakes, the SLP’s role in the transition to oral feedings, and areas of concerns regarding the transition from …

Saliva Production And Enjoyment Of Real-Food Flavors In People With And Without Dysphagia And/Or Xerostomia, Angela M. Dietsch, Cathy A. Pelletier, Nancy Pearl Solomon

Department of Special Education and Communication Disorders: Faculty Publications

Non-food gustatory stimulation has multiple potential therapeutic benefits for people with dysphagia and xerostomia. This study examined palatability and saliva flow associated with dissolvable flavored films. Taste strips with real-food flavors dissolved on the tongues of 21 persons with dysphagia and/or xerostomia and 21 healthy age- and sex-matched adults while sublingual gauze pads absorbed saliva over randomized 3-min trials. Participants rated taste enjoyment for each trial on a hedonic general labeled magnitude scale. Flavored strips elicited more saliva than baseline for both groups, and production was higher for controls than patients (M = 2.386 and 1.091 g, respectively; p = …

Perceptual And Physiologic Analysis Of Dystussia In Amyotrophic Lateral Sclerosis, Stephanie Anne Watts

USF Tampa Graduate Theses and Dissertations

Swallowing and cough are two vital functions that are reflexive in nature and are related to each other in terms of shared neural and anatomical space. When a disorder impacts normal and effective swallowing and/or cough, the consequences can be life-threatening. Evaluation and treatment of swallowing and cough disorders can fall under the scope of practice of the speech-language pathologist and speech-language pathologists often are leading professionals. Furthermore, much of the current research on swallowing and cough is spearheaded by speech-language pathologists often working with a multi-disciplinary team. The focus of this dissertation is on the clinical evaluation of cough …

A Healthy Subject’S Perspective Undergoing Dysphagia Diets, Carmen J. Meyer

Honors Projects

Because there are only a small number of publications that have examined dysphagia from the perspective of people living with this disorder, the primary purpose of this project is to help expand the clinical knowledge base by systematically recording and analyzing the experiences of a healthy subject placed on modified consistency diets. The first component of this project addresses research pertaining to swallowing disorders, diet levels on which clients with swallowing disorders are placed, medical conditions associated with dysphagia, the process that clinicians follow when making decisions about modified diets, and the emotional effects of being placed on a modified …

The Effects Of Lung Volume On Swallowing In Chronic Obstructive Pulmonary Disease, Teresa C. Drulia

Dissertations, 2014-2019

Chronic Obstructive Pulmonary Disease (COPD), a respiratory disease that leads to reduced airflow, may result in difficulty swallowing with disease progression. The coordination between the respiratory and swallowing systems decouple and they may experience increased risk of aspiration. This study aimed to determine the effects of lung volume on swallowing in individuals with COPD compared with older healthy. Specifically, the study examined if altering lung volume at the time of the swallow changed swallowing timing, specifically pharyngeal swallow duration, and impacted the respiratory-swallow pattern in individuals with COPD. Measurement of estimated lung volume (ELV), pharyngeal swallow duration, and respiratory-swallow patterning …

A Comparison Of Neuromuscular Electrical Stimulation And Acupuncture To Traditional Dysphagia Therapy In Stroke Patients, Rachel A. Hale, Dr. Ann E. Perreau

Communication Sciences and Disorders: Student Scholarship & Creative Works

A comparison of neuromuscular electrical stimulation and acupuncture to traditional dysphagia therapy in reducing dysphagia in individuals who suffered a stroke.

Effect Of Taste Stimuli On Swallowing Function In Persons With Traumatic Injuries, Megan Asselin, Angela M. Dietsch

UCARE Research Products

Background

Swallowing disorders are prevalent and costly. As of now, there are limited therapeutic options available to treat them. Extant research in limited populations has suggested that swallowing mechanics can be improved by extremely sour liquids, but this has not been tested in traumatically injured populations. However, sour tastants are unpleasant, and more palatable taste mixtures have not been tested.

Methods

The quantitative data were extracted from an existing pool of de-identified video fluoroscopic swallowing studies (moving radiographs) obtained from traumatically injured young adults under another research protocol. Each participant completed swallows of custom-mixed plain, sour, and sweet-sour boluses. Positions …