Medicine and Health Sciences Commons^™

A Survey Of Early-Career Speech-Language Pathologists: Determining Perceived Readiness For Clinical Management Of Adults With Dysphagia After Completing Graduate School, Christine A. Lee, Ashwini Namasivayam-Macdonald, Zuleikha Wadhwaniya, Juliana Mclaren, Rebecca H. Affoo

Teaching and Learning in Communication Sciences & Disorders

Several studies have identified a recurring trend that speech-language pathologists (S-LPs) in countries such as the United States (Caesar & Kitila, 2020), South Africa (Singh et al., 2015), and Malaysia (Kamal et al., 2012) report lower levels of confidence in dysphagia management, whether in comparison to other practice areas or in certain skill areas within the specialty of dysphagia. No data currently exists exploring self-perceptions of Canadian S-LP graduates with regards to clinical management of adults with dysphagia. Therefore, the purpose of this study was to determine the self-reported readiness of recently graduated Canadian S-LPs who manage dysphagia. Our survey …

Exploring The Use Of An Interprofessional Education Session For Speech-Language Pathology And Pharmacy Students, Sophia Werden Abrams, Heather Macphee, Linnea Hodge, Justine Hamilton, Ashwini Namasivayam-Macdonald

Teaching and Learning in Communication Sciences & Disorders

Interprofessional education (IPE) occurs when students are provided the opportunity to learn with and from others of related professions to improve the potential for future collaboration. The aim of this study was to explore the perceptions of students about working with professionals from different disciplines before and after their engagement in an interprofessional learning activity and determine any changes in their willingness to work in interprofessional teams.

Doctor of Pharmacy students from the University of Manitoba and Master’s speech-language pathology students from McMaster University participated in an online inter-university and inter-provincial education module. Students were invited to complete the Interprofessional …

Case Report Of Unilateral Dysphagia In The Context Of A Classical Type Of Eagle Syndrome, Ryan Tam, Stephen D. Howard, Timothy Ehmann, Bryan Scott

Advances in Clinical Medical Research and Healthcare Delivery

A patient presents with unilateral, right-sided dysphagia and generalized facial symptoms following past surgical history of tonsillectomy that is consistent with an underdiagnosis of Eagle Syndrome. The elongation of the styloid process likely impinged on the glossopharyngeal and vagus nerves resulting in symptoms. Given the lack of recognition of the disease, this case report describes the presentation of Eagle Syndrome to encourage physicians to consider this disease as part of a broader differential diagnosis.

Assessments Of Thickeners For Home Cooked Pureed Diets Meals For Patients With Dysphagia On Pureed Diets, Amy Rosales

Electronic Theses, Projects, and Dissertations

Managing dysphagia can help prevent adverse outcomes for patients with swallowing issues. This project aims to identify the best thickener that holds food texture and to identify which thickener is most palatable and acceptable by evaluators. A Spoon Tilt test was used to as one of the objective tests to determine the best thickener that holds food texture. The three thickening agents used were: apple pectin powder, tapioca starch, and a commercial thickener. The three pureed food items used to test the thickening agents were baked chicken, broccoli, and rice. An audit tool by the International Dysphagia Diet Standardization Initiative …

Evaluating Dysphagia In Patients With Cervical Spinal Cord Injury Using The Modified Barium Swallow Impairment Profile, Ting-Huan Chen, Bai-Hong Chen, Shih-Chung Chang

Rehabilitation Practice and Science

Background/Purpose: To clarify the characteristics of dysphagia in patients with cervical spinal cord injury (CSCI) by using modified barium swallow impairment profile (MBSImP) scoring in a videofluoroscopic swallowing study (VFSS). Methods: This retrospective study included the data of 10 patients with CSCI (9 men and 1 woman) with dysphagia admitted to the rehabilitation ward of a university medical hospital who had undergone VFSS. The patients’ oral, pharyngeal, and esophageal impairments were evaluated using the MBSImP. Results: Comprising the MBSImP overall score, the median oral impairment total score (OT) was 10.5 (interquartile range [IQR]: 9–11), the median pharyngeal impairment total score …

Impact Of Rotenone Treatment On Respiration And Swallowing Rate In Drinking Rats, Taylor Good, Shivam Patel, Nicholas Zanghi, Francois Gould

Rowan-Virtua Research Day

Parkinson’s disease is a neurodegenerative disorder known to cause dysphagia, the major contributor to mortality via aspiration pneumonia. The neurological basis of swallowing dysfunction in Parkinson patients is poorly understood. To explore the mechanisms of swallowing dysfunction, we studied the impact of rotenone treatment on respiration rate and swallowing rate in liquid-drinking rats. We hypothesized that rotenone treatment will cause a decrease in respiratory and swallowing rate compared to untreated liquid-drinking rats. Six rats were injected with 2.75 mg/kg/day intraperitoneal rotenone for 16 days to create the parkinsonian phenotype and subsequently recorded with 200fps video fluoroscopy during barium-infused liquid drinking. …

Effect Of Dosage On Severity Of Dysphagia In A Toxicological Rat Model Of Parkinson's Disease, Shivam Patel, Taylor Good, Nicholas Zanghi, Francois Gould

Rowan-Virtua Research Day

Parkinson’s Disease (PD) is a prevalent and devastating neurodegenerative disorder that causes progressively worsening motor symptoms affecting locomotor and oropharyngeal function. There is limited research in animal models on swallowing dysfunction in PD. To examine how neurodegeneration in PD produces progressive impairment in the oropharyngeal and locomotor processes, rotenone, a type II mitochondrial inhibitor, was injected into Lewis rat models to reproduce a parkinsonian phenotype. We hypothesized that the animal models injected with the rotenone will exhibit both oropharyngeal dysfunction and locomotor deficiency with an increased deficit that correlates with prolonged treatment. We utilized 18 rats receiving either 2.75 mg/kg …

Identifying Chewing Alterations In A Parkinsonian Model, Nicholas Zanghi, Taylor Good, Shivam Patel, Francois Gould

Rowan-Virtua Research Day

Patients suffering from Parkinson’s Disease will typically experience a range of motor and nonmotor symptoms. Characteristic signs of Parkinson’s include pill-rolling tremor, stooped posture, and shuffling gate. Patients with this disease can also develop oropharyngeal dysfunction, which can disable patients from meeting their physiologic needs. Understanding this disability and the changes in mastication kinematics can lead to potential future treatment. Our study induced Parkinson’s in rats with rotenone injections. Their jaw kinematics were identified through fluoroscopy of radio-opaque beads implanted into different areas of their jaws. The Parkinson’s induction altered mastication significantly with an increase in anterior/posterior range of motion …

A Case Of Esophagogastric Junction Outflow Obstruction Resulting To Megaesophagus In A 37-Year-Old Male, Dean Esma, Robin Lahr, James A. Espinosa, Alan Lucerna

Rowan-Virtua Research Day

Esophagogastric junction outflow obstruction (EGJOO) is a major motility disorder characterized by an increase of > 15 mmHg in the integrated relaxation pressure (IRP) with or without problems in esophageal motility. This presents as dysphagia, chest pain, regurgitation, heartburn, cough, and a globus sensation, with dysphagia. Severe cases may lead to a megaesophagus causing compression of mediastinal structures.6 Its similarity to other esophageal disorders urge an investigation to improve its identification and treatment. This report presents a case of EGJOO in a 37-year-old cachectic male patient with dysphagia and vomiting, eventually determined to be EGJOO with diagnostic manometry.

Case Report: Dysphagia In Inclusion Body Myositis Leading To Respiratory And Gastrointestinal Complications, Veroneka Mikhail, James A. Espinosa, Alan Lucerna

Rowan-Virtua Research Day

Inclusion Body Myositis (IBM) stands as a rare and complex neuromuscular disorder (NMD) characterized by progressive muscle weakness and atrophy. Among its cardinal symptoms are dysphagia and respiratory distress, which are the most common cause of death in this disease. While the differential diagnosis of respiratory distress is vast and includes aspiration, pneumonia, acute coronary syndrome, emphysema, and congestive heart failure, a clinician should recognize that respiratory distress can also be secondary to dysphagia in NMDs like IBM and can quickly become life threating. Here we present the case of a 68-year-old female with a history of IBM who presented …

Tongue-Tie: Impact On Oropharyngeal Function During Swallow., Kolbie A. Vincent

Electronic Theses and Dissertations

Swallowing is an intricate process involving over 50 muscle pairs and numerous nerves, with dysphagia resulting from deficits in various stages (Hennessy & Goldenberg, 2016). Lingual restriction may adversely impact swallowing function, affecting bolus preparation, size, and overall efficiency. Tongue-tie can pose challenges to speech, chewing, and swallowing (Becker & Mendez, 2022; Chaubal et al, 2011; García-Pola, M. J., et al., 2002). This pilot study seeks to determine how tongue-tie affects swallowing function in an adult male, and whether surgical revision of a submucosal lingual tether leads to measurable changes in oropharyngeal swallow function. Results showed inconsistent changes in diameter …

The Good, The Bad, And The Ugly: A Review Of Evidence-Based Practice Within Communication Sciences And Disorders, Mackenzie Morehead

WWU Honors College Senior Projects

The usage of evidence-based practice (EBP) within the field of Communication Sciences and Disorders (CSD) is highly important. It includes three main factors: external evidence, internal evidence, and client preferences (Dollaghan, 2007). External evidence represents contributions from high quality research, internal evidence is based on clinician knowledge and experiences, and client preferences consider clients personal beliefs, fears, and goals. By combining these factors, clinicians make sound decisions within the field of CSD. The American Speech-Language Hearing Association (ASHA) endorses the need for EBP within this field (Robey, et al. 2005). This review investigated the usage of EBP across the 9 …

Severe Dysphagia With Eosinophilic Esophagitis Pattern Of Injury Related To Pembrolizumab Therapy, James S Barnett, Kevin K Yu, Xavier Rivera Rivera, Asmeen Bhatt

Student and Faculty Publications

While immune checkpoint inhibitor (ICI) therapies are effective treatments for many cancers, ICI therapies are associated with immune-related adverse events. We present a 67-year-old man with non-small cell lung carcinoma, who developed severe dysphagia with biopsies from an esophagogastroduodenoscopy showing histopathology consistent with eosinophilic esophagitis while on ICI maintenance therapy with pembrolizumab. The patient's symptoms worsened despite standard therapy. However, he had complete resolution of dysphagia symptoms once pembrolizumab was discontinued. While immune-related adverse events affecting the gastrointestinal system are increasingly recognized, ICI-associated eosinophilic esophagitis is a rare entity.

The Effects Of Exercise-Based Voice Therapy On Swallowing Outcomes: A Pilot Study Framework, Jenna F. Johnson

Theses and Dissertations--Communication Sciences and Disorders

In a 2019 study analyzing dysphonic patients in relation to coexisting dysphagia, approximately 11.8% of clients receiving treatment for voice disorders reported difficulty swallowing. However, the literature exploring the use of voice exercises to improve swallow function is limited to a small amount of voice treatment approaches, which does not reflect the wide range of evidence-based treatment approaches that may be prescribed for treatment of one’s voice complaints. This project proposes a descriptive study that would identify if completion of prescribed voice therapy exercises has implications on swallowing function in clients with co-occurring voice and swallow impairments. A pilot study …

Advancing Dysphagia Screening: A Comparison Of Patient-Reported Outcome Measures And Bolus-Driven Screenings In Aspiration Prediction, Arica Amie Rusco

Theses and Dissertations--Communication Sciences and Disorders

It is known that dysphagia impacts an individual’s health and quality of life. Due to this, early identification of dysphagia is crucial. There are many different dysphagia screening tools with no consensus. This study aimed to compare the two most frequently used dysphagia screenings, a patient-reported outcome measure (PROM), the EAT-10, and bolus-driven swallow screening, the Yale Swallow Protocol, to determine if one tool is superior in aspiration prediction on a videofluoroscopic swallow study (VFSS). This study also aimed to discover the best cutoff score on the EAT-10 for aspiration prediction. A total of 66 participants were recruited after physician …

Improve Dysphagia Screening In Patients With Neurological Conditions Through Education: A Quality Improvement Project, Kendra Mcintosh

Master's Theses and Capstones

Background: A macrosystem in Southern Massachusetts faces challenges in patients with neurological conditions recieveing a dysphagia screening prior to anything enter the patients mouth in the Emergency Room.

Local Problem: The educational gap identified in Registered Nurses regarding the frequency of screening being completed and the knowledge of the indications for a dysphagia screening.

Methods: Using the Plan-Do-Study-Act model, an educational intervention was implemented. An educational poster was displayed in the microsystem. Data was collected pre-and post-intervention through a survey to measure change.

Interventions: The educational poster was displayed in high-traffic areas of the microsystem. This educational poster included …

Flexibility For Intensity Dosing In Lingual Resistance Exercises: A Large Randomized Clinical Trial In Typically Aging Adults As Proof Of Principle, Sarah Szynkiewicz, Teresa Drulia, Lindsay Griffin, Rachel Mulheren, Kelsey Murray, Theresa Lee, Erin Kamarunas

Department of Communication Sciences and Disorders - Faculty Scholarship

Objective: The objective of this study was to determine the effect of intensity dosing during tongue exercise on tongue pressure generation, adherence, and perceived effort.

Design: This was a five-site, prospective, randomized clinical trial. Outcome measures were obtained across multiple baselines, biweekly during exercise, and 4-weeks post-intervention.

Setting: The general community at each study site. Participants: Typically aging adults between 55–82 years of age with no history of neurological or swallowing disorders. Eighty-four volunteers completed the study.

Interventions: Participants were randomly assigned to one of four exercise groups: (a) maximum intensity/no biofeedback, (b) progressive intensity/no bio- feedback, (c) maximum intensity/biofeedback, …

Laryngeal Symptoms Related To Motor Phenotypes In Parkinson's Disease: A Systematic Review, Zoë Thijs Ph.D., Matthew Dumican

Faculty Publications: Communication Sciences and Disorders

Objective This study aimed to systematically review the associations between motor clinical phenotypes in Parkinson's disease (PD) and laryngeal disease symptoms. Laryngeal dysfunctions such as dysphonia and dysphagia are ubiquitous in people with Parkinson's disease (PwPD). Similar to other disease symptoms, they manifest variably across PwPD. Some of the variability within PD has been explained by clinical phenotypes. However, it is unclear how laryngeal symptoms of PD express themselves across these phenotypes.

Methods Five databases were searched (MEDLINE, CINAHL, Web of Science, Embase, Scopus) in May 2022. After the removal of duplicates, all retrieved records were screened. Cohort, case–control, and …

Swallow, Breathing And Survival: Sex-Specific Effects Of Opioids., Michael Frazure

Electronic Theses and Dissertations

This dissertation presents a series of studies examining mechanisms of deglutition and respiration, and how these vital processes are impacted by opioids. The experiments in Chapter Two investigated the role of the upper esophagus in airway protection through systematic activation of pharyngeal and esophageal mechanoreceptors in a cat electromyography model. Chapter Three compared effects of opioid administration on breathing and swallowing between male and female rats, and found that females are more susceptible to opioid-induced depression of breathing and swallow than males. Findings from Chapters Two and Three led to the development of a translational model of opioid-induced dysphagia using …

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 …

Case Report: Vocal Cord Paralysis In The Ed, Richard Baluyot, Russell Mordecai, James Espinosa, Alan Lucerna

Rowan-Virtua Research Day

The incident rate of vocal cord paralysis varies greatly depending on the cause of paralysis as well as if it's unilateral or bilateral, for this poster we will be focusing on unilateral paralysis. From 1985 to 1995 cancer was the primary cause for vocal cord paralysis, however this shifted to primarily iatrogenic surgical injury from 1996 to 2005. In another study it was found that idiopathic paralysis and tumors to both be the primary cause (31.11% respectively), with surgery consisting of 28.89%, and trauma, brain problems, systemic disease and other causes being 2.2%.

Swallowing Disrupts Tongue-Jaw Coordination During Chewing In A Rat Model Of Parkinson's Disease, Meejan Palhang, N. Charles, Francois Gould

Rowan-Virtua Research Day

The primary motor symptoms of Parkinson’s disease, including bradykinesia, rigidity, and tremor, are associated with difficulties regulating transitions between motor behaviors due to basal ganglia dysfunction. Chewing and swallowing, which are disordered in most patients with Parkinson’s disease, are two complex motor behaviors which overlap in time and share some neuromuscular components. The objective of this study is to identify how Parkinson’s disease affects the coordination of chewing and swallowing. We hypothesize that as a result of impaired regulation of shift between motor patterns, chewing cycles that occur with a swallow will be more affected that chewing cycles occurring in …

The Utility Of Peer-To-Peer Practice For Teaching Speech-Language Pathology Students Transnasal Endoscopy, Laura L. Wolford, George W. Wolford, Charlotte A. Bolch

Teaching and Learning in Communication Sciences & Disorders

Introduction: Transnasal flexible endoscopy (TNFE) is necessary for multiple assessments in speech-language pathology (SLP), but it is generally considered an advanced practice technique to be learned during clinical practice. As such, there is no standardized way that it is taught in training programs, leading to a substantial knowledge gap for new graduates. Though peer-to-peer practice has been discussed as an important step in training, it is not clear whether it confers additional benefits above and beyond simulation. This study sought to answer that question in the areas of student confidence, endoscopy speed, and motivation to pursue further TNFE experiences. Methods: …

Bulbar-Predominant Presentation Of Myasthenia Gravis: Poster Presentation, Duncan Mckinney, Rumana Khan, Edward Griffin

Capital Division GME Research Day 2023

No abstract provided.

Efficacy Of A Compound Swallowing Training Program Incorporating Neuromuscular Electrical Stimulation On Postoperative Chronic Dysphagia In Patients With Tongue Cancer, U-Hin Lai, Yu-Chi Huang, Ching-Yi Liao, Xiao-Rou Ding, Chau-Peng Leong

Rehabilitation Practice and Science

Objective: To investigate therapeutic effects of a compound swallowing training program(CSTP) that includes neuromuscular electrical stimulation, swallowing muscle strengthening, posture training, food texture modification, and the use of adaptive feeding devices on chronic dysphagia after surgical treatment of tongue cancer(TC), and review the long-term swallowing outcomes and possible adverse effects.

Materials and methods: In this retrospective longitudinal study, we included patients with chronic dysphagia after surgical treatment of TC, who received a total of 10 CSTPs three times weekly, for one hour each time. Penetration-Aspiration Scale (PAS), Functional Dysphagia Scale (FDS), and Swallowing Performance Rating Scale (SPS) scores were compared …

Three-Dimensional Food Printing: Its Readiness For A Food And Nutrition Insecure World, Liezhou Zhong, Joshua R. Lewis, Marc Sim, Catherine P. Bondonno, Mark L. Wahlqvist, Amin Mugera, Sharon Purchase, Kadambot H. M. Siddique, Michael J. Considine, Stuart K. Johnson, Amanda Devine, Jonathan M. Hodgson

Research outputs 2022 to 2026

Three-dimensional (3D) food printing is a rapidly emerging technology offering unprecedented potential for customised food design and personalised nutrition. Here, we evaluate the technological advances in extrusion-based 3D food printing and its possibilities to promote healthy and sustainable eating. We consider the challenges in implementing the technology in real-world applications. We propose viable applications for 3D food printing in health care, health promotion and food waste upcycling. Finally, we outline future work on 3D food printing in food safety, acceptability and economics, ethics and regulations. . .

Swallowing Function In Parkinson's Disease: Correlation With Disease Duration And Hoehn And Yahr Stage, Yi-Ya Pan, Hsueh-Pei Wang, Ruey-Meei Wu, Tyng-Guey Wang

Rehabilitation Practice and Science

Oropharyngeal dysphagia is a common complication of Parkinson's disease (PD). Swallowing assessment scales, videofluoroscopics wallowing study (VFSS), and fiberoptic endoscopic evaluation of swallowing (FEES) are used to evaluate the swallowing function of patients with dysphagia. However, few studies have been conducted that assessed tongue muscle strength and hyoid bone movement in patients with PD. To better understand the correlation between disease duration, Hoehn and Yahr (H&Y) stage and swallowing function in patients with PD, this study evaluated the swallowing function in patients with PD using ultrasonography and Iowa Oral Performance Instrument (IOPI). Ultrasonography was performed to evaluate hyoid movement, and …

Viscosity Of Commercial Thickeners In Combination With Different Beverages Of Honey- And Nectar-Like Consistency And Their Change Over Time, Wei-Chun Che, Yuan-Ching Tsai, Meng-I Kuo, Tsan-Hon Liou

Rehabilitation Practice and Science

Objective: This study investigated the viscosity of four beverages (green tea, grape juice, sugar-free soy milk, and Ensure®) thickened to a nectar- and honey-like consistency with five thickening products (Resource® Thickenup® Clear, Toromeal, Toromi-up, eNutrition, and Sentosa) marketed in Taiwan. The sample viscosity over time was compared. Furthermore, the results were compared with the guidelines of National Dysphagia Diet (NDD) established by the American Dietetic Association. Methods: The viscosity was measured using the Brookfield RVDV-II+ Pro viscometer with small sample adaptor, shear rate set at 50 s-1, temperature at 25℃. Results: The results showed that almost all thickening products in …

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 …

Assessing Dysphagia Related Quality Of Life Using Dysphagia Handicap Indexin Stroke Survivors, Sai Shreya R Ms.

Manipal College of Health Professions, Manipal Theses and Dissertations

ABSTRACTPurpose. There are limited studies that have reported the psychosocial impact of dysphagiausing the Kannada version of DHI among the stroke survivors. The aim of this study is toassess Dysphagia related QOL using DHI in Stroke Survivors.Method. Eighty five stroke survivors were recruited based on the inclusion and exclusioncriteria. Two weeks after NG tube removal, the participants were asked to fill the DHI –Kquestionnaire and rate their self-perceived severity of dysphagia. The data was analysed usingSPSS version 20.0 . Descriptive statistics analysis was used. Spearman correlation coefficientwas used to assess the relationship between the subscales of DHI-K, total DHI-K scores …