Dysphagia 7
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When is the compensatory strategy of tilting the client's chin down when swallowing indicated? | Delayed triggering of pharyngeal swallow, reduced laryngeal closure, reduced tongue base retraction (widens vallecular space) | |
When is the compensatory strategy of turning the client's head to the left or right indicated? | When there is paralysis on one side of the pharynx, turn head to the weak or affected side when swallowing | |
When is the compensatory strategy of tilting the client's head to the left of right indicated? | When there is lingual or pharyngeal weakness on one side, residue may collect on weaker side of oral cavity, tilt towards stronger side | |
What are some other compensatory strategies for dysphagia? | reduce the size of the bolus (1/2 to 1/3 tsp size), swallow twice per bite or sip, alternate solids with liquids, tongue or finger sweeps | |
Describe the rehabilitation technique of thermal-tactile stimulation. | Stimulates triggering of pharyngeal swallow, Cold laryngeal mirror is moved along anterior faucial arches, very effective | |
Describe the rehabilitation technique of the sour lemon bolus. | Improve triggering pharyngeal swallow, increase tongue base retraction, sour lemon slushy utilizes thermal-tactile stimulation as well | |
Describe the rehabilitation technique of oral-motor exercises. | For jaw strengthening and ROM, tongue, lip exercises | |
Describe the rehabilitation technique of the Mendolsohn Maneuver. | Manually lifting the larynx to improve swallowing, when there is decreased laryngeal elevation and cricopharyngeal opening, practice 2-5 times per day | |
*Describe the rehabilitation technique of the 6 step supraglottic swallow technique. | Hold breath throughout entire process, small bite of food, swallow, cough, swallow, resume breathing, requires cognition, and motivation |
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