Concordance and discriminatory power of cough measurement devices for individuals with Parkinson disease.

Background: Dysphagia and aspiration pneumonia are two causes of morbidity in Parkinson disease (PD). In PD, impaired airway clearance can lead to penetration of foreign material, resulting in a high prevalence of aspiration pneumonia and death. This study examines three different devices for measurement of peak airflow during voluntary cough in healthy control subjects and those with PD.

The effect of chronic obstructive pulmonary disease on laryngopharyngeal sensitivity.

Patients with chronic obstructive pulmonary disease (COPD) may be at increased risk of aspiration secondary to impaired swallow function. One possible cause of this impairment is a reduction in laryngopharyngeal sensitivity. The relationship between COPD and laryngopharyngeal sensitivity has not been previously determined.

Normalization of temporal aspects of swallowing physiology after the McNeill dysphagia therapy program.

Objectives: We examined the timing of physiological swallowing events in patients before and after completion of an exercise-based dysphagia intervention (McNeill Dysphagia Therapy Program; MDTP) and compared their performance to that of healthy volunteers.

Methods: Eight adults (mean age, 57.5 years) with chronic dysphagia (mean, 45 months) completed 3 weeks of the MDTP.

Dysphagia, nutrition, and hydration in ischemic stroke patients at admission and discharge from acute care.

Dysphagia may predispose stroke patients toward undernutrition and hydration. These comorbidities increase patient risks for reduced functional outcome and short-term mortality. Despite this impact, available information on relationships among dysphagia, nutrition, and hydration status in acute stroke is limited and conflicted.

"Pharyngocise": randomized controlled trial of preventative exercises to maintain muscle structure and swallowing function during head-and-neck chemoradiotherapy.

Purpose: Dysphagia after chemoradiotherapy is common. The present randomized clinical trial studied the effectiveness of preventative behavioral intervention for dysphagia compared with the "usual care."

Methods And Materials: A total of 58 head-and-neck cancer patients treated with chemoradiotherapy were randomly assigned to usual care, sham swallowing intervention, or active swallowing exercises (pharyngocise).

Measurement of hyoid and laryngeal displacement in video fluoroscopic swallowing studies: variability, reliability, and measurement error.

Video fluoroscopy is commonly used in the study of swallowing kinematics. However, various procedures used in linear measurements obtained from video fluoroscopy may contribute to increased variability or measurement error. This study evaluated the influence of calibration referent and image rotation on measurement variability for hyoid and laryngeal displacement during swallowing.

McNeill dysphagia therapy program: a case-control study.

Objective: To compare the effectiveness of the McNeill Dysphagia Therapy Program, a systematic exercise-based rehabilitation framework for swallowing remediation, with traditional swallowing therapy techniques paired with surface electromyography (sEMG) biofeedback.

Design: Matched case-control study.

Setting: University medical center.

Treatment of vocal fold bowing using neuromuscular electrical stimulation.

Objective: To investigate the clinical effectiveness and safety of a novel behavioral voice therapy program combining structured vocal exercise with adjunctive neuromuscular electrical stimulation for rehabilitating dysphonia secondary to vocal fold bowing.

Design: Prospective interventional clinical case series with a 3-month follow-up.

Setting: Outpatient speech and hearing clinic in an academic medical center.

Analysis of a physician tool for evaluating dysphagia on an inpatient stroke unit: the modified Mann Assessment of Swallowing Ability.

Background: Although many dysphagia screening protocols have been introduced in recent years, no validated, physician-administered dysphagia screening tool exists for acute stroke that can be performed at the bedside. Based on the psychometrically validated Mann Assessment of Swallowing Ability (MASA), we developed the Modified MASA (MMASA) as a physician-administered screening tool for dysphagia in acute stroke.

Objective: The purpose of this study was to complete initial validation of this new screening tool for dysphagia in acute ischemic stroke.

The bedside examination in dysphagia.

The evaluation of swallowing disorders currently uses a variety of methods. The most common dichotomy is between instrumental and noninstrumental or clinical examinations. The clinical bedside assessment often is considered the mainstay of dysphagia management.

Cross-system effects of dysphagia treatment on dysphonia: a case report.

Traditionally, treatment of dysphagia and dysphonia has followed a specificity approach whereby treatment plans have focused on each dysfunction individually. Recently however, a therapeutic cross-system effect has been proposed between these two dysfunctions. At least one study has demonstrated swallowing improvement in subjects who completed a dysphonia treatment program.

Adjunctive neuromuscular electrical stimulation for treatment-refractory dysphagia.

Objectives: Neuromuscular electrical stimulation (NMES) has been proposed as an adjunctive modality for the treatment of swallowing disorders. We present data from a prospective case series to define and measure effects of a systematic therapy for chronic pharyngeal dysphagia using adjunctive NMES.

Methods: Six adult patients with pharyngeal dysphagia received 15 sessions of a standardized protocol of swallowing exercises with adjunctive NMES.

Dysphagia and nutritional status at the time of hospital admission for ischemic stroke.

Background: Dysphagia and poor nutritional status occur frequently after stroke; however, potential associations between them are unknown. We evaluated potential associations between dysphagia and poor nutritional status in patients with acute ischemic stroke. Potential associations between these outcomes and more global stroke severity measures were also assessed.

Examining the evidence on neuromuscular electrical stimulation for swallowing: a meta-analysis.

Objective: To evaluate the effect of transcutaneous neuromuscular electrical stimulation (NMES) on swallowing rehabilitation.

Data Sources: MEDLINE, PubMed, CINAHL, NML, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, doc online, Google, and EMBASE were searched for studies using NMES to treat dysphagia between January 1966 and August 2006.

Study Selection: Included were published or unpublished, English-language, clinical trials with a quantifiable dependent variable.

Comparison of surface electromyographic (sEMG) activity of submental muscles between the head lift and tongue press exercises as a therapeutic exercise for pharyngeal dysphagia.

Objective: The present study compared surface electromyographic (sEMG) activity obtained from the submental muscle group for a tongue press and a head lift exercise as potential therapeutic exercises for dysphagic elderly.

Materials And Methods: Fifty-three healthy volunteers with a mean age of 35.3 participated in this study.

Electrical stimulation therapy for dysphagia: descriptive results of two surveys.

Given the paucity of objective information on neuromuscular electrical stimulation approaches to dysphagia therapy, and the expanding utilization of this clinical approach, we designed and conducted two surveys to gather large-scale information regarding reported practice patterns, outcomes, complications, and professional perceptions associated with electrical stimulation approaches to dysphagia therapy. Self-administered questionnaires were mailed to 1000 randomly selected speech-language pathologists in each of two groups: (1) clinicians who had completed a formal electrical stimulation training course and were actively using these techniques, and (2) clinicians who were members of Special Interest Division 13 of the American Speech-Language and Hearing Association. Survey responses were anonymous and no incentive to respond was included.

Identification of swallowing events from sEMG Signals Obtained from Healthy Adults.

Surface electromyography (sEMG) is being used with increasing frequency to identify the occurrence of swallowing, to describe swallow physiology, and to treat impaired swallowing function in dysphagic patients. Despite this increased utilization, limited information is available regarding the validity and reliability of investigators and clinicians to interpret sEMG data in reference to swallowing. This study examines the validity and interjudge reliability of swallow identification using sEMG records obtained from healthy adults.

The impact of rheologically controlled materials on the identification of airway compromise on the clinical and videofluoroscopic swallowing examinations.

Numerous studies have suggested that the clinical evaluation of swallowing fails to adequately identify those patients who aspirate or do not aspirate on a videofluoroscopic swallowing examination. These conclusions, however, are based on comparisons between swallowed materials that were not rheologically matched. The present study used a battery of rheologically matched test materials, involving thin and thick liquids and cohesive and adhesive semisolids.

Biomechanical correlates of surface electromyography signals obtained during swallowing by healthy adults.

Purpose: The purpose of this study was to describe biomechanical correlates of the surface electromyographic signal obtained during swallowing by healthy adult volunteers.

Method: Seventeen healthy adults were evaluated with simultaneous videofluoroscopy and surface electromyography (sEMG) while swallowing 5 mL of liquid barium sulfate. Three biomechanical swallowing events were analyzed: hyoid elevation, pharyngeal constriction, and opening-closing of the pharyngoesophageal segment.

Pill swallowing by adults with dysphagia.

Objective: To evaluate differences in swallowing physiology and safety in patients with dysphagia between conventional tablets and a new method of tablet transportation, orally disintegrating technology (ODT) (RapiTab; Schwarz Pharma Inc, Milwaukee, Wis).

Design: The study observed a single group, crossover design.

Setting: Outpatient clinic within an academic teaching hospital.

Pattern of dysphagia recovery after thermal burn injury.

Providing nutritional support after thermal burn injury is a critical element in achieving successful patient outcomes. The medical records of 28 patients admitted to an acute care burn unit and referred to speech pathology for a swallowing evaluation were reviewed for patterns of dysphagia care. Results revealed a strong positive linear relationship between percent body burns (r = .

Functional benefits of dysphagia therapy using adjunctive sEMG biofeedback.

This article describes a retrospective analysis of functional outcome, time in therapy, and cost per unit of functional change in patients who received therapy for pharyngeal dysphagia. Twenty-five patients presenting dysphagia following stroke and 20 patients with dysphagia following treatment for head/neck cancer completed a systematic therapy program supplemented with surface electromyographic (sEMG) biofeedback. Eighty-seven percent (39/45) of all patients increased their functional oral intake of food/liquid including 92% of stroke patients and 80% of head/neck cancer patients.