Course Summary (0.6 CEUs): This comprehensive one-day live streaming dysphagia course was presented by 12 clinical and research swallowing disorder experts on February 28, 2017. The course begins with a review of the basics of the normal swallowing mechanics, taking neurology and age into consideration. It then moves into evaluation techniques, coping mechanisms, and diet modifications. From there, we move into rehabilitation and address exercises, device-driven options, and biofeedback techniques. It wraps up with surgical options, methods for staying healthy, and a panel discussion on living with dysphagia.
*This course is no longer available for ASHA CEU credit.
- Participants will identify the anatomy and physiology involved in normal swallowing for children and adults.
- Participants will identify the symptoms, primary etiologies, and pathophysiology of disordered swallowing in children and adults.
- Participants will demonstrate knowledge and skills needed to implement research-supported strategies for instrumental and non-instrumental evaluation of swallowing.
- Participants will demonstrate the ability to devise research-supported treatment plans for specific swallowing impairments, taking into account motivation level, quality of life, cultural, ethical, and moral issues.
We recognize and apologize for the substandard quality of the audio and video at times during the recording. We are missing the recording for Denise Barringer’s presentation, “Evaluation 101: Basic Toolbox” and the initial portion of Molly Knigge’s presentation, “Evaluation: Beyond the Basics.”
In May 2017, the NFOSD teamed up with Dysphagia Grand Rounds to host a webinar on electrical stimulation. Participants were encouraged to read a research article prior to attending the webinar. Below is the recording of the webinar, presentation description, presenter bios, and the link to the free-access article.
Link to the Webinar Recording: https://vimeo.com/221877703
Evidence-Based Practice (EBP) is the integration of clinical expertise, patient values, and the current best research evidence, into the clinical decision-making process for patient care. Learning how to access, appraise and apply scientific evidence to clinical practice significantly enhances the opportunity for optimal patient outcomes and quality of life. Dysphagia Grand Rounds (DGR) is an online monthly journal club for speech-language pathologists, which focuses on swallowing and swallowing disorders across the lifespan. The goal of DGR is help clinicians learn how to critically appraise dysphagia research literature and to apply research evidence to clinical practice, with greater confidence and critical thinking. In this webinar, swallowing researcher and expert Dr. Ianessa Humbert and speech-language pathologist Rinki Varindani Desai introduce clinicians to Dysphagia Grand Rounds. Using the DGR format, they further discuss a research study regarding the effects of surface electrical stimulation on swallow function in patients with chronic pharyngeal dysphagia in detail. Clinicians are encouraged to read the open-access journal article below before viewing this webinar, to maximize their learning experience.
Title: Effects of Surface Electrical Stimulation Both at Rest and During Swallowing in Chronic Pharyngeal Dysphagia
Download Link (open-access): https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1790908/
Abstract: We tested two hypotheses using surface electrical stimulation in chronic pharyngeal dysphagia: that stimulation 1) lowered the hyoid bone and/or larynx when applied at rest, and 2) increased aspiration, penetration or pharyngeal pooling during swallowing. Bipolar surface electrodes were placed on the skin overlying the submandibular and laryngeal regions. Maximum tolerated levels of stimulation were applied while patients held their mouth closed at rest. Videofluoroscopic recordings were used to measure hyoid movements in the superior-inferior (s-i) and anterior-posterior (a-p) dimensions and the subglottic air column (s-i) position while stimulation was on and off. Patients swallowed 5 ml liquid when stimulation was off, at low sensory stimulation levels, and at maximum tolerated levels (motor). Speech pathologists blinded to condition, tallied the frequency of aspiration, penetration, pooling and esophageal entry from videofluorographic recordings of swallows. Only significant (p=0.0175) hyoid depression occurred during stimulation at rest. Aspiration and pooling were significantly reduced only with low sensory threshold levels of stimulation (p=0.025) and not during maximum levels of surface electrical stimulation. Those patients who had reduced aspiration and penetration during swallowing with stimulation had greater hyoid depression during stimulation at rest (p= 0.006). Stimulation may have acted to resist patients’ hyoid elevation during swallowing.
Meet the Presenters:
Dr. Ianessa Humbert, Ph.D., CCC-SLP is an Associate Professor at the University of Florida in the Department of Speech, Language, and Hearing Sciences. She has expertise in swallowing and swallowing disorders. Dr. Humbert’s research program is focused on the physiological mechanisms of swallowing disorders and development of rehabilitation strategies for dysfunction. More recently, a major interest of her program has been to understand the neural mechanisms underlying normal and disordered swallowing and how principles of motor learning can be applied to examine these as well as swallowing interventions. Dr. Humbert’s research has been steadily supported by grants from the National Institutes of Health, The American Heart Association, and The American Speech Language Hearing Association since 2006. Dr. Humbert is a widely sought after invited speaker at several national and international clinical and scientific meetings. She has created online courses for CEU credit on swallowing physiology and clinical practice, for which hundreds of clinicians have registered to date and is also the author of the Swallowing Pocket Guide: A Quick Reference for Muscles and Innervation, which has sold several hundred copies nationally and internationally.
Rinki Varindani Desai, M.S.,CCC-SLP is an ASHA-certified Speech-Language Pathologist and a BIAA-certified Brain Injury Specialist, specializing in the assessment and treatment of cognitive-linguistic and swallowing disorders in adults. She has extensively treated adults with dysphagia in the acute care and long-term care medical settings. She is trained in the use of Fibreoptic Endoscopic Evaluation of Swallowing (FEES), Myofascial Release for swallowing disorders and certified in the use of NMES (Vitalstim) for dysphagia management. Rinki founded the Medical SLP Forum and co-developed the mobile app Dysphagia Therapy . She serves on ASHA’s SIG 13 Editorial Review Committee as the CE Editor of Perspectives and on the Dysphagia Research Society’s Website, Communications and Public Relations Committee . She has spoken at several national and international conferences on topics related to dysphagia in adults. Her articles have been featured in popular SLP blogs such as The ASHA Leader , Medbridge Education , Tactus Therapy and Dysphagia Café . Originally an SLP from Mumbai, India; Rinki currently practices in Rochester, New York. You can follow her Medical SLP Blog on Facebook or reach out to her via LinkedIn or Twitter.
Learn more here (Resources)
● DGR Website: www.dysphagiagrandrounds.com
● DGR webinars can be downloaded at: http://dysphagiagrandrounds.yondo.com/ .
● Clinicians can earn 1.0 ASHA CEUs for participating in Dysphagia Grand Rounds by
downloading the DGR ASHA CEU bundle here:
● Watch Dysphagia Grand Rounds Research 101 free webinar here:
● Additional reading references will be provided during the course of the webinar related
to e-stim and swallowing
Medical disclaimer. This Webinar is for informational purposes only and should not be used as a substitute for consultation with an appropriate health care professional, as each individual’s medical situation is unique. It is important that you consult with your medical professional (e.g., physician, SLP) before implementing any course of treatment. Experiences that are new to you should be done with the help of a caregiver and when access to emergency medical care is available.
The Head and Neck Cancer Living Foundation out of Kansas City put together a 15-minute documentary describing the journeys of six head and neck cancer survivors from diagnosis through the aftermath of the treatments.
The HNC Living Foundation funded this video to help compassionate people understand the devastation and intensity of the process and to draw donations to help those who have no insurance, are under-insured or who’s insurance simply runs out. The costs of living after the treatment can break a person financially and emotionally.
Watch this video: https://vimeo.com/212089320
Originally Broadcast Live on December 7, 2016
Presentation Description: Dysphagia is an increasing problem worldwide and conventional treatments are not keeping up with the demand for timely and more effective management. A exciting array of new technologies is emerging which will make life very different — in good ways — for those with swallowing difficulties in decades to come. This presentation will discuss some of the most exciting developments with some guesses about the future shape of swallowing rehabilitation.
Presenter: Dr. Martin Birchall, is a Surgeon specializing in the management of disorders of the head and neck, voice and swallowing. Martin, with co-workers at UCL and overseas, developed decellularized biologic airway scaffolds combined with autologous cells and stem cells (either differentiated or undifferentiated), culminating in the world’s first stem cell based organ transplant in an adult (Lancet, 2008, 2014) and in a child (Lancet, 2012). In October, 2010, Martin performed the world’s first combined laryngeal and tracheal transplant with surgeons at the University of California Davis in a Californian woman who is now talking well. He was named Daily Telegraph-Morgan Stanley Briton of the Year for Science and Technology in 2009 and is the first ENT surgeon to be elected to the Academy of Medical Sciences (2011) and the first to be elected NIHR Senior Investigator (2014) and to serve on the UK’s REF exercise. He runs a large multi-million pound transatlantic research programme funded by MRC, CIRM, TSB and NIHR, dedicated to the development of tissue-engineered organ replacements.