Breathing/Swallowing Coordination
Respiratory System
- Anatomy and physiology
- Coordination and aspiration
- Airway protective mechanisms
- Impact of various respiratory diseases
Gastroesophageal System
- Esophageal and digestive functions
- GERD and feeding/swallowing difficulties
- Reflux mechanisms
- Esophageal/Pharyngeal inter-relationships
GI/RESPIRATORY RELATIONSHIPS
What’s the connection?
- Pressure, energy, and innervation
- Extra-esophageal reflux
- Aspiration and the Airway
- Risk factors for pneumonia
- Aspiration and Oral Hygiene – It Takes a team
Disease Processes and Impact on Breathing, Digestion, and Swallowing
- Airway Management, biopsychosocial factors, and implications for feeding and swallowing
- Intubation, tracheostomies, nasal cannula and more
- Implications for feeding
Reflux, biopsychosocial factors, and implications for feeding and swallowing
- Interpreting test results and implications for treatment
- Lifestyle factors
Swallow Assessment
Determine Aspiration Risk
Cognitive, Sensorimotor, and Respiratory Muscle Strength Assessment Tools
3 oz Water Test, Pulse Oximetry and More
Understanding lab values
Instrumental assessment:
- Modified barium swallow studies
- Fiberoptic endoscopic evaluation of swallowing
Feeding Interventions
- Multisensory cues
- Utensil selection
- Environmental modifications
- Assisted feeding options
- Feeding schedules
- Behavioral interventions
Aspiration Management
Diet modifications – Not such a benign intervention
- Implications of dietary changes
- Compliance issues
- Thick liquids – pros and cons
- Water protocols
Strategies and Exercises – What does the evidence tell us?
- Compensation
- Sensory interventions
- Principles of exercise physiology
- Motor learning principles
- Exercise dose
- Skill training vs strengthening
- Biofeedback
- Lingual strengthening
- Pharyngeal strengthening
- Expiratory muscle strength training
- Modifications and adaptations: impairment specific strategies
REFLUX ASSESSMENT
What do these tests tell me?
- Upper GI studies
- Ph Monitoring
- Esophagoscopy
- Scintigraphy
REFLUX MANAGEMENT
What’s the dysphagia clinician to do?
- Lifestyle modifications
- Positioning
- Diet modifications
- Medications
- Effects of acid suppression
- Surgical interventions
- New directions in reflux management