The rehab in neurogenic dysphagia based on evidences imply in the relation between interventions and the results. Aim: evaluate the efficacy of speech therapy intervention in swallowing of carrier patients of swallowing disorders after stroke, examine the grade of swallowing, the level of anxiety and the nutritional state of carrier patients of swallowing disorders after stroke, before and after speech therapy treatment. Methods: Exploratory study, transverse of quantitative character. The sample consisted in 12 patients, media of age 64.6 years with medical diagnosis of hemorrhagic and ischemic stroke without cognitive disorders. It was realized clinical assessment of dysphagia with the partial use of the Protocol of Risk Assessment for Dysphagia (PARD), application of the Functional Oral Intake Scale for Dysphagia in Stroke Patients FOIS, videofluoroscopy assessment of swallowing, questionnaire about perception swallowing, application of Beck Anxiety Scale(BAI) and application of mini nutritional assessment MNA®. All tests were applied before and after speech therapy (15 sessions) Results: Statistically significant changes in the degree of dysphagia through clinical assessment (p=0,017) and oral intake through FOIS (p=0,003).On videofluoroscopy assessment and perception of swallowing it wasn`t observed statistics results, but it was possible to observe an evolution in their scores, 33% showed functional swallowing and 25% characterized swallowing with excellency after the therapy sessions. It was observed during assessments pre speech therapy that 47.1% of the patients showed picture of malnutrition and 35.3% of patients had a mild degree of anxiety. After fifteen treatment sessions it was found that 16.7% were malnourished and 50% of patients had minimal degree of anxiety. Conclusion: It was observed therapy efficacy on dysphagias after stroke on this sample, evolution on the level of oral intake and in the grade of dysphagia, also confirmed by videofluoroscopy. In relation to the grade of anxiety and to the nutritional state of this sample, there was an considerable evolution after therapeutic procedure. Although the sample number is small, the reached progress in all variables showed importance of use of a therapeutic program, providing benefits in life quality of the dysphagic patient. / A reabilitação em disfagia orofaríngea baseada em evidências implica a relação entre as intervenções e os seus resultados. Objetivo: avaliar a eficácia da intervenção fonoaudiológica na deglutição de pacientes portadores de disfagia orofaríngea pós-AVC, analisar o grau de disfagia, o nível de ansiedade e o estado nutricional de pacientes portadores de disfagia orofaríngea pós-AVC, antes e após o tratamento fonoaudiológico. Método: estudo exploratório, transversal de caráter quantitativo. A amostra foi constituída por 12 pacientes, média de idade de 64,6 anos com diagnóstico médico de AVC hemorrágico e isquêmico e sem distúrbios cognitivos. Foi realizada a avaliação clínica da disfagia com o uso parcial do Protocolo de Avaliação do Risco para a Disfagia - PARD, aplicação da escala Funcional Oral Intake Scale for Dysphagia in Stroke Patients FOIS, avaliação videofluoroscópica da deglutição, questionário sobre a percepção da deglutição, aplicação da Escala de Ansiedade de Beck (BAI) e utilização da miniavaliação nutricional MNA®. Todos os exames foram aplicados pré e pós-terapia fonoaudiológica (15 sessões). Resultados: evolução estatisticamente significativa no grau de disfagia através da avaliação clínica (p=0,017) e da ingesta oral através da FOIS (p=0,003). Nas avaliações videofluoroscópica e da percepção da deglutição, não foram observados resultados estatisticamente significativos, porém foi possível verificar uma evolução em seus escores, 33% apresentaram deglutição funcional e 25% caracterizaram a deglutição com excelente após as sessões terapêuticas. Observou-se também, durante as avaliações pré-terapia fonoaudiológica, que 47,1% dos pacientes evidenciaram quadro de desnutrição, e 35,3% dos pacientes apresentaram o grau de ansiedade leve. Após as sessões terapêuticas, verificou-se que 16,7% estavam desnutridos, e 50% dos pacientes apresentaram grau mínimo de ansiedade. Conclusão: observou-se eficácia terapêutica nas disfagias orofaríngeas após AVC nesta amostra, evolução no nível de ingestão oral e no grau de disfagia, confirmado também pela videofluoroscopia. Em relação ao grau de ansiedade e ao estado nutricional desta amostra, verificou-se evolução considerável pós-procedimento terapêutico. Embora o número da amostra seja pequeno, o progresso obtido em todas variáveis demonstra a importância da utilização de um programa terapêutico, proporcionando benefícios na qualidade de vida do paciente disfágico.

Syfte: Syftet med studien var att undersöka sjuksköterskornas beskrivning av sväljbedömning hos äldre personer med misstänkt dysfagi i kommunal hälso- och sjukvård. Metod: Metoden var en kvalitativ intervjustudie. Resultat: I resultatet visades följande kategorier ” Observationer av symtom”, ”En praktisk bedömning”, ”Närvaro vid måltiderna” , ”Kostanpassning”, ”Anpassning av vården”, ”Handledning av personal” , ”Teamträffarna hade betydelse för planering av vården” och ”Brist på kunskap och bedömningsinstrument”. Slutsats: Sjuksköterskor beskriver att sväljbedömning är en viktig uppgift i det dagliga arbetet. Sjuksköterskans närvaro och samverkan bidrar till att vägleda personalen så att inte olämpliga metoder använts, samt att närvara vid måltider och att observera en patients sväljfunktion. Sjuksköterskor som arbetar i kommunal hälso- och sjukvård behöver mer kunskaper angående sväljbedömningar samt hanteringen av ett bedömningsinstrument / Aim: The aim of this study was to investigate Registered Nurses’ (RNs) description of swallowing assessments in older people with suspected dysphagia in municipal health care. Method: The method was a qualitative interview study. Results: The results demonstrated the following categories “ Observation of symtoms”, "A practical assessment", "Attendance at mealtime", ”Adapting food", "Adaptation of care", “Supervision of staff " , "Team meetings had significance for planning of health care" , and "Lack of knowledge and assessment instruments". Conclusion: RNs describe that swallowing assessment is an important task in the daily work. The RNs presence and collaboration will help to guide staff so that no inappropriate methods are used, as well as to attend meals and observing a patient's swallowing function. RNs who work in municipal health care need more knowledge about swallowing assessments and management of an assessment instrument.

Neonatal abstinence syndrome (NAS) refers to the withdrawal infants exposed to opioids in utero may experience following birth. In recent years, the number of infants born who present with NAS has grown exponentially. This increase in the number of infants with NAS has led to a new population within the caseloads of speech-language pathologists (SLPs) who work in neonatal intensive care units (NICUs). SLPs’ knowledge base and skill set of assessment and treatment of swallowing and feeding disorders in infancy play a vital role in the treatment of infants with NAS in the NICU. A dearth of research exists regarding the specific nature of the feeding problems and skills of infants with NAS and whether SLP intervention for infants with NAS needs to differ from that of other infant NICU populations. Identifying how SLPs can best serve infants with NAS in the NICU is essential to their immediate well-being as well as the development of these infants. The purpose of this survey-based research study was to examine NICU SLPs’ perceptions of infants with NAS, and more specifically, how NAS affects the infants’ feeding skills, structural, and oral-motor characteristics. A questionnaire was developed based on an in-depth literature review to collect information on NAS, caseloads, treatment environment, and respondent demographics. The survey consisted of three sections: NAS (further divided into Assessment, Treatment, and Education), Environmental Description, and Respondent Demographics. The secure web-based questionnaire was distributed through SurveyMonkey™, an online survey platform. Survey research was conducted, and hospital-based speech-language pathologists within the USA acted as respondents. The findings will contribute to establishing a preliminary base of information on this topic. The results are expected to further inform the field as well as current practices in evidenced-based practice care for infants with NAS.

Introduction: To date, few research studies have evaluated pediatric feeding and swallowing practices in school systems across the United States. This study aims to i) understand the factors that impact a speech-language pathologists (SLPs) level of comfort in providing these services, ii) to identify barriers to service provision, iii) develop a concrete understanding of a SLPs role in providing feeding and swallowing services in a school setting, and iv) to identify the types of service suggested by school-based SLPs in response to a fictional case study. Methods: School-based SLPs and clinical fellows were invited to participate in a 10-15 minute web-based survey. The survey questions focused on basic demographic information, vocational history, barriers to treatment, and clinician comfort level. In addition, survey respondents were asked to develop a treatment plan in response to a fictional case study. In total, 200 anonymous survey responses were collected and analyzed. Results: Descriptive data, summarizing the demographic and vocational factors of the survey respondents, are provided. In addition, independent Pearson Chi-Square analyses were performed to determine the degree of association between the demographic/vocational factors and the SLPs self-reported comfort level. The results of these correlation analyses are reported and discussed. Barriers to dysphagia management and a summary of the services currently provided in the school setting are discussed from the perspective of professional practice issues. Analysis of the case study results indicated a wide range of treatment plans. The most common type of direct intervention suggested was an oral motor exercise regime, followed by diet modifications and the implementation of safe swallow strategies. Discussion: The survey results indicate a number of factors impact clinician comfort level including geographic region, previous medical experience and current service provision. A number of barriers to practice were identified which include academic and/or clinical preparedness and concerns related to the educational relevance of service. Approximately 26.5% of survey respondents indicated that there were providing feeding and swallowing related services in a school setting with 98.1 % of these clinicians providing collaborative consultation. The case study results highlighted the variability in treatment approaches.

Die Spezifischen Phobien stellen die häufigste Gruppe der Angststörungen dar. Die Angst vor dem Verschlucken bzw. dem Ersticken wurde jedoch nur sehr selten beschrieben. Bei der Behandlung der Spezifischen Phobien wird fast immer eine Konfrontation in vivo eingesetzt. Die Angst vor dem Verschlucken scheint aber eine der Spezifischen Phobien zu sein, bei der eine Konfrontation schwierig ist. Die hier vorgestellte Fallgeschichte schildert eine mögliche Vorgehensweise, die Ängste vor dem Verschlucken mit einer Reizkonfrontation in vivo zu behandeln. Dabei werden die verschiedenen Schwierigkeiten, die aufgetreten sind, und ihre Lösungen geschildert. Die Therapie wurde erfolgreich abgeschlossen, und auch die Ergebnisse der Nachuntersuchungen zeigten eine stabile Verbesserung. / Specific phobias are the most common anxiety disorders. However, the fear of swallowing the wrong way and choking has rarely been described. Specific phobias are usually treated using exposure therapy. The excessive fear of swallowing the wrong way does not seem to be very well suited for an exposure in vivo. In this case study, a patient afflicted with the fear of swallowing and choking was treated with flooding. The various difficulties encountered during treatment and their remedies will be described. The therapy was successful. The patient showed stable and lasting improvements at posttreatment and at one-year follow-up. / Dieser Beitrag ist mit Zustimmung des Rechteinhabers aufgrund einer (DFG-geförderten) Allianz- bzw. Nationallizenz frei zugänglich.

No description available.

Larynxcancer är den tredje vanligaste formen av huvud- och halscancer och drabbar cirka 175 personer årligen i Sverige. En vanlig behandlingsmetod vid larynxcancer är strålbehandling. Detta är en retrospektiv journalstudie med syfte att undersöka hur svälj- och röstfunktion samt nutritionsstatus påverkas av strålbehandling för larynxcancer. Studiens syfte är även att undersöka om det finns något samband mellan tumörgrad och sväljförmåga efter avslutad behandling samt om och när svälj- och röstfunktion återhämtas. Studien har även undersökt andelen patienter som erbjudits logopedkontakt. I studien har 52 patienter med larynxcancer (C.32) inom region Gävleborg inkluderats. Resultaten indikerar att strålbehandling påverkar svälj- och röstfunktion samt nutritionsstatus. Vid strålavslut hade 24 av 48 patienter tecken på sväljsvårigheter och 33 av 52 patienter hade en påverkan på röstfunktionen. Under behandlingen noterades ett ökat behov av näringsdryck och 24 av 37 deltagare gick ner i vikt under eller efter behandling vilket indikerar nutritionssvårigheter. Andelen patienter som var i behov av enteral nutrition vid strålavslut var 7 av 52 patienter. Sammanlagt erbjöds 33 av 52 patienter logopedkontakt. Återhämtning av sväljfunktionen rapporterades hos 22 av 39 patienter inom ett år efter avslutad strålbehandling. Återhämtning av röstfunktionen noterades hos 8 av 40 patienter inom fem år efter avslutad strålbehandling. Studiens resultat ger värdefull information om strålbehandlingens påverkan på livsviktiga funktioner och hoppas kunna bidra med underlag till prospektiva studier inom huvud- och halscancer. / Laryngeal cancer is the third most common form of head- and neck cancer and each year approximately 175 people receive the diagnosis in Sweden. Radiotherapy is a common treatment against laryngeal cancer. This is a retrospective cohort study, and it has investigated how swallowing, voice function and nutritional status can be affected by radiotherapy. The aim of the study was to explore whether there is a correlation between the grade of tumor and swallowing after treatment and when swallowing and voice function recover. The aim was also to research how many patients received contact with a speech- and language pathologist before or during treatment. The following study included 52 patients with laryngeal cancer (C.32) within the region of Gävleborg, Sweden. The results indicate that radiotherapy affects swallowing, voice function, and nutritional status. By the end of treatment, 24 of 48 patients had signs of dysphagia and voice function was affected in 33 of 52 patients. An increase in the need for nutritional drinks was noted throughout radiotherapy and 24 of 37 patients lost weight during or after treatment, which indicates nutritional difficulties. At the end of the treatment, 7 of 52 patients needed enteral nutrition. In total, 33 of 52 patients were offered contact with a speech- and language pathologist. Recovery of the swallowing function was reported in 22 of 39 patients at some point during the first year after radiotherapy. Recovery of voice function was reported in 8 of 40 patients at some point during five years after radiotherapy. The results of the study indicates possible implications that radiotherapy might have on vital functions, and it can suffice as a basis for further prospective studies within the area of head- and neck cancer.

No description available.

Thesis "Myofunctional disorder of children" is about myofunctional disorder with a focus on logopedics and issues of human speech. The whole work has, however, significantly multidisciplinary character. The theoretical part of the thesis is focused on orofacial complex, swallowing and speech complex in all its breadth. It is also focused on nutrition problems at an early age and on related activities. Readers can also find information about orthodontic anomalies that are directly related to myofunctional disorder. A large area is dedicated to myofunctional disorder itself - terminology, etiology, symptomatology, diagnosis, prevention and therapy. As an important section of practical part of the work serves a research on a sample of 15 children diagnosed with myofunctional disorder. The sample was subjected to qualitative analysis, where an outcome demonstrates 3 case studies demonstrating the degree of seriousness of 3 myofunctional disorders. Additionally, there is also simple quantitative analysis and its outcome is an overview chart. KEYWORDS Myofunctional disorder, orofacial, tongue, ortodontic anomalies, breast- feeding, suckling, mastification, swallowing, speech - articulation.

The topic of this thesis is discussion of usage of myofunctional therapy on persons with communicative disorders. The main goal is to map the extent and possibilities of this therapy in speech therapy practice. The theoretical part deals with physiology and patophysiology of breathing, sucking, swallowing and the orofacial system. Further, in connection with myofunctional therapy it discusses its historical development, methodical approaches, utilities, therapeutical benefits and possibilities of education on this field. The empirical part contains a quantitative investigation, which analyses the extent and usage possibilities of this therapy by speech-language pathologists in the Czech Republic. Based on the data obtained by a questionnaire distributed to speech-language pathologists it can be stated, that about 20 % of the respondents do not use the myofunctional therapy in practice, while those (with one exception) never took part on an expert training. The offer of the trainings is rated as insufficient. The myofunctional therapy can be used on persons with orofacial disorders regardless of age or communicative disorder. KEYWORDS: myofunctional therapy, communicative disorder, swallowing, dysphagia, bite disorders, orofacial area