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Dysphagia Case Study

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ROLE OF SPEECH LANGUAGE PATHOLOGIST IN ASSESSMENT AND MANAGEMENT OF DYSPHAGIA AND COMMUNICATION FOLLOWING SPINAL CORD INJURY
Ankita Bhutada*, Abhishek Srivastava*

Introduction:
It is well established to have Dysphagia following neurological conditions such as Stroke, Neurodegenerative disorders Head and Neck Cancers. Dysphagia in these conditions is attributed to the involvement of Central Nervous System (CNS) or any aberrations at structural and physiological level. Moreover, it is well understood the role and responsibilities of Speech Language Pathologist in rehabilitation of swallowing impairment in these conditions. However, Dysphagia is also prevalent in certain cervical spine disorders such as scoliosis, kyphosis, lordosis, and vertebral …show more content…

ii) Pharyngeal phase strengthening exercises: this includes a set of exercises in terms of Masako Maneuver, Pitch glides, laryngeal adduction exercises iii) Respiratory- Swallowing Coordination and Strengthening exercises: This included purse breathing, Expiratory Muscle strength training (EMST) iv) Oral-Motor Exercise/ Range of motion exercises (Active …show more content…

Penetration Aspiration Scale (Pen/Asp Scale) was used to assess airway safety, there has been significant improvement with Pre therapy mean score of 7,that suggests material passes glottis, but is not ejected from airway; visible Subglottic stasis despite patient’s response. Post therapy mean score of 1, material does not enter airway. Also ,Post therapy there has been significant improvement in all subjects on Functional Oral Intake Scale (FOIS) FOIS with a shift of scores from mean Level 1 No oral intake, to post therapy scores of mean Level 6 Total oral intake with no special preparation, but must avoid specific foods or liquid items.
Thus, with intensive Swallow therapy along with use of Respiratory Muscle strength training, there has been significant improvement of Communication, due to usage of speaking valve which reduced the distress due to inability to communicate. Moreover improved swallowing abilities lead to decannulation of tracheostomy tubes in 7 of the 8 subjects. Furthermore, improved swallowing mechanism caused per oral intake of

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