Perspectives on Swallowing and Swallowing Disorders (Dysphagia)

Editor's Corner

Davis, L. — 2009-06-09

Applications of Exercise Science in Dysphagia Rehabilitation

Burkhead, L. M. — 2009-06-09

Dysphagia clinicians are charged with improving strength, skill, and endurance in order to rehabilitate oropharyngeal swallowing. The obvious method is exercise training. Dysphagia clinicians often use trial-and-error and experience to develop effective regimens. This article is intended to invoke broader and more accurate perspectives from our colleagues in exercise science.

Rationale for Strength and Skill Goals in Tongue Resistance Training: A Review

Steele, C. M., Bailey, G. L., Molfenter, S. M., Yeates, E. M. — 2009-06-09

Recent evidence in the dysphagia literature shows that tongue resistance training can be used to improve tongue strength. In this review article, we summarize what is known about the tongue and its role in swallowing. We review the literature on tongue pressure generation capacity (strength) and response to tongue resistance exercises. Tongue skill is introduced as a possible alternate goal in tongue resistance training, based on consideration of related literature regarding neural adaptation and improvements in motor performance resulting from treatment approaches in which goal-oriented practice and performance-specific feedback are provided.

Effects of Chemoradiotherapy on Tongue Function in Patients With Head and Neck Cancer

Lazarus, C. L. — 2009-06-09

In this review article, the effects of radiotherapy ± chemotherapy on tissues and on oropharyngeal swallowing are reviewed. In addition, normal tongue function for swallowing is reviewed, as are the effects of tongue exercise programs designed to improve tongue strength and swallow functioning. Current literature on swallow exercise programs for head and neck cancer patients is provided. Also discussed are potential new avenues for research in this population.

The Application of Tongue Endurance Measures to Functional Dining

Kays, S., Robbins, J. — 2009-06-09

While tongue strength has been shown to be critical for safe swallowing, measures of tongue endurance may be more functional, given that dining requires multiple swallows performed over a period of time. Recent findings demonstrate that the act of eating a meal reduces tongue endurance in both young and older adults, but young adults tend to have higher baseline endurance measures, suggesting that older adults present with reduced reserve to safely complete a meal with minimal effort. Furthermore, observed changes in tongue endurance after dining vary with respect to anatomic tongue location, age, and gender. Evidence from studies of limb muscle endurance is utilized to discuss these findings.

Food For Thought: Self-Criticism and Raising the Bar of Dysphagia Practice

Murray, J. — 2009-06-09

The assessment and treatment of swallowing disorders have become central to the practice of the medical speech-language pathologist. The outcomes associated with swallowing and swallowing disorders are severe with aspiration pneumonia, malnutrition and dehydration, and reduced quality of life among the most concerning. Clinicians practicing in this area possess unequal skills, training, and experience, and there is considerable variation in practice in the field. This article focuses on variation and error in swallowing assessment with attention to reliability and accuracy of the videofluoroscopic swallowing assessment. In this self-critical overview of the practice, recommendations are made for developing a standardized assessment protocol, shared lexicon, and specialty recognition in the area of swallowing and swallowing disorders.