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Oral Phase Mgmt/Tx
Oral Phase Compensatory Strategies
| Question | Answer |
|---|---|
| Downward Pressure on Tongue (w/spoon) | To treat reduced oral sensation, delayed oral/pharyngeal swallow. Improves oral sensory awareness. |
| Sour & Cold Bolus | To treat reduced oral sensation, delayed onset of swallow, pharyngeal delay. Improves oral sensory awareness. Put in mesh cloth if swallowing not wanted. |
| Thermal Tactile Swallow | Treats delayed initiation of pharyngeal aspect of swallowing. Improves oral sensory awareness. Stroke anterior faucial pillars w cold stimulus. Effect continues for several swallows after. Not permanent. |
| Bolus requiring chewing & Large Volume & Suck-Swallow | treats reduced oral sensation, delayed oral/pharyngeal swallow. Improves oral sensory awareness. |
| Tactile + Proprioceptive Input from | bolus requiring chewing |
| Increased tongue elevation from | Suck-Swallow |
| Other compensatory strategies | multiple swallows, small sips/amounts, modifying food presentation |
| Liquid Wash | immediately following pudding/solid if its getting stuck (oral/pharyngeal residue) |
| 3 second prep | from neurological/psychological research, preparing to swallow mentally |
| External support | external pressure to weaker cheek, labial & chin support |
| Intraoral prosthetics | For tongue resection, palatal work, lower palatal work, helps swallow |
| Most Invasive Strategy | Changing food consistency |
| Thickened Liquids | Treats oral tongue dysfunction, delayed pharyngeal swallow |
| Purees | Treats delayed pharyngeal swallow, reduced laryngeal closure |
| Rehabilitative Strategies for Oral Phase | Stretch Reflex, OM exercises, resistance, bolus propulsion, ROM exercises (passive & active), lifting back of tongue, |
| Stretch Reflex- rehab strategy | for oral weakness |
| OM exercises- rehab strategy | for Oral weakness, drecreased ROM, therapist initiated (passive) lip stretches, patient initiated (active)=pucker/release,close lips smack hard, smack,retract/hold,puff cheeks,resist ext. pressure |
| Resistance- rehab strategy | for oral weakness/decreased ROM. Push against tongue depressor. |
| Bolus Manipulation- rehab strategy | for decreased ROM. therapist holds bolus in mesh on string and pt moves it around |
| Bolus Propulsion- rehab strategy | for decreased ROM. Juice in gauze, pt squeezes juice out and swallows |
| ROM exercise- rehab strategy | for decreased ROM. Elevate anterior/posterior tongue and hold. side to side. pull tongue back/hold. |
| Lift back of tongue- rehab strategy | for decreased lingua velar seal, not base of tongue. Hard /k/ words |
| protocol recommendations- how many trials a day? | 25 |
| protocol recommendations- how many days a wk? | 6 |
| protocol recommendations- how many wks? | 8 |
Created by:
kaskas
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