Compensatory Mgmt Techniques for Dysphagia
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| Chin Tuck/Head Flexion - Postural Technique | To improve airway protection, prevent premature spillage. Moves base of tongue posteriorly, widens/flattens valleculae spaces, improves laryngeal vestibule closure, narrows oropharynx, reduces dist. b/w hyoid bone-larynx.
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| Chin Up/Head Extension- Postural Technique * Pt should have good airway protection, adequate pharyngeal fx, laryngeal closure* | Benefits pts w/ glossectomy, oral resection, reconstruction, significant lingual paralysis (oral transit dysfunction), poor labial seal, nasal regurgitation. Widens the oropharynx, helpful in moving bolus fr mouth into pharynx posteriorly bc of gravity
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| Head Rotation/Turn- to WEAK side.- Postural Technique | Closes off/reduces area of damaged side. Use for pts. w/ unilateral pharyngeal dysfunction, reduced PES opening. Reduces post-swallow residue/asp.
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| Head Tilt- to UNAFFECTED side.- Postural Technique | For pts. w unilateral oral damage/unilateral oral pharyngeal dysfunction. Eliminates involvement fr affected side, keeps food on functional side.
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| Side-Lying Technique- | Lie down on STRONGER side. Gravity pulls bolus/residue to unaffected side. Increases hypopharyngeal pressure on bolus. For pts. w/ unilateral pharyngeal dysfunction, PES dysfunction. Slows bolus, provides time to adjust/protect airway.
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| Postural adjustments not ideal for those: | that are noncompliant due to physical/cognitive limitations.
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| Upright posture helps reduce/prevent: | reflux that contributes to aspiration
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| Compensatory Strategies- when are they performed? | During the exam.
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