Oral Phase Compensatory Strategies
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| 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 |
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Created by:
kaskas
on 2012-04-23