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Rehab Strateg Pharyn

Rehabilitation Strategies for Pharyngeal Phase

Falsetto Pitch for decreased laryngeal elevation. produce /i/ continuously increasing pitch & hold
Shaker Head lift, for decreased laryngeal mvmt, pyriform residue. sustained= lie flat on back, raise and hold head for 1 min., rest 1 min., repeat 2x. repetitive= raise,lower head 30x. increases anterior mvmt of larynx. not for cardiac problems,hypertension
pull/push on chair for decreased laryngeal closure. while seated, hold breath & push/pull on chair
glottal attack for decreased laryngeal closure, produce clear voice5x, repeat "ah" w hard glottal attack
Masako (Tongue Hold) for decreased anterior pharyngeal wall mvmt, decreased posterior base of tongue mvmt. Pt holds tongue between teeth and swallows. supposed to strengthen pharyngeal wall by making it move forward to meet BOT. INDIRECT only, no food.
Supraglottic Swallow for decreased: airway protection, laryngeal elevation, hyoid mvmt, penetration/aspiration before the swallow. Take deep breath, hold, place food in oral cavity, swallow w held breath, cough, swallow again.
Super spraglottic swallow for decreased airway protection, penetration/aspiration before the swallow. Take deep breath, hold, place food in oral cavity, swallow w held breath, cough, swallow again. Use add'l force/musc tension. true&false vocal folds close. decreases UES opening.
Effortful swallow for oral/pharyngeal dysfunction, BOT dysfunction (reduced BOT retraction to the posterior pharyngeal wall), residue in valleculae. squeeze all the swallowing muscles hard when you swallow. this increases pressure in the post. mvmt of BOT & PPW
Showa breath hold+ hard swallow
Mendelsohn for decreased: range/duration hyolaryngeal elevation(resulting in vallecular residue), decreased range/duration cricopharyngeal opening, pharyngeal swallow coordination (decreased BOT/PPW mvmt) May be compensatory & rehabiliatitve.
Mendelsohn Compensatory functions Reduced postswallow residue/ aspiration
Mendelsohn Rehab functions Improved swallowing after use of technique w/o dependence on technique
Mendelsohn Steps 1. Let pt feel elevation of larynx when swallowing. 2. Swallow and when you feel your adam's apple lift, don't let it drop. 3. hold @ peak of our swallow when you feel your adam's apple lifted for several seconds before finishing the swallow.
Negative Consequences of Masako 1.reduced duration of airway closure. 2. increased post-swallow residue 3. increased delay in the initiation of the pharyngeal component of the swallow
Rationale of Mendelsohn 1. increased laryngeal mvmt stretches/opens the CP. 2. prolonging hylolaryngeal elevation keeps the CP open longer.
Shaker improves what and how Improve opening of the PES by increasing the strength of muscle groups that contribute to PES opening.
Created by: kaskas