Table 4.
Treatment recommendations for chosen impairment.
| List the treatments you would recommend to address the problem you chose to target first | Bolus modification |
Compensatory <--------------------> rehabilitative strategies |
Other |
|||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Bolus temperature modification (hotter/colder) | Bolus viscosity modification (increase) | Bolus volume modification (increase) | Bolus volume modification (decrease) | Bolus viscosity modification (decrease) | Head tilt | Chin tuck (head flexion) | Head rotation (head turn) | Supraglottic swallow | Super-supraglottic swallow | Mendelsohn maneuver | Tongue hold (Masako) | Effortful swallow | Shaker exercise | Thermal tactile stimulation | Oral swabs | Alternative nutrition (NDT/NGT/PEG/V nutrition) | NPO | I would refer to other specialty for treatment | None | Other | ||
| Patient 1 (easy) | ||||||||||||||||||||||
| Initiation of pharyngeal swallow/swallow onset time | 58% | 52% | 27% | 23% | 15% | 4% | 1% | 29% | 2% | 6% | 9% | 10% | 18% | 40% | 11% | 58% | 10% | 7% | 2% | 5% | 1% | 25% |
| Tongue control during posterior propulsion | 8% | 38% | 25% | 19% | 31% | 13% | 0% | 44% | 0% | 25% | 19% | 38% | 56% | 63% | 31% | 19% | 6% | 13% | 6% | 0% | 0% | 31% |
| Premature spillage | 7% | 27% | 27% | 7% | 0% | 0% | 0% | 73% | 0% | 13% | 0% | 20% | 40% | 40% | 13% | 33% | 7% | 0% | 0% | 27% | 0% | 20% |
| Poor sensation | 5% | 91% | 45% | 36% | 0% | 0% | 0% | 9% | 0% | 27% | 0% | 0% | 18% | 45% | 0% | 91% | 18% | 0% | 0% | 9% | 0% | 0% |
| Patient 2 (moderate) | ||||||||||||||||||||||
| Laryngeal vestibule closure (delayed closure/reaction time) | 23% | 5% | 10% | 8% | 13% | 3% | 0% | 40% | 5% | 45% | 55% | 35% | 18% | 30% | 23% | 13% | 3% | 3% | 3% | 10% | 3% | 13% |
| Tongue control during posterior propulsion | 8% | 29% | 14% | 0% | 64% | 21% | 0% | 43% | 0% | 36% | 14% | 21% | 29% | 21% | 21% | 14% | 0% | 7% | 7% | 7% | 0% | 14% |
| Premature spillage | 7% | 8% | 15% | 8% | 15% | 8% | 0% | 54% | 0% | 15% | 23% | 15% | 31% | 23% | 8% | 31% | 8% | 8% | 8% | 0% | 15% | 23% |
| Initiation of pharyngeal swallow/swallow onset time | 7% | 23% | 8% | 0% | 38% | 8% | 0% | 54% | 0% | 31% | 46% | 8% | 0% | 23% | 15% | 38% | 15% | 0% | 15% | 23% | 0% | 0% |
| Hyoid anterior movement | 7% | 0% | 25% | 8% | 33% | 8% | 0% | 25% | 17% | 25% | 25% | 58% | 50% | 58% | 75% | 0% | 0% | 17% | 0% | 8% | 0% | 0% |
| Penetration | 6% | 20% | 20% | 10% | 20% | 10% | 10% | 70% | 10% | 50% | 10% | 30% | 30% | 50% | 50% | 30% | 0% | 0% | 0% | 0% | 0% | 10% |
| Epiglottic inversion | 6% | 9% | 18% | 0% | 9% | 0% | 0% | 45% | 9% | 18% | 55% | 45% | 18% | 36% | 55% | 9% | 0% | 18% | 18% | 0% | 0% | 18% |
| Laryngeal vestibule closure (amount) | 6% | 0% | 9% | 0% | 36% | 0% | 9% | 55% | 18% | 36% | 27% | 36% | 18% | 36% | 45% | 9% | 9% | 27% | 36% | 9% | 0% | 9% |
| Hyoid superior movement | 6% | 10% | 10% | 10% | 30% | 0% | 0% | 50% | 0% | 30% | 40% | 90% | 10% | 30% | 70% | 10% | 0% | 10% | 10% | 10% | 0% | 0% |
| Aspiration | 5% | 11% | 33% | 0% | 44% | 0% | 0% | 67% | 0% | 67% | 44% | 67% | 67% | 56% | 67% | 0% | 0% | 22% | 11% | 0% | 0% | 11% |
| Patient 3 (complex) | ||||||||||||||||||||||
| Aspiration | 17% | 11% | 70% | 4% | 30% | 4% | 4% | 48% | 0% | 41% | 41% | 41% | 37% | 44% | 44% | 30% | 4% | 41% | 15% | 7% | 0% | 7% |
| Size/amount of UES opening | 12% | 5% | 20% | 15% | 30% | 0% | 0% | 30% | 15% | 10% | 20% | 50% | 10% | 45% | 65% | 5% | 0% | 20% | 20% | 35% | 0% | 10% |
| Laryngeal vestibule closure (amount) | 12% | 0% | 68% | 0% | 32% | 0% | 0% | 47% | 26% | 47% | 74% | 74% | 32% | 53% | 63% | 11% | 0% | 47% | 21% | 5% | 0% | 5% |
| Premature spillage | 11% | 11% | 61% | 11% | 28% | 0% | 0% | 56% | 6% | 17% | 17% | 17% | 22% | 39% | 33% | 33% | 6% | 22% | 22% | 0% | 0% | 6% |
| Tongue control during posterior propulsion | 9% | 13% | 60% | 7% | 40% | 7% | 0% | 67% | 7% | 33% | 33% | 40% | 40% | 47% | 33% | 27% | 0% | 27% | 13% | 0% | 0% | 20% |
| Laryngeal vestibule closure (delayed closure/reaction time) | 7% | 9% | 36% | 0% | 27% | 0% | 9% | 45% | 0% | 27% | 45% | 55% | 9% | 36% | 27% | 9% | 9% | 18% | 18% | 9% | 0% | 0% |
| Initiation of pharyngeal swallow/swallow onset time | 7% | 36% | 64% | 9% | 82% | 0% | 0% | 64% | 0% | 45% | 27% | 55% | 36% | 55% | 36% | 27% | 0% | 36% | 45% | 27% | 0% | 0% |
| Hyoid superior movement | 7% | 0% | 18% | 0% | 0% | 0% | 0% | 27% | 18% | 27% | 27% | 64% | 27% | 36% | 73% | 9% | 0% | 55% | 64% | 9% | 0% | 18% |
| Hyoid anterior movement | 6% | 0% | 22% | 0% | 22% | 0% | 0% | 22% | 22% | 22% | 22% | 67% | 22% | 33% | 100% | 22% | 0% | 0% | 0% | 22% | 0% | 22% |
Note. UES = upper esophageal sphincter; NDT = nasoduodenal tube; NGT = nasogastric tube; PEG = percutaneous endoscopic gastrostomy tube; IV = intravenous; NPO = nothing by mouth.