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Dysphagia Following Stroke


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Table of Contents

Foreword Preface Acknowledgements Abbreviations Chapter 1 Introduction to Dysphagia and Stroke Overview of Stroke Dysphagia in Stroke Chapter 2 The Neural Control of Swallowing: From Central to Peripheral Methods for Understanding Neural Control Higher Nervous System Control Central Pattern Generator/Brainstem Mechanisms Peripheral Neuromuscular Mechanisms Chapter 3 Normal Swallowing Anatomy and Physiology Defining Normal and Abnormal Swallowing Phases of Swallowing Chapter 4 Screening of Swallowing Defining Screening Considerations When Implementing Swallowing Screening Available Swallowing Screening Tools Chapter 5 The Clinical Swallowing Examination: History and Patient Interview Patient History Patient and Family Interview Chapter 6 The Clinical Swallowing Examination: Cognition and Communication Assessments The Cognitive Assessment The Communication Assessment Chapter 7 The Clinical Swallowing Examination: The Evaluation of the Oral Mechanism Structural Integrity The Cranial Nerve Examination: Inferring Physiology Case Example Chapter 8 The Clinical Examination of Swallowing: Assessment of Oral Intake Chapter 9 The Clinical Swallowing Examination: Predicting Dysphagia and Aspiration The Water Swallow Test The CSE with a Focus on Clinical Features Predicting Dysphagia and Aspiration The Mann Assessment of Swallowing Ability Chapter 10 Adjuncts to the Clinical Swallowing Examination Pulse Oximetry Cervical Auscultation Cough Reflex Testing Chapter 11 The Instrumental Examination: The Videofluoroscopic Swallow Study The Need for Diagnostic Specificity The Videofluoroscopic Swallowing Study Chapter 12 The Instrumental Examination: Evaluation of Swallowing Respiratory Coordination - An Auxiliary to the Videofluoroscopic Swallow Study Chapter 13 The Instrumental Examination: Videoendoscopic Evaluation of Swallowing Chapter 14 The Instrumental Examination: Manometric Evaluation of Swallowing What Can Manometry Offer to Clinical Practice? Case Examples Chapter 15 Professional Responsibilities in Dysphagia Diagnosis in Stroke Case Example Chapter 16 Diagnosis of Dysphagia in Stroke Oral Phase Pharyngeal Phase Oral and Pharyngeal Dysmotility in Stroke Chapter 17 Diet Considerations: To Feed or Not to Feed An Overview of Options for Feeding the Dysphagic Patient Non-Oral, Enteral Feeding Options Decision Making for Non-Oral Nutrition Free Water Chapter 18 Compensatory Management Postural Changes Sensory Enhancement Volitional Control of Oral Transfer Breath-Holding Techniques Bolus Modification Chapter 19 Rehabilitation of Oropharyngeal Dysphagia Oral Motor Exercises Effortful Swallow Mendelsohn Maneuver Masako Maneuver (Tongue-Hold Maneuver) Head-Lift Exercise Expiratory Muscle Strength Training Neuromuscular Strength Training Chapter 20 Maximizing Rehabilitation Effectiveness Biofeedback Modalities in Dysphagia Rehabilitation Dose Paradigms for Rehabilitation: Applying Models of Motor Learning nd Strength Training to Swallowing Rehabilitation Chapter 21 Emerging Modalities in Dysphagia Management Chapter 22 Medical and Surgical Management Medical Management Surgical Intervention Chapter 23 Lagniappe Management Effectiveness with Stroke Patients Reassessment Last Thoughts

About the Author

Stephanie Daniels, PhD Research Speech Pathologist Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas Assistant Professor, Department of Physical Medicine and Rehabilitation, Baylor College of Medicine Stephanie K. Daniels, Ph.D. is a research speech pathologist at the Michael E. DeBakey Veterans Affairs Medical Center in Houston, Texas and is Assistant Professor in the Department of Physical Medicine and Rehabilitation at the Baylor College of Medicine. Prior to obtaining her doctorate, she was a practicing clinician for twelve years. Her research and clinical work has focused on neurogenic dysphagia. Maggie-Lee Huckabee, PhD Senior Lecturer Department of Communication Disorders, University of Canterbury Senior Researcher Van der Veer Institute for Parkinson's and Brain Research in Christchurch, New Zealand Maggie-Lee Huckabee, Ph.D., practiced as a clinician for thirteen years before the frustration of never knowing "the answers" led her to an academic career. She is now senior lecturer in the Department of Communication Disorders, University of Canterbury and senior researcher at the Van der Veer Institute for Parkinson's and Brain Research in Christchurch, New Zealand. She still hasn't found "the answers" but is trying, with research interests focusing on the complexities of behaviorally-driven neural adaptation and biomechanical change leading to swallowing recovery. Dr. Huckabee has a great time supervising terrific, emerging researchers, overseeing a busy laboratory and enjoying the beauty of New Zealand.


Jess Karol, Advanced SLT for We Do Therapy, Royal College of Speech & Language Therapists, (2014): "The authors describe this book as 'practical and easy-to-use'. This is an accurate synopsis. It is a complete resource for clinicians working within stroke settings. Students and newly-qualified therapists may also find it an excellent guide. It provides practical advice from assessment and diagnosis to management, intervention and remediation strategies. Although the focus is on the assessment and management of dysphagia, importance is also placed on cognition and communication assessments - areas that may have a significant impact upon the assessment and management of swallowing disorders. ------------------------------------------------------------------ Sequentially and logically written, the book details how to assess and manage various types of dysphagia following stroke. It outlines models for screening, clinical and instrumental assessment techniques, interpreting assessment findings and making a diagnosis, to teaching remediation strategies for rehabilitation. Tables make information clear and accessible, and clinical examples and case studies facilitate implementation in clinical settings. Research is also presented in a practical way so it can be applied to everyday practice." ================================================================== Grace McCann, Deputy Editor, Royal College of Speech and Language Therapists, Bulletin, (2009): "Written by two very experienced practicing SLTs, each with a very solid research background, the book provides the reader with a thorough description of the current evidence base for the assessment and management of dysphagia. Among the 22 chapters, clear tables of evidence are provided, for example on the epidemiology of dysphagia in stroke, clinical features of aspiration, and rehabilitation strategies. [Refers to first edition.]" ================================================================= Julia Edgar, PhD (Washington University School of Medicine), Doody's Review Service, (2009): "This book provides a unique level of detail on dysphagia in the stroke population, thus making it a valuable contribution to the literature. The authors are clearly in tune with commonly occurring clinical practices as they provide substantial rationale to support the need for adequate objective testing as a prelude to appropriate intervention. [Refers to first edition.]" ================================================================== Stacey A. Skoretz, MSc, CCC-SLP, PhD Candidate, Canadian Journal of Speech-Language Pathology and Audiology, (2009): "With its clinically relevant content and well-written text, this book provides information both for the junior and senior dysphagia clinician. The authors provide balanced and objective information which is well-grounded in research. The book's up-to-date discussion of challenging issues provide the readers with insights and methods by which to approach their roles and responsibilities. [Refers to first edition.]"

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