Fortbildungen 2019 > Dysphagia Some of the Old and Some of the New > Inhalt und Referentin (en)


Dysphagia: Some of the Old and Some of the New

In very few areas of clinical practice is the rate of change moving as rapidly as in dysphagia diagnosis and management. The next years promise to bring about enormous changes in how we understand swallowing neurophysiology and manage patients with neurogenic swallowing impairment. From greater precision in diagnostic specificity to far greater options in rehabilitative approaches, the skilled clinician will struggle to stay abreast and provide optimal care. It is an exciting time to work in this area. However, maintaining a solid foundation for this growth is critical.

Day 1 Going Deep: levels of assessment and understanding of swallowing pathophysiology

In our very early days of dysphagia practice, we focused heavily on identifying signs of dysphagia on clinical swallowing assessment. As instrumental assessments increased in availability, we shifted our focus to careful interpretation of swallowing biomechanics. But as our understanding of swallowing increases further, we now recognise that understanding biomechanics is insufficient for rehabilitation planning and we need to better develop our assessment of underlying physiology. We don’t need to know HOW things move or don’t move; we need to know WHY they do or don’t move.
The first day of this two-day professional development event will consist of an integrative workshop for combining clinical and biomechanical analysis into more specific diagnoses of swallowing pathophysiology.
The morning will provide an overview of clinical assessment practices with an emphasis on neurophysiology, followed by a brief review of biomechanics seen on videofluoroscopic swallowing study.
The afternoon will consist of a series of case study analyses that integrate knowledge from a clinical assessment into radiographic interpretation, leading to an improved understanding of pathophysiology.
Particular emphasis throughout the day will be paid to limitations in our current practices, which may heavily influence management decisions.
Be prepared for active learning and application of neurophysiologic models of clinical and instrumental assessment in this WORKshop with the use of small groups to analyse clinical problems.

Day 2: The changing face of rehabilitation of swallowing:

The final day of the professional development event will shift attention to a preview of the changing landscape of rehabilitative management. A significant conceptual shift is underway in approaches to rehabilitation of swallowing impairment. Emerging concepts related to the strength vs skill paradigm will be presented, followed by a discussion of potential rehabilitation approaches to accommodate this new thinking. sEMG biofeedback as a treatment adjunct will be introduced within the context of skill training paradigms. Potential options for skill training will be discussed with a demonstration of the skill training paradigm in the recently released Biofeedback for Strength and Skill Training software.


Maggie-Lee Huckabee Maggie-Lee Huckabee PhD
University of Canterbury Rose Centre for Stroke Recovery and Research Christchurch New Zealand

Prof Maggie-Lee Huckabee practiced as a clinical speech language pathologist for 15 years before the frustration of never knowing ‘the answers’ led her to an academic career. She is now Founder and Director of the University of Canterbury Rose Centre for Stroke Recovery and Research, and Professor in the Department of Communication Disorders 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 following neurological injury. In her 19 year academic career, Maggie-Lee has co-authored three books, one of which is going into its 3rd edition, 15 book chapters and has published 84 peer reviewed scientific papers. A recent research programme has resulted in a reduction in pneumonia rates from 27 to 10%, with a subsequent savings in health care costs for the regional health board of over $1.5 million in one year. For this research, she was awarded one of the top research medals from the University of Canterbury – The Innovation Medal and was a finalist in the New Zealand Women of the Year Award in the Science and Innovation category. Her research programme focuses primarily on development of neurorehabilitation approaches. She is well known as a clinical teacher and is an invited speaker by health systems worldwide to provide clinical training, particularly in rehabilitation practices.
Rose Centre - For Stroke Recovery & Research