Seminar-Content
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.
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.
Referentin
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.
