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[Dysphagia] Thermal/tactile stim
Before describing approaches and results, it would be
informative, indeed, essential, to know what TYPE of
patient one is describing. Those with CVA are all
different from one another, and those with progressive
diseases also individual as well as different from
those woth cortical, brain stem, cerebellar strokes,
motor neuron diseases, hyperthyroidism etc. etc. It is
not possible to discuss any approach, especially one
(sorry, now two approaches) that are, physiologically
impossible without identifying those features that one
infers might make a difference of some kind, patient
to patient. Generalizations are not possible in this
field.
--- Janet <justjanetlynn@email.msn.com> wrote:
> I do not have any references as it has been years
> since I read the research
> on this topic (which I did so critically at one time
> in my career). My
> recollection is that the research showed that there
> is a positive effect but
> that it is only temporary. Thus, I reserve TTS as
> one of my last resort
> techniques. For example, when a pt is NPO and I want
> to treat the dysphagia
> without any p.o. involved. If the pt can not trigger
> saliva swallows at all
> to complete pharyngeal exercises, I will sometimes
> try TTS as a means of
> triggering a swallow for them to use to complete an
> exercise. I do not use
> TTS with the expectation that, by itself, it will
> improve the physiology.
> However, over more recent years I have used DPNS for
> this purpose rather
> than TTS. CLINICALLY and INFORMALLY (holding my
> breath waiting for all kinds
> of responses that I can already predict) I do seem
> to get better results in
> this manner c DPNS rather than TTS. Again, this is
> reserved for pts who
> can't seem to benefit from tx otherwise. And I know,
> the data is not there -
> if it was I would alter my approach based on that.
> Unfortunately we don't
> have the data either way.
>
> Happy Thanksgiving everyone. I am sitting here ready
> to explode :)
> Janet
>
> _______________________________________________
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> Dysphagia@b9.com
> http://www.b9.com/mailman/listinfo/dysphagia
=====
www.dricampbell-taylor.com
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