"At present, there remain more questions than answers regarding how to most effectively and efficiently approach dysphagia rehabilitation," Dr. Burkhead and her co-authors write. Historically, research has focused on compensatory maneuvers such as changing body position or modifying the amount or consistency of food and liquid. Compensation is important, but the problem still remains unless it is addressed through rehabilitation efforts, they say.

Although exercise principles used in physical rehabilitation and sports training have been gaining attention in dysphagia rehabilitation, Dr. Burkhead proposes more emphasis on these theories and more studies to learn to optimize these principles.

Dr. Burkhead asserts that many of the treatment techniques used in physical rehabilitation or athletic training are applicable and beneficial in dysphagia rehabilitation. "Physical therapists won't just tell a stroke patient to get up and walk; they first work on strengthening muscles of interest and discrete movements until patients can stand and take a few steps. They start with the components of a movement and then ultimately train the movement of interest, which in this case would be walking. The same thing goes for swallowing therapy. We can start with tongue movement or lip closure, but then we must be very conscious of moving toward task-specific exercise and working our patients at more challenging levels of intensity, which is something that our field is now starting to pay more attention to," says Dr. Burkhead.

There also is heightened interest in using tools such as neuromuscular electrical stimulation and biofeedback to boost the effects of exercise. She already routinely incorporates biofeedback. "It provides concrete information for the therapist as well as the patient and empowers them to take a more active r
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Contact: Toni Baker
tbaker@mcg.edu
706-721-4421
Medical College of Georgia
30-Apr-2007