The Principles of Neurological Speech Therapy in Dysphagia
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The word dysphagia has its origins in the Greek language. In Greek, the prefix dys- implies difficulty, and –phagia applies to eating, swallowing. Impairment in swallowing can affect both adults and children. The therapy of this disorder is conducted by neuro speech therapists, mainly. The therapist chooses particular treatment methods for particular patients according to the causes and symptoms that are observed in the patient. Therapists can choose from two types of exercises: therapeutic and compensatory ones. The aim of therapeutic exercises is to improve the effectiveness of swallowing by modifying the mechanism of swallowing. Neuro speech therapist can teach special manoeuvres to the patient or perform the exercises that stimulate the swallowing reflex with the patient. Direct exercises comprise two categories: indirect and direct exercises. Indirect exercises are also known as the exercises that strengthen the muscles that take part in the act of swallowing. Neither food, nor drinks are used when performing this kind of exercises. Direct exercises, i.e. exercises in which food and drinks are used, affect the strength of the muscles of the oral cavity and the pharynx. The main aim of this method is to improve the act of swallowing. Compensatory exercises form the second type of exercises. They are aimed to teach the patient to compensate for the deficits that accompany dysphagia. They do not lead to a change in the act of swallowing. Neuro speech therapist gives some hints to the patients and also teaches them some special manoeuvres that utilise, i.e. a change in the position of the head while swallowing. The principle of this method is to reduce the risk of aspiration. The therapy of children with swallowing disorders is a great challenge for neuro speech therapists. The therapist trains the basic movements of the tongue and the position of the organs within the oral cavity that take part in swallowing. Afterwards, he teaches the patient how to make use of these skills while swallowing saliva, eating or drinking. The effectiveness of dysphagia therapy relies on good cooperation between the therapist and the patient, as well as the patient’s autonomy and the amount of exercise performed by the patient between therapy sessions.
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