Overview

This practical and easy-to-use handbook provides up-to-date coverage of the evaluation and treatment of swallowing disorders in the stroke population. The gap between academics and clinical practice is narrowed with the latest research packaged for clinical application. Particular focus is on the clinical and instrumental evaluation of swallowing, measurements of dysphagia, principles of care for patients with dysphagia following stroke, rehabilitation and risk management. Clinical examples are incorporated throughout the text to facilitate clinical integration and relevance.

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Reviews

• Stacey A. Skoretz, MSc, CCC-SLP, PhD Candidate, Canadian Journal of Speech-Language Pathology and Audiology, (2009):
  "With its clinically relevant content and well-written text, this book provides information both for the junior and senior dysphagia clinician. The authors provide balanced and objective information which is well-grounded in research. The book's up-to-date discussion of challenging issues provide the readers with insights and methods by which to approach their roles and responsibilities."

• Grace McCann, Deputy Editor, Royal College of Speech and Language Therapists, Bulletin, (2009):
  "Written by two very experienced practicing SLTs, each with a very solid research background, the book provides the reader with a thorough description of the current evidence base for the assessment and management of dysphagia. Among the 22 chapters, clear tables of evidence are provided, for example on the epidemiology of dysphagia in stroke, clinical features of aspiration, and rehabilitation strategies."

• Julia Edgar, PhD (Washington University School of Medicine), Doody's Review Service, (2009):
  "This book provides a unique level of detail on dysphagia in the stroke population, thus making it a valuable contribution to the literature. The authors are clearly in tune with commonly occurring clinical practices as they provide substantial rationale to support the need for adequate objective testing as a prelude to appropriate intervention."

Audience

Primary Subject: Speech and Language Pathology / Swallowing
Audience Level: Professional/Textbook - 90 Days

• Foreword by Jay Rosenbek, PhD
• Chapter 1: Introduction to Dysphagia and Stroke
  • Overview of Stroke
  • Dysphagia in Stroke
  • Multidisciplinary Management of Dysphagia in Stroke
• Chapter 2: The Neural Control of Swallowing: From Central to Peripheral
  • Methods for Understanding Neural Control
  • Higher Nervous System Control
  • Central Pattern Generator/Brainstem Mechanisms
  • Peripheral Neuromuscular Mechanisms
• Chapter 3: Normal Swallowing Anatomy and Physiology
  • Defining Normal and Abnormal Swallowing
  • Phases of Swallowing
• Chapter 4: The Clinical Swallowing Examination: History and Patient Interview
  • Patient History
  • Patient and Family Interview
• Chapter 5: The Clinical Swallowing Examination: Cognition and Communication Assessments
  • The Cognitive Assessment
  • The Communication Assessment
• Chapter 6: The Clinical Swallowing Examination: The Evaluation of the Oral Mechanism
  • Structural Integrity
  • The Cranial Nerve Examination: Inferring Physiology
  • Case Example
• Chapter 7: The Clinical Examination of Swallowing: Assessment of Oral Intake
  • Executing the Assessment of Oral Intake
  • Interpreting the Assessment of Oral Intake
• Chapter 8: The Clinical Swallowing Examination: Predicting Dysphagia and Aspiration
  • The Water Swallow Test
  • The CSE with a Focus on Clinical Features Predicting Dysphagia and Aspiration
  • The Mann Assessment of Swallowing Ability
• Chapter 9: Adjuncts to the Clinical Swallowing Examination
  • Pulse Oximetry
  • Cervical Auscultation
  • Cough Reflex Testing
• Chapter 10: The Instrumental Examination: The Videofluoroscopic Swallow Study
  • The Need for Diagnostic Specificity
• Chapter 11: The Instrumental Swallowing Examination: Evaluation of Swallowing Respiratory Coordination—An Auxiliary to the Videofluoroscopic Swallow Study
  • Executing the Evaluaton of Swallowing Repiratory Coordination
  • Interpreting the Evaluaton of Swallowing Repiratory Coordination
• Chapter 12: The Instrumental Swallowing Examination: Videoendoscopic Evaluation of Swallowing
  • Executing the Videoendoscopic Evaluation of Swallowing
  • Interpreting the Videoendoscopic Evaluation of Swallowing
• Chapter 13: The Instrumental Swallowing Examination: Manometric Evaluation of Swallowing
  • Executing the Manometric Evluation
  • Interpreting the Manometric Evaluatin
  • Variables Influencing Pharyngeal Pressure Measurement
  • What Can Manometry Offer to Clinical Practice?
  • Case Examples
• Chapter 14: Professional Responsibilities:Dysphagia Diagnosis in Stroke
  • Case Example
• Chapter 15: Diagnosis of Dysphagia in Stroke
  • Oral Phase
  • Pharyngeal Phase
  • Oral and Pharyngeal Dysmotility in Stroke
• Chapter 16: Diet Considerations: To Feed or Not to Feed **An Overview of Options for Feeding the Dysphagic Patient **Non-Oral, Enteral Feeding Options
  • Decision Making for Non-Oral Nutrition
  • Free Water
• Chapter 17: Compensatory Management
  • Postural Changes
  • Sensory Enhancement
  • Volitional Control of Oral Transfer
  • Breath-Holding Techniques
  • Bolus Modification
• Chapter 18: Rehabilitation of Oropharyngeal Dysphagia
  • Oral Motor Exercises
  • Effortful Swallow
  • Mendelsohn Maneuver
  • Masako Maneuver (Tongue-Hold Maneuver)
  • Head-Lift Exercise
• Chapter 19: Maximizing Rehabilitation Effectiveness
  • Biofeedback Modalities in Dysphagia Rehabilitation
  • Dose
• Chapter 20: Emerging Modalities in Dysphagia Management
  • Expiratory Muscle Strength Training
  • Neuromuscular Electrical Stimulation
  • The Need for Intelligent Enthusiasm
• Chapter 21: Medical and Surgical Management
  • Medical Management
  • Surgical Intervention
• Chapter 22: Lagniappe
  • Management Effectiveness with Stroke Patients
  • Reassessment
  • Last Thoughts
• References
• Index

About The Authors

Stephanie Daniels, Ph.D.

Research Speech Pathologist
Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas
Assistant Professor,
Department of Physical Medicine and Rehabilitation, Baylor College of Medicine

Stephanie K. Daniels, Ph.D. is a research speech pathologist at the Michael E. DeBakey Veterans Affairs Medical Center in Houston, Texas and is Assistant Professor in the Department of Physical Medicine and Rehabilitation at the Baylor College of Medicine. Prior to obtaining her doctorate, she was a practicing clinician for twelve years. Her research and clinical work has focused on neurogenic dysphagia.

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Maggie-Lee Huckabee, Ph.D.

Senior Lecturer
Department of Communication Disorders, University of Canterbury
Senior Researcher
Van der Veer Institute for Parkinson's and Brain Research in Christchurch, New Zealand

Maggie-Lee Huckabee, Ph.D., practiced as a clinician for thirteen years before the frustration of never knowing “the answers” led her to an academic career. She is now senior lecturer in the Department of Communication Disorders, University of Canterbury and senior researcher at the Van der Veer Institute for Parkinson's and Brain Research 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. Dr. Huckabee has a great time supervising terrific, emerging researchers, overseeing a busy laboratory and enjoying the beauty of New Zealand.

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