Dysphagia Training

FREE Laryngology Webinar: Swallowing Update

I am honoured to be invited to speak at this upcoming Laryngology Webinar alongside with the Legendary Dysphagia Guru, Professor Susan Langmore and all other renowned dysphagia experts.

The topic that I will be covering: “Clinical Application of sEMG in Dysphagia & Understanding Chin Tuck Against Resistance / CTAR”.

Other exciting topics include:

– Fiberoptic Endoscopic Evaluation of Swallowing (FEES) & Videofluoroscopy (VFS) interpretation

– Transnasal Oesophagoscopy

– High Resolution Manometry

– Endoscopic Management of GERD

– Surgical Management of Dysphagia

– Therapeutic Considerations in Dysphagia Following Stroke

Date of Webinar: 8 November 2020

Time: 8.30am to 1.30pm (Indian Standard Time) / 11.00am to 4.00pm (Singapore / Malaysia Time)

Please download the following PDF flyer for more details of this webinar:

You may click on the following link to register for this FREE Webinar.

https://webinaronline.in/pentax004/

Dysphagia Therapy, Uncategorized

(Korean) Dysphagia Swallowing Therapy – Chin Tuck Against Resistance with Rubber Ball. 삼킴 장애 요법 – 고무공 사용하는 저항성 턱 당기기 (한국어)

GDM would like to thank Ms Sandy Lim (SLP from USA) for her help in translation and presentation of the Korean Version of the CTAR video.

This Korean translated CTAR video and blog post are initiative of the Global Dysphagia Movement (GDM).

The Chin Tuck Againt Resistance (CTAR) exercise works on strengthening the suprahyoid muscles, necessary for opening your upper food pipe sphincter (or known as the upper esophageal sphincter) to allow food to enter the stomach.

저항성 턱 당기기 운동은 목뿔의근을 강화시켜 상부 식도 괄약근을 열어 음식이 위장에 들어갈수있게 해줍니다.

Since CTAR was introduced in 2013, Mr Yoon (The CTAR inventor) has been receiving enquiries from clinicians from around the world. We hope that this video will provide the details to facilitate the carrying out of the exercise. We plan to translate this and all our upcoming videos into different languages.

2013년 저항성 턱 당기기 운동이 소개 된 이후 운동 발명가 윤선생님께서는 전 세계에서 문의를 받고 있습니다. 이 동영상이 연습수행을 용이하게 하는데에 도움이 되길를 바랍니다. 이 동영상과 앞으로 나올 모든영상들은 여러 언어로 번역될  예정입니다.

The following is the CTAR exercise instructions. You may download a PDF copy of this instructions at the bottom of this page.

다음은 저항성 턱 당기기 운동 지침입니다. 이 페이지 하단에서 이 지침의 PDF사본을 다운로드 할 수 있습니다.

For clinicians, you may download the above QR code and print it on your exercise handouts to facilitate clients’ search for the above YouTube Video.

치료사일 경우, 위 QR 코드를 다운로드 받은 후 유인물에 인쇄하면  환자가 위의 YouTube 동영상을 쉽게 검색 할수있습니다.

저항성 턱 당기기 고무공 사용법

목적: 삼키는데 사용되는 목뿔위근육을 강화시키기 위함. 상부 식도 괄약근을 열어 음식이 위장에 들어갈수 있도록 하려면 목뿔위근이 중요하다.

준비물: 1. 고무공  2. 공기 펌프, 공 펌프 니들 밸브 (추가 필요물) – 공의 직경과 압력을 높이기 위해

설명:

1부: 지속적인 저항성 턱 당기기 (등척성)

  1. 바로 앉거나 서서 어깨를 뒤로 폅니다. 이 자세를 유지 하십시오.
  2. 손으로 공을턱 아래에 고정시키고 이 자세를 유지하십시오.
  3. 턱을 세게 당겨주세요; _____초 동안 유지하십시오.
  4. 언어 치료사가 권장하는대로 ____세트를 반복하십시오.
  5. 세트 사이 일분동안 휴식을 취하십시오.

2부: 반복적인 저항성 턱 당기기 (등장성)

  1. 바로 앉거나 서서 어깨를 뒤로 폅니다. 이 자세를 유지 하십시오.
  2. 손으로 공을턱 아래에 고정시키고 이 자세를 유지하십시오.
  3. 턱을 세게 당긴다음 턱을 드세요.
  4. 언어 치료사가 권장한 대로 위의 단계를 ____회 ____세트를 반복하십시오.
  5. 세트 사이 일분동안 휴식을 취하십시오.

YouTube 동영상을 보시려면

-다음 링크를 https://youtu.be/CExiSYvpcSo 클릭하면 YouTube 동영상으로 바로 연결됩니다.

To download a PDF copy of the CTAR exercise instructions, please click on:

저항성 턱 당기기 운동 지침의 PDF 사본을 다운로드 하시려면 ?? 눌러주십시오.

CTAR with Rubber Ball Exercise videos are available in the following languages:

* Click to view CTAR videos in the following languages.

** Chin Tuck Against Resistance or CTAR is suitable for:

  • dysphagia or swallowing difficulties following strokes,
  • dysphagia following head and neck cancer,
  • dysphagia following Parkinson’s disease,
  • dysphagia due to late effect of radiotherapy i.e. Nasopharyngeal cancer
  • etc.

Dysphagia Therapy

(Taiwanese Minnan) Dysphagia Swallowing Exercise – Chin Tuck Against Resistance with Ball 臺灣閩南語(臺語) 吞嚥障礙復健運動-下巴阻抗運動 CTAR 創始者示範運用橡皮球做練習

GDM would like to express our heartfelt thanks to the Taiwanese SLP team for their help in translation and presentation of the Taiwanese Minnan Version of the CTAR video.

This Taiwanese Minnan translated CTAR video and blog post are initiative of the Global Dysphagia Movement (GDM).

縮下巴阻抗運動能訓練你的上舌骨肌群,以打開進食通道(上食道括約肌),讓食物順利的進入胃。

The Chin Tuck Againt Resistance (CTAR) exercise works on strengthening the suprahyoid muscles, necessary for opening your upper food pipe sphincter (or known as the upper esophageal sphincter) to allow food to enter the stomach. 

這個運動從袁伟琳先生於2013年創始後,就在國際間廣為使用,我們希望這支影片可以提供更多執行運動的細節。我們計畫將這隻影片以及未來更多的影片翻成不同語言,提供世界各地使用。

Since CTAR was introduced in 2013, Mr Yoon (The CTAR inventor) has been receiving enquiries from clinicians from around the world. We hope that this video will provide the details to facilitate the carrying out of the exercise. 

如果你喜歡這個影片,請不吝按讚,同時記得分享及訂閱我們的頻道,以收看更多關於CTAR和吞嚥的影片。 想知道更多吞嚥困難處置的有用資訊和方法,請追蹤我們的部落格https://dysphagia.sg/news-and-updates/

Please LIKE , SHARE and SUBSCRIBE to our channel for more upcoming CTAR series and swallowing exercises tips in different languages. Follow us at our blog at https://dysphagia.sg/news-and-updates/ for more useful informations and tips on dysphagia management.

下載CTAR運動指導的PDF,請點擊下方的連結: (To download a PDF copy of the CTAR exercise instructions):

CTAR with Rubber Ball Exercise videos are available in the following languages:

* Click to view CTAR videos in the following languages.

Chin Tuck Against Resistance / CTAR is suitable for individuals with:

  • dysphagia or swallowing difficulties following strokes,
  • dysphagia following head and neck cancer,
  • dysphagia following Parkinson’s disease,
  • dysphagia due to late effect of radiotherapy i.e. Nasopharyngeal cancer
  • etc.

Dysphagia Therapy

(Japanese) Dysphagia Swallowing Exercise – Chin Tuck Against Resistance with Rubber Ball ゴムボールを使用した顎引き抵抗運動(CTAR) 

YouTube Video on Japanese CTAR with Rubber Ball
GDM would like to express our heartfelt thanks to Dr Kotomi Sakai for her help in translation and presentation of the Japanese Version of the CTAR video.

This Japanese translated CTAR video and blog post are initiative of the Global Dysphagia Movement (GDM).

The following is the CTAR exercise instructions. You may download a PDF copy of this instructions at the bottom of this page.

下記にCTARの運動方法が記載してあります。このページの下でそのPDFがダウンロードできます。

Chin Tuck Against Resistance (CTAR) with a Rubber Ball

Purpose: To strengthen the suprahyoid muscles used in swallowing. The suprahyoid muscles are important to open your upper food pipe sphincter (upper esophageal sphincter) to allow food to enter your stomach.

Translation:

目的:嚥下に使用する舌骨上筋群の筋力を強化するため。舌骨上筋群は食物が胃にはいるように導く道の上部(上部食道入口部)が開くために重要な働きをします。

Equipment: a)Rubber ball, b)Air pump and ball pump needle valve (optional) – to increase diameter and pressure of the ball

Translation:

道具:1)ゴムボール、2)エアポンプとボール用空気注入針(オプション:ボールの大きさや圧を増加させるため)

Instructions:

Part 1: Sustained CTAR (Isometric)

Part 1:持続CTAR(等尺性)

  1. Sit / stand upright and pull your shoulders back. Maintain this posture during the exercise.

まっすぐに座るか立って、肩を軽く後ろに引きます。この姿勢を運動中は維持するようにします。

  • Hold the ball under your chin with your hand and keep it in position during the exercise.

ボールを手で持って顎の下ではさんで、この姿勢を運動中は維持します。

  • Sustain chin tuck against the ball for as hard as possible; for the duration of _______ sec.

ボールに向かって可能な限り強く顎を引き続けます。持続時間は_______秒です。

  • Repeat _______ sets as recommended by your speech therapist / pathologist.

嚥下リハビリテーションの担当者の指示に基づいて_______セットを繰り返しましょう。

  • Rest for 1 minute in between each set of the exercise.

各セットの間は1分間の休憩をとりましょう。

Part 2: Repetitive CTAR (Isokinetic)

Part 2: 反復CTAR(等張性)

  1. Sit / stand upright and pull your shoulders back. Maintain this posture during the exercise.

まっすぐに座るか立って、肩を軽く後ろに引きます。この姿勢を運動中は維持するようにします。

  • Hold the ball under your chin with your hand and keep it in position during the exercise.

ボールを手で持って顎の下ではさんで、この姿勢を運動中は維持します。

  • Tuck your chin in, as hard as possible against the ball; then lift your chin.

ボールに向かって可能な限り強く顎を引いて、そして力を抜きます。

  • Repeat the above steps for ________ times and ________ sets as recommended by your speech therapist / pathologist.

上記のステップを担当治療者の指示に基づいて________回、________セット繰り返します。

  • Rest for 1 minute in between each set of the exercise.

各セットの間は1分間の休憩をとるようにします。

To view the YouTube video, you may

scan on the following QR code with your mobile device camera access YouTube via https://youtu.be/E0qUYlihHNM

Translation:

YouTubeビデオをみるためには

- QRコードをスキャンして

- YouTubeサイトhttps://youtu.be/E0qUYlihHNM にアクセスをして下さい

CTAR with Rubber Ball Exercise videos are available in the following languages:

* Click to view CTAR videos in the following languages.

Chin Tuck Against Resistance or CTAR is suitable for:

  • dysphagia or swallowing difficulties following strokes,
  • dysphagia following head and neck cancer,
  • dysphagia following Parkinson’s disease,
  • dysphagia due to late effect of radiotherapy i.e. Nasopharyngeal cancer
  • etc.
Dysphagia Therapy

(Bengali) Dysphagia Swallowing Exercise – Chin Tuck Against Resistance with Rubber Ball খাবার গলধকরনজনিত সমস্যার থেরাপি- রাবার বলের মাধ্যমে সি টি এ আর থেরাপি

GDM would like to thank Mr Abul for his help in translation and presentation of the Bengali Version of the CTAR video.

This Korean translated CTAR video and blog post are initiative of the Global Dysphagia Movement (GDM).

উল্লেখিত সি টি এ আর ব্যায়ামের নির্দেশাবলী আপনি ডাউনলোড করতে হলে পৃষ্ঠার নিচে চলে যেতে হবে । থেরাপিস্টরা কিউ আর কোড ডাউনলোড করতে পারেন এবং প্রিন্ট করে নিতে পারেন যদি আপনার রুগীকে এই ইউটিঊব ভিডিওটি দেখাতে চান ।

রাবার বলের মাধ্যমে সি টি এ আর থেরাপি

উদ্দেশ্যঃ

সুপ্রাহাইওয়েড মাংসপেশির শক্তিবৃদ্ধির জন্য এবং সুপ্রাহাইওয়েড মাংসপেশির শক্তিবৃদ্ধির মাধ্যমে খাদ্যনালির উপরিভাগের মধ্যদিয়ে খাবার পাকস্থলীর মধ্যে যেতে সাহায্য করে

যন্ত্রপাতিঃ 

সি টি আর এর জন্য জিনিসপত্রঃ  

রাবারের বল , বল পাম্প দেওয়ার ভাল্ব (ঐচ্ছিক) – হস্তচালিত পাম্প (ঐচ্ছিক); বলের পরিধি কমানো বাড়ানোর জন্য

নির্দেশাবলীঃ

অংশ ১ঃ সাস্টেইন সি টি আরঃ

১। সোজা হয়ে বসা বা দাঁড়ানো অবস্থায় কাঁধটাকে শরীরের পিছনের দিকে তুলে ধরতে হবে এভাবে সঠিক দেহভঙ্গি নিয়ন্ত্রণ করতে হবে

২। থুতনির নিচে বলটি  হাত দিয়ে ধরে রাখতে হবে

৩। থুতনির নিচে বলটি রাখার পর থেরাপিস্টের পরামর্শ অনুযায়ী থুতনিকে বলের বিপরীতে চাপ দিয়ে ধরে রাখতে হবে ___ সেকেন্ডের জন্য যতটুকু পর্যন্ত শক্তি প্রয়োগ করা যায়

৪। থেরাপিস্টের পরামর্শ অনুযায়ী __ বার করতে হবে

৫। প্রত্যেকবার ব্যায়াম করার মাঝখানে ১ মিনিট করে বিশ্রাম নিতে হবে

অংশ ২ঃ রিপিটিটিভ সি টি আরঃ

১। সোজা হয়ে বসা বা দাঁড়ানো অবস্থায় কাঁধটাকে শরীরের পিছনের দিকে তুলে ধরতে হবে এভাবে সঠিক দেহভঙ্গি নিয়ন্ত্রণ করতে হবে

২। থুতনির নিচে বলটি  হাত দিয়ে ধরে রাখতে হবে

৩। থুতনির নিচে বলটি রাখার পর থেরাপিস্টের পরামর্শ অনুযায়ী থুতনিকে বলের বিপরীতে চাপ দিয়ে ধরে রাখতে হবে এবং উপরের দিকে থুতনি উঠানো লাগবে

৪। রিপিটিটিভ সি টি এ আর এর ক্ষেত্রে কতবার  পুনরাবৃত্তি করতে হবে এবং কতসময়  করতে তা একমাত্র একজন গ্রাজুয়েট স্পিচ অ্যান্ড ল্যাঙ্গুয়েজ থেরাপিস্ট নির্ধারণ করবেন

৫। প্রত্যেকবার ব্যায়াম করার মাঝখানে ১ মিনিট করে বিশ্রাম নিতে হবে

ইউটিউব ভিডিওর জন্য-

– আপনার ফোনের ক্যামেরা দিয়ে কিউ আর কোড স্ক্যান করুন

– ইউটিউব লিঙ্ক  https://youtu.be/Z-kmMnjsNd4

অনুবাদক

আবুল কাশেম সিহাব

স্পিচ অ্যান্ড ল্যাঙ্গুয়েজ থেরাপিস্ট

CTAR with Rubber Ball Exercise videos are available in the following languages:

* Click to view CTAR videos in the following languages.

Chin Tuck Against Resistance (CTAR) exercise is suitable for most patients with swallowing difficulties / dysphagia i.e.

  • dysphagia or swallowing difficulties following strokes,
  • dysphagia following head and neck cancer,
  • dysphagia following Parkinson’s disease,
  • dysphagia due to late effect of radiotherapy i.e. Nasopharyngeal cancer
  • etc.
swallowing therapy

Latihan Menelan (Dysphagia Therapy) Chin Tuck Against Resistance / CTAR dengan Bola Getah

Video latihan menelan Chin Tuck Against Resistance / CTAR
GDM would like to express our heartfelt thanks to Ms Siti Amirah for her help in translation of the Malay Version of the CTAR video.

Video latihan menelan Chin Tuck Against Resistance / CTAR ini merupakan video Bahasa Melayu pertama yang dihasilkan oleh Singapore Swallowing Specialists.

Chin Tuck Against Resistance (CTAR) dengan Bola Getah

Tujuan: Untuk menguatkan otot suprahyoid yang digunakan semasa menelan. Otot-otot suprahyoid penting untuk membuka sfinkter paip makanan atas anda (sfinkter esofagus atas) untuk membolehkan makanan memasuki perut anda.

 Peralatan: 1) Bola getah, 2) jarum pam udara dan pam udara (pilihan) – untuk meningkatkan diameter dan tekanan bola

 Arahan:

 Bahagian 1: CTAR berkekalan (Isometrik)

  • Duduk / berdiri tegak dan tarik bahu ke belakang.  Kekalkan postur ini semasa latihan.
  • Pegang bola di bawah dagu dengan tangan anda dan kekalkan posisi bola sepanjang latihan.
  • Tundukkan dagu anda pada bola sekeras mungkin; dan kekalkan  selama _______ saat.
  • Ulangi _______ set seperti yang disyorkan oleh terapis / patologis pertuturan anda.
  • Rehat selama 1 minit di antara setiap set latihan.

 Bahagian 2: CTAR berulang (Isokinetik)

  • Duduk / berdiri tegak dan tarik bahu ke belakang.  Kekalkan postur ini semasa latihan.
  • Pegang bola di bawah dagu dengan tangan anda dan kekalkan posisi bola sepanjang latihan.
  • Tundukkan dagu anda, sekeras mungkin pada bola;  kemudian angkat dagu.
  • Ulangi langkah di atas untuk ________ kali dan set ________ seperti yang disyorkan oleh terapis / patologis pertuturan anda.
  • Rehat selama 1 minit di antara setiap set latihan.

Klik pada yang berikut untuk memuat turun (download) arahan latihan:

CTAR with Rubber Ball Exercise videos are available in the following languages:

* Click to view CTAR videos in the following languages.

Chin Tuck Against Resistance (CTAR) exercise is suitable for most patients with swallowing difficulties / dysphagia:

  • dysphagia or swallowing difficulties following strokes,
  • dysphagia following head and neck cancer,
  • dysphagia following Parkinson’s disease,
  • dysphagia due to late effect of radiotherapy i.e. Nasopharyngeal cancer
  • etc.
Dysphagia Training

Free Webinar by NFOSD: Managing Dysphagia in Adults with Intellectual Disability

Date and Time: Wednesday, June 17, 5:00 pm Pacific (June 18, 8.00am Singapore / Malaysia / Philippine )

Webinar Description:  

Adults with intellectual disability are at risk for dysphagia.  The unique swallowing, feeding, and behavioral challenges experienced in this population are vital considerations in the assessment and treatment of these patients.  This webinar will discuss the nature of dysphagia management in adults with intellectual disability by exploring the current evidence in this area and discuss the clinical experiences of speech pathologists who assess and treat adults with intellectual disability in the Intermediate Care Setting.

At the completion of this webinar, participants will:

  • Understand the impacts of dysphagia in people with intellectual disability
  • Identify the systems that must be considered in the assessment and treatment of dysphagia in those with intellectual disability
  • Anticipate the physical-nutritional needs of those with intellectual disability as they age
  • Describe the interdisciplinary team collaborations required to manage dysphagia in this population

Click here to register for the FREE webinar:

https://register.gotowebinar.com/register/76969519229535757

NFOSD website:

Dysphagia & Special Populations: Managing Dysphagia in Adults with Intellectual Disability

swallowing therapy

(Recommended article) Moving Forward with Dysphagia Care: Implementing Strategies during the COVID-19 Pandemic and Beyond

Mark A. Fritz · Rebecca J. Howell · Martin B. Brodsky · Debra M. Suiter · Shumon I. Dhar · Anais Rameau · Theresa Richard · Michelle Skelley · John R. Ashford · Ashli K. O’Rourke · Maggie A. Kuhn

Abstract
Growing numbers of SARS-CoV-2 cases coupled with limited understanding of transmissibility and virulence, have challenged the current workfow and clinical care pathways for the dysphagia provider. At the same time, the need for non-COVID-19-related dysphagia care persists. Increased awareness of asymptomatic virus carriers and variable expression of the disease have also focused attention to appropriate patient care in the context of protection for the healthcare workforce. The objective of this review was to create a clinical algorithm and reference for dysphagia clinicians across clinical settings to minimize spread of COVID-19 cases while providing optimal care to patients sufering from swallowing disorders. Every practitioner and healthcare system will likely have different constraints or preferences leading to the utilization of one technique over another. Knowledge about this pandemic increases every day, but the algorithms provided here will help in considering the best options for proceeding with safe and effective dysphagia care in this new era.

Click here to access full article (Open access):

Dysphagia
https://doi.org/10.1007/s00455-020-10144-9

speech therapy singapore

Our Online Speech Therapy or Telepractice Experience in Singapore during Covid-19

According to ASHA definition: https://www.asha.org/Evidence-Maps/
‘Telepractice is the application of telecommunications technology to the delivery of speech language pathology and audiology professional services at a distance by linking clinician to client or clinician to clinician for assessment, intervention, and/or consultation.’

Telepractice for Speech Therapy has been proven to be effective and has been practiced in countries like the United States, Canada and Australia.

Our experience:
Since Covid-19 outbreak started, the acceptance of telepractice for speech therapy in Singapore has increased significantly especially during the circuit breaker period.

Our experience shows that it benefits most of our clients who require speech and language therapy, and to some of our clients who require swallowing therapy. We prefer to use Zoom Meetings for our telepractice. We find it easy to be used for 1-to-1 session as well as for group therapy sessions. Therapy tasks can to be shared and be viewed easily by our client(s). Clients are able to respond easily by indicating their answers on the screen by using the writing/drawing function. The Zoom file sharing function has allowed us to still customize and personalize each therapy sessions for our clients.

However, we need to take into consideration client’s proficiency level in technology. For clients who are less tech proficient, our experience shows that simple apps such as Facetime and Whatapp video call can work as well.

LATEST: On 24/4/2020, Facebook has just announced their videoconferencing function that allows video meeting up to 50 people without downloading any apps. That will open up another platform for telepractice.

For Speech-Language Therapists who would like to adopt Telepractice, you may refer to the following links for resources: