Intensive Dysphagia Rehabilitation- IDR

Question 1

Intensive Dysphagia Rehabilitation- IDR

Answer 1

• Comprehensive and intensive rehabilitation approach based on the principles of neuroplasticity and exercise philosophy
• Patients with moderate-severe neurogenic dysphagia
• Patient seen 2x/week in the clinic for 60 minutes with a daily home program 3x/day for 45-60 min/day. Usually 4,8,12 weeks
• Daily Evidenced Based Oropharyngeal Training
• Daily Targeted Swallowing Practice
• Adherence Inducing Features

Question 2

Daily Evidenced Oropharyngeal Training

Answer 2

• 2 exercises chosen, completed on alternating days- allows for muscle rest and recovery and help to sustain patient motivation
• Intensity increases biweekly
• Each exercise should target different muscle groups or neuromuscular goals:
   Lingual Strength
   Effortful Swallowing
   Mendelsohn Maneuver
   Shaker

Question 3

Daily Targeted Swallowing Practice (TSP)

Answer 3

• Increases gradually in complexity
• Challenge the swallow with a bolus
• Small sets of single swallows of materials identified during instrumental assessment are used.
• Use textures/viscosities that are observed to be difficult but manageable with compensatory strategy

Question 4

Adherence Inducing Features

Answer 4

• Patient chooses 1 exercise per day
• Patient chooses flavor of the challenge swallows
• Caregiver becomes coach at home