Differences between drinking and eating from the viewpoint of dysphagia rehabilitation

Abstract

Dysphagia rehabilitation in JapanDysphagia rehabilitation holds a very prominent position in rehabilitation medicine in Japan. The Japanese Society of Dysphagia Rehabilitation (JSDR) was established in 1995 as a "conference" and became a "society" from 1996. In 2020, the number of members exceeded 14,000. Among the members of the JSDR speech-language-hearing therapists account for one third, followed by dentists. Many patients with dysphagia have problems not only with swallowing but also with the meal itself. Therefore, many medical professionals are expected to be involved including physicians, dentists, nurses, speech-language-hearing therapists, physical therapists, occupational therapists, dental hygienists, nutritionists, and medical social workers. However, this is not possible in practice, so the role of transdisciplinary teamwork must be adjusted to satisfy the patient's needs and problems [1]. Thus, in a transdisciplinary team the role of medical professionals changes depending on the patient's needs. We require a wide range of common fundamental knowledge beyond the traditional job role. The JSDR has a certification system and 3,211 people are currently certified, with the largest number being speech-language-hearing therapists, followed in order by dentists, nurses, and physicians. The certified members who have passed the examination after taking the e-learning system are expected to work beyond their traditional roles.

Effects of head flexion posture in patients with dysphagia

“…STD indicates the delayed onset of the swallowing reflex, and delayed STD is a risk factor for aspiration in discrete swallows; however, STD is not associated with aspiration in chew–swallow 15,17,18 …”

“…STD indicates the delayed onset of the swallowing reflex, and delayed STD is a risk factor for aspiration in discrete swallows; however, STD is not associated with aspiration in chew-swallow. 15,17,18 We evaluated discrete swallows using thin or thick liquids in this study, so delayed STD was a risk factor for aspiration. However, STD did not change, whereas the duration from the onset of the swallowing reflex to the initiation of laryngeal closure was shortened in this study.…”

Value of the Hyodo score in predicting dysphagia severity, recommended diet, and liquid consistency

“…An assessment scale using gelatin jelly called the Hyodo-Komagane score has been developed [15]. Thin liquids are more easily aspirated than thick liquid [16][17][18]; therefore, when performing VE at our institution, we generally administer a thick liquid bolus first, and in case of aspiration, a thin liquid bolus is not typically administered. In our previous study wherein VE was performed on 998 hospitalized patients, 7% of the patients had a DSS score of 1, and 31% had a score of 2 [12]; thus, the cases in the present study were clearly less severe.…”