I wanted to give you an update on my progress with TheraSIP treatment. I have worked with it this week and found it to be extremely helpful. My therapist will be sending you my progress with it and she also mentioned another patient who would benefit from this treatment and would be in touch with you. I could feel the pulling of muscles, which I haven't used in a long time and it actually felt good!! If you can believe that!! I now have it at home and I plan to use it as much as I can.
Case Study 1
The patient is a 68-year-old male with a diagnosis of Primary Lateral Sclerosis with a six-year onset. His speech was slow but clear of distortion. Voice resonance was hypernasal and voice quality was mildly dysphonic. The patient had no swallowing complaints and no history of apnea. He was given oral exercise drills to perform daily, voice drills for flexibility and loudness, diaphragmatic breathing drills to strengthen the duration and volume of his voice, and TheraSIP Swallowing Trainer to increase base of tongue elevation and retraction, laryngeal elevation and UES emptying to help decrease wet dysphonia and hypernasality. Exercises designed for the patient included taking effortful sucks from the RED micro-resistance straw followed by an 'effortful swallow'.
The patient's speech is stable. He continues to demonstrate increased tone, which affects the rate of his speech. However, his voice is less hypernasal. His wet dysphonia clears following drills and his volume is enhanced. The patient had reported that phlegm tended to collect in the back of his throat, which made speaking difficult. However, he has found that his phlegm is handled well by exercising with the TheraSIP Swallowing Trainer. The patient has a TheraSIP Swallowing Trainer in his car to clear the phlegm before going places requiring communication. He continues to use the device daily as part of his home exercise program.
Case Study 2
The patient is a five- year-old male with a history of unilateral vocal fold paralysis. A modified barium swallow study (MBSS) and Fiber-optic Evaluation of Swallow (FEES) revealed aspiration of thin liquids. The child received voice and swallowing treatment using voice drills to increase stretching and contraction. He drilled exercises to increase the duration of his voice and adduction. TheraSIP Swallowing Trainer was used prior to his voice drills. The patient practiced an effortful suck followed by an effortful swallow with all three micro-resistance straws. He is no longer aspirating and does not require thickened liquids. This patient continues to show increased duration, loudness and quality of voice. He is now on a normal diet without thin liquid restriction.
Case Study 3
The patient was a 43-year-old veteran with a history of medulablastoma postoperative. Initially, he presented with a spastic dysarthria, dysphagia, hypernasality and a strangled voice quality. Swallowing was treated via traditional swallowing therapy and TheraSIP Swallowing Trainer. Speech rehabilitation included oral exercises, voice drills, and diaphragmatic breathing exercises. The patient progressed in swallowing and was progressed to a normal diet. He continued to have difficulty with thin liquids as characterized by cough and difficulties with choking/coughing in the night. He drilled TheraSIP Swallowing Trainer and showed improvements in his speed of swallowing, strength of swallowing and ability to drink thin liquids continuously. He no longer has difficulty with thin liquids or with nighttime bouts with coughing on his saliva. His nasality has decreased and his speech rate has substantially improved. His volume of voice also showed significant improvement.
Case Study 4
The patient was a thirty-year-old male with cerebral palsy who had a chronic history of hospitalizations for aspiration pneumonia. His physician had advised the patient and his mother that a gastrostomy would be necessary if benefit from swallowing treatment failed. He was seen for NMES using the TheraSIP Swallowing Trainer and traditional swallowing techniques. In addition to his daily NMES treatment, the patient was given the TheraSIP to practice 30 swallows 3X per day at home. Additionally, the patient was instructed in compensatory techniques to increase airway protection. At the completion of treatment, the patient underwent videofluoroscopy, which indicated safe swallowing and habituation of compensatory strategies.
The patient is now on a dental soft diet with thin liquids between meals.