I try not play favorites with strategy use during MBS studies, but the effortful swallow can be just so… dreamy. SO EASY to instruct, it makes sense to patients and it's easy to see on fluoro, really, what more could a #mobileMBSSLP ask for?
For this particular patient, it was quite effective. In this clip, the first swallow is thin liquid with no strategy use, for the subsequent swallows, the patient is using the effortful swallow with the same amount of thin liquid, and finally a larger amount of thin. (We only change one variable at a time in our protocol!) Of course, as with any other strategy, we must assess on an instrumental before implementing with a patient clinically. For every video clip I have of a strategy being helpful, I have 2-3 of it making no difference. You just can’t know which category your patient falls into using only clinical assessment.
The effortful swallow has been around for quite a while (I recently read an article that referred to it as “dysphagia dogma” which is now my favorite phrase), and has recently been the topic of more research with regard to efficacy and it’s potential effect on heart rate. All of this draws our attention to the evolving nature of our field, and how important it is to keep up with the latest chatter. Check the links below: