Patient Information: Male, Age 79

Diagnosis: Wallenberg - Stroke / Dysphagia

History: This gentleman was admitted to a skilled nursing facility for rehabilitation services after hospitalization due to a stroke. A feeding tube was placed to address his dysphagia (difficulty swallowing). Prior to the stroke, he lived in his assisted living apartment and was able to eat a regular diet.

Pre-Therapy Status:
•ASHA’s National Outcomes Measurement System (NOMS) Swallowing Scale: Level 1; Individual is not able to swallow anything safely by mouth. All nutrition and hydration are received through non-oral means.
•Modified Barium Swallow Study (MBSS): Evidence of aspiration (liquid entering the lungs) on all consistencies (regular food and liquids).
•Diet Modification: Nothing by mouth; all nutrition, fluids, and medication delivered through the feeding tube.

Therapy Information:
•Modality: OmnisEMG™ Biofeedback.
•Frequency: 5x per week.
•Protocol Specifics: Typical swallow and effortful swallow exercises performed with biofeedback visualizations (bar graph, kangaroo and bow/arrow) to improve the force, quality and coordination of swallow muscle contractions.
•Duration: Eight weeks.
•Other Therapy Services Provided: Chin tuck against resistance exercises and safe swallowing strategy education.

Outcome:
• NOMS Swallowing Scale: Level 5; Swallowing is safe with minimal diet restrictions.
• MBSS: No evidence of aspiration.
• Diet Modification: Mechanical soft foods with thin liquids.

This gentleman is thrilled to achieve his therapy goals, allowing the feeding tube to be removed! He has returned to his assisted living apartment and is able to drink thin liquids and eat mechanical soft foods. He is continuing his swallowing exercises with out-patient speech therapy.