A5085566426- Dysphagia Assessment and Management
- Child Nutrition and Feeding Issues
- Tracheal and airway disorders
- Amyotrophic Lateral Sclerosis Research
- Neurogenetic and Muscular Disorders Research
- Esophageal and GI Pathology
- Voice and Speech Disorders
- Geriatric Care and Nursing Homes
- Frailty in Older Adults
- Nutrition and Health in Aging
- Health Systems, Economic Evaluations, Quality of Life
- Clinical Nutrition and Gastroenterology
- Chronic Disease Management Strategies
- Obstructive Sleep Apnea Research
- Parkinson's Disease Mechanisms and Treatments
- Gastroesophageal reflux and treatments
- Health disparities and outcomes
- Palliative Care and End-of-Life Issues
- Tuberculosis Research and Epidemiology
University of Wisconsin–Madison
2022-2025
Google (United States)
2022-2024
University of Florida
2015-2023
William S. Middleton Memorial Veterans Hospital
2022-2023
Geriatric Research Education and Clinical Center
2022
University of South Florida
2015
ABSTRACT Introduction The purpose of this study was to determine the impact an in‐home expiratory muscle strength training (EMST) program on pulmonary, swallow, and cough function in individuals with amyotrophic lateral sclerosis (ALS). Methods EMST tested a prospective, single‐center, double‐blind, randomized, controlled trial 48 ALS who completed 8 weeks either active ( n = 24) or sham 24). primary outcome assess treatment efficacy change maximum pressure (MEP). Secondary outcomes...
Abstract Background Oropharyngeal dysphagia is prevalent in individuals with amyotrophic lateral sclerosis ( ALS ) leading to malnutrition, aspiration pneumonia, and death. These factors necessitate early detection of at‐risk patients prolong maintenance safe oral intake pulmonary function. This study aimed evaluate the discriminant ability Eating Assessment Tool EAT ‐10) identify unsafe airway protection during swallowing. Methods Seventy completed ‐10 survey underwent a standardized...
We evaluated the feasibility and impact of expiratory muscle strength training (EMST) on respiratory bulbar function in persons with amyotrophic lateral sclerosis (ALS).Twenty-five ALS patients participated this delayed intervention open-label clinical trial. Following a lead-in period, completed 5-week EMST protocol. Outcome measures included: maximum pressure (MEP); physiologic swallow cough; penetration-aspiration scale (PAS) scores.Of participants who entered active phase study (n = 15),...
Purpose To date, research characterizing swallowing changes in individuals with amyotrophic lateral sclerosis (ALS) has primarily relied on subjective descriptions. Thus, the degree to which physiology is altered ALS, and relationships between such alterations swallow safety and/or efficiency are not well characterized. This study provides a quantitative representation of physiology, safety, sample estimate difference comparison published healthy reference data identify parameters that pose...
Abstract Frailty is a complex and multidimensional condition wherein declines in physiologic reserve function place individuals state of heightened vulnerability decreased resiliency. There has been growing interest both research clinical settings to understand how best define, assess characterise frailty older adults. To this end, various models assessment tools have used define measure frailty. While differences exist among these tools, common unifying theme focus on physical activity....
Abstract INTRODUCTION Eating and swallowing difficulties are prevalent distressing among persons living with dementia (PLWD). These challenges may be especially burdensome for PLWD in lower‐resourced settings, where environmental factors such as social support, health‐care infrastructure, food access critical meeting quality standards of eating care. However, clinical practices research methods have not sufficiently focused on the lived environment to promote high‐quality, socially...
The ALS Functional Rating Scale-Revised (ALSFRS-R) is the most commonly utilized instrument to index bulbar function in both clinical and research settings. We therefore aimed evaluate diagnostic utility of ALSFRS-R subscale swallowing item detect radiographically confirmed impairments safety (penetration or aspiration) global pharyngeal individuals with ALS.Two-hundred one completed gold standard videofluoroscopic exam (VFSE). Validated outcomes including Penetration-Aspiration Scale (PAS)...
Abstract We examined the impact of expiratory muscle strength training on maximum pressure, cough spirometry, and disease progression in a 71‐year‐old male with amyotrophic lateral sclerosis. Maximum pressure declined 9% over an 8‐week sham period, but subsequently improved by 102% following 8 weeks training. Improvements spirometry mitigated were also observed post pressures maintained 6 months 79% higher than baseline data obtained 301 days prior. In this spinal‐onset sclerosis patient,...
Socioeconomically disadvantaged areas are more resource poor, impacting adherence to swallowing care recommendations. Neighborhood-level disadvantage metrics, such as the Area Deprivation Index (ADI), allow for examination of social determinants health (SDOH) in a precise region. We examined ADI cohort persons living with dementia (PLWD) determine representation those residing socioeconomic (high ADI), distribution provided, and frequency SDOH-related counseling or linking prior discharge.
Background: Alzheimer’s disease and related dementias (ADRD) patients who are hospitalized often develop oropharyngeal dysphagia, increasing risk for adverse outcomes, such as aspiration pneumonia. However, prevalence estimates of dysphagia highly variable based on patient report or clinical testing rather than visualization the swallow. Objective: The aims this study were to determine severity among inpatients with ADRD referred swallowing evaluation. Methods: Electronic health record (EHR)...
Abstract This case study examined the impact of a respiratory strength training program targeting inspiratory and expiratory musculature in an individual with C9orf72 amyotrophic lateral sclerosis ( ALS ). The tolerated 24 months completed at home, 50 repetitions per day, 5 days week. Significant increases maximum pressure (from 71 to 134 centimeters water), 108 197 water) peak cough flow 331 655 Liters minute) were noted forced vital capacity remained unchanged. A moderate intensity applied...
Objective: Our aim was to evaluate relationships between swallowing difficulty (dysphagia) and social determinants of health (SDOH) in older adults ≥65 years. Method: Cross-sectional analyses were performed community-dwelling Medicare beneficiaries from the National Health & Aging Trends Study (NHATS). The primary exposure self-reported chewing/swallowing prior month. Dependent measures included a variety SDOH outcomes (e.g., food insecurity [FI]). Weighted logistic regression models...
Hyoid bone and laryngeal approximation aid airway protection (laryngeal vestibule closure) while moving toward their peak superior anterior positions during swallowing. Submental surface electrical stimulation (SES) is a therapeutic technique that targets the muscles move hyoid It unknown whether submental SES only increases swallowing but not positions, which could require faster or greater movement to achieve adequate closure.We examined effects of on hyo-laryngeal kinematics in 30 healthy...
Abstract Background Despite research demonstrating the risks of using feeding tubes in persons with advanced dementia, they continue to be placed. The natural history dysphagia among patients dementia has not been examined. We conducted a secondary analysis national cohort staying at nursing home stay before hospitalization examine (1) pre‐hospitalization prevalence and (2) risk tube placement during based on preexisting dysphagia. Methods A retrospective study consisting all (NH) residents...
Purpose: Swallowing efficiency impairments are the most prevalent and earliest manifestation of dysphagia in people with amyotrophic lateral sclerosis (pALS). We aimed to profile number swallows elicited pALS across thin liquid, moderately thick extremely crackers compared expected healthy reference data determine relationships between degree pharyngeal residue, swallows, swallowing safety. Method: underwent standardized videofluoroscopic studies 10 bolus trials. Trained raters performed...