Question
I have been referred a patient for vital-stim dysphagia exercises. I am the only speech therapist in a remote area of Idaho and do not have a lot of request for dysphagia. Is vital-stim the same or similar to thermal stimulation techniques to enhance awar
Answer
These two techniques are vastly different. Thermal stimulation techniques typically involve touching the posterior mouth or upper pharynx areas with a cold stimulus (initially small laryngeal mirrors were used....more recently frozen swabs have been suggested). This was a very popular technique in the early years of dysphagia rehabilitation, but subsequent research has cast doubt on its effectiveness and its practicality.
VitalStim is a form of electrical stimulation applied to the muscles in the anterior neck. Electrodes are placed on the anterior neck in various positions and a very small electrical current is applied across the skin. The rationale for this technique is that the electrical stimulation may help certain muscles to function better. When applied with a functional activity like swallowing, the hope is for improved muscles activity to support better swallowing. Preliminary data on this technique shows a positive outcome, but the research is flawed and considered to have very low validity. Current projects are in the works and better data should be available within the year. Clinicians must complete a training course before acquiring this equipment.
Michael A. Crary, PhD., is a Professor of Speech-Language Pathology and Director of the Florida Dysphagia Institute at the University of Florida Health Science Center. Dr. Crary's current clinical and research interests revolve around disorders of swallowing, specifically improving assessment and treatment strategies. Current research projects include studies of the clinical and instrumental evaluation of dysphagia and outcomes of various treatments. He has a long history as a practicing clinician and remains active in patient care. He has written and lectured extensively, including internationally, on these topics. His latest project is the text "The Introduction to Adult Swallowing Disorders" with Michael Groher. He has served as assistant director of the ASHA Special Interest Division #13: Dysphagia. He is a former nominee for the DiCarlo award from ASHA, a recipient of the Outstanding Clinical Achievement Award from ASHA, and has been elected as a Fellow of ASHA.
Michael Crary, Ph.D
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