Rethinking Rehab: Skill-Based Training for Swallowing Impairment Current rehabilitation approaches for swallowing impairment are limited by a general lack of specificity to associated pathophysiology, with many of our practices focusing on increasing strength of muscle activation. However, alternative rehabilitative options are emerging. One of these speculates on the concept of “skill training” for swallowing rehabilitation in neurogenic ... Article
Article  |   February 2014
Rethinking Rehab: Skill-Based Training for Swallowing Impairment
Author Affiliations & Notes
  • Maggie-Lee Huckabee
    Department of Communication Disorders, University of Canterbury, Christchurch, New Zealand
  • Phoebe Macrae
    Department of Physical Medicine and Rehabilitation, Johns Hopkins School of Medicine, Baltimore, MD
  • Financial Disclosure: Maggie-Lee Huckabee is a Senior Lecturer at the University of Canterbury and Coordinator of Postgraduate Speech-Language Sciences Programme. Phoebe Macrae is a Post-doctorate fellow at John Hopkins University. This research was conducted during the tenure of a Postgraduate Scholarship of the New Zealand Neurological Foundation awarded to Dr. Phoebe Macrae.
    Financial Disclosure: Maggie-Lee Huckabee is a Senior Lecturer at the University of Canterbury and Coordinator of Postgraduate Speech-Language Sciences Programme. Phoebe Macrae is a Post-doctorate fellow at John Hopkins University. This research was conducted during the tenure of a Postgraduate Scholarship of the New Zealand Neurological Foundation awarded to Dr. Phoebe Macrae.×
  • Nonfinancial Disclosure: Maggie-Lee Huckabee has previously published in the subject area. Phoebe Macrae has previously published in the subject area.
    Nonfinancial Disclosure: Maggie-Lee Huckabee has previously published in the subject area. Phoebe Macrae has previously published in the subject area.×
  • Copyright © 2014 American Speech-Language-Hearing Association
Article Information
Swallowing, Dysphagia & Feeding Disorders / Articles
Article   |   February 2014
Rethinking Rehab: Skill-Based Training for Swallowing Impairment
SIG 13 Perspectives on Swallowing and Swallowing Disorders (Dysphagia), February 2014, Vol. 23, 46-53. doi:10.1044/sasd23.1.46
SIG 13 Perspectives on Swallowing and Swallowing Disorders (Dysphagia), February 2014, Vol. 23, 46-53. doi:10.1044/sasd23.1.46

Current rehabilitation approaches for swallowing impairment are limited by a general lack of specificity to associated pathophysiology, with many of our practices focusing on increasing strength of muscle activation. However, alternative rehabilitative options are emerging. One of these speculates on the concept of “skill training” for swallowing rehabilitation in neurogenic dysphagia. The presumed intent of this approach is to modulate neural substrates and refine motor planning for swallowing using intrinsically generated cortical modulation and adaptive practice. This manuscript provides a discussion of skill training in the context of physical rehabilitation, illustrating how this information may translate to the diagnosis and remediation of swallowing impairment. This information prompts the consideration of more diverse swallowing pathophysiologies, beyond peripheral muscle weakness. The focus on skill training approaches provides a pathway by which greater specificity of diagnosis and treatment can occur.

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