IOPI Medical Q1 2023 Newsletter - UDI Labeling, a New IOPIian, and Returning to In-Person Events!

Happy New Year!! With the beginning of a new year come the typical resolutions we all tend to make. Eat better, move more, finally organize that porcelain cat collection left to you by great gammy Betty. Inevitably we make the determined vow that this year will be different. We have great news for you! This year can be different, and we’re here to help.

Resolve to always learn and expand your horizons by reading more educational and industry related resources. With CEU courses, articles and webinars, we have just what you need!

If you work in a facility, resolve to present to your boss exactly what the monetary cost of dysphagia is to the business. We can help you stick to that too with our Dysphagia Cost Tool.

Resolve to meet new people, or simply reconnect with old friends. With the AVASLP conference back to in-person this April, that’s an easy one to stick to. We’ll be there! Come find us and say hello. We’d love to see you!

This quarter we are bringing news of new UDI labeling on our products, our newest IOPIian, and our return to in-person events with April’s AVASLP conference in West Palm Beach, and as always, helpful resources and articles, including one on the importance and benefits of mastication from our Clinical Consultant, Ed Bice.

Also don’t forget to visit our always-evolving website. We are continuing to make improvements, giving you the opportunity to interact with our IOPI staff, Patient Advocacy tools, and Covid-19 resources. You can also follow us on Instagram (iopimedical), Twitter (@iopimedical) & Facebook (IOPI Medical LLC) for the latest news and information.

As you may know, IOPIians are a unique bunch, passionate about what we do and driven to provide you with the absolute best service and products possible. And now there are more of us!

Meet Kavita! As Quality Assurance Specialist at IOPI Medical, Kavita is responsible for providing support to our Quality Department to ensure that IOPI Medical products and Quality management system adhere to the applicable regulations and standards. She has over 5 years of experience in Quality assurance in Medical Devices. On a personal front, she enjoys cooking, watching true crime documentaries, playing video games and hiking with her dog Tinkerbell.

Mastication is more than breaking down food. It provides several health benefits, including regulating insulin, heart rate, blood pressure, gastric emptying, and oral health (Forde & Stieger, 2022; He et al., 2022; Sitanaya et al., 2022). Assessing mastication may fall to clinicians who evaluate and treat swallowing. A better understanding of the masticatory process may assist in improving health outcomes.

Teeth and saliva play essential roles in mastication. A minimum of ten occlusal surfaces are required to achieve maximal bite force (Cichero, 2016; Cichero, 2020; Käyser et al., 1987; Korfage et al., 2005). However, many patients without teeth manage a variety of solids (Ekelund, 1989). Saliva moistens the food particles, and salivary mucins bind the food into a cohesive bolus that can be easily swallowed (Bice & VanSickle, 2020); Pedersen, Bardow, Jensen, & Nauntofte, 2002).

The role of the tongue in mastication has been studied for many years. Abd-El-Malek (1955) described the role of the tongue in mastication in five stages. In the preparatory stage, the tongue rests on the floor of the mouth, becoming “trough-like” with the tip pointing upwards. During the throwing stage, the tongue twists to one side, turning through a right angle so that the dorsum faces the lingual surface of the teeth to “throw” the food on the surface of the lower molars. The guarding stage is when the tongue remains twisted while the dorsum presses on the edges of the teeth to prevent the food from falling into the buccal cavity. The tongue and the buccal muscles keep the food between the teeth. In the sorting out stage, the food is pushed onto the tongue by the buccal muscle as the tongue regains a more neutral position. The tongue sorts out larger particles that need to be returned to the teeth for further grinding. The stage is repeated until the appropriate particle size is obtained. The final stage is bolus formation, when the tongue alternates from side to side to mix the food with saliva.

The Test of Masticating and Swallowing Solids (Huckabee et al., 2018) and the Karaduman Chewing Performance Scale (Arslan et al., 2016) provide guidance for assessing mastication in adults and children. However, the clinician must determine the nature of the impairment (bite force, saliva production, tongue strength, tongue range of motion, tongue coordination, cognition) to develop a treatment plan. Clinicians can measure saliva production with a Saxon Test (Kohler & Winter, 1985), and obtaining a diadochokinetic rate can assist in assessing lingual coordination (Fletcher, 1972). Lazarus et al. (2014) developed a lingual range of motion scale for patients with head and neck cancer that may provide guidance in other populations. The Iowa Oral Performance Instrument (IOPI) can provide lingual strength measurements that can be compared to normative data (Adams et al., 2013, 2014; Fei et al., 2013; J. A. Stierwalt & S. R. Youmans, 2007; J. A. G. Stierwalt & S. R. Youmans, 2007; Youmans & Stierwalt, 2006; Youmans et al., 2009).

When considering interventions, proper use of the IOPI is known to improve lingual strength (Robbins et al., 2005; Robbins, 2007). However, strength benefits go beyond increased power. Research indicates that strength training increases the coordination (Mayer et al., 2011) and range of motion (Moscao et al., 2020) of skeletal muscles. The information indicates the IOPI may be of benefit to patients who have mastication issues related to these impairments.

When making diet recommendations after evaluating a patient, it is essential to understand that recommending the patient only eat foods that do not require mastication may result in adverse health consequences. Decreased insulin production, poor gastric emptying, decreased oral health, and many others may be the end result. Additionally, the consumption of a pureed diet impacts quality of life (Keller et al., 2012). Such knowledge should encourage clinicians to investigate rehabilitation approaches that may restore mastication abilities.

The AVASLP conference will be back in-person this year, and so will IOPI Medical!! We can’t wait to see you all again!

A variety of topics related to the practice of speech-language pathology will be included this year. Topics include assessment and treatment of acquired speech and language disorders, traumatic brain injury, dysphagia, voice disorders and laryngectomy, progressive neurological disease, and the use of assistive technology in persons with cognitive and communication impairments.

For more information, please click the button below:

To help you achieve the greatest level of success for your patients, we continue to provide you with the necessary Purchasing Advocacy tools, as well as clinical support.

Our Purchasing Advocacy tools can be found on our Medical Professionals page. Here you will find our IOPI Dysphagia Cost Tool as well as a ready-to-use Benefits of IOPI for Dysphagia PowerPoint. Just populate it with information specific to your patient’s needs.

You also have clinical support at your fingertips. Our clinical consultant, Ed M. Bice, M.Ed., CCC-SLP, is available to mentor through the advocacy process to assess and report the estimated cost of dysphagia to your facility. You can reach Ed for a patient consultation or clinical question by calling (844) 844-IOPI or emailing ed@iopimedical.com.

To access our IOPI Dysphagia Cost Tool, the Benefits of IOPI for Dysphagia PowerPoint, and tips on advocating for your patients, please visit: https://iopimedical.com/purchasing-advocacy/

Lastly, we are not currently scheduling any future webinars as we are focusing on the previously mentioned ASHA CEU course. So exciting!

The investigation sought to determine modifiable factors contributing to the reduced dysphagia-related quality of life in 31 community-dwelling people who had survived a stroke. The findings indicate that number of medical conditions, degree of diet modification, Stroke Impact Scale emotional subscale score, and partner employment status predicted dysphagia-related quality of life. People with more medical conditions or a partner working outside the home had worse quality of life ratings, and those with better mental health or fewer diet modifications had better ratings. The authors suggest clinicians working with people with dysphagia consider a more holistic approach to assessment and treatment.

Many holiday traditions and memories are related to food, and days are often associated with special meals and libations. Eating and mealtimes may have a different meaning for people with swallowing problems. In honor of the holiday season, this edition of the newsletter examines quality of life from the perspective of people with dysphagia.

The articles below are only a small fraction of the number of IOPI-related studies in general. You can find many more, covering a variety of topics, by visiting https://iopimedical.com/studies/ or clicking the button at the end of the section.

The True Cost of Dysphagia on Quality of Life: The Views of Adults with Swallowing Disability

Rebecca Smith, Lucy Bryant, Bronwyn Hemsley

https://onlinelibrary.wiley.com/doi/full/10.1111/1460-6984.12804

The participants’ responses indicated that dysphagia and its interventions reduced their quality of life. Participants identified reduced physical safety, reduced choice, and control, poor mealtime experiences, and poor social engagement as contributing factors to reduced quality of life. Several barriers and facilitators included being involved in meal design, being adaptable, owning their swallowing difficulties, managing the perceptions of others, and resisting changes to oral intake. The authors suggest that clinicians should openly communicate with their clients regarding the impact of dysphagia on their lifestyle and quality of life and recommend more acceptable interventions to the person, which may positively affect their mealtime experience.

A Review of the Impact of Food Design on the Mealtimes of People with Swallowing Disability Who Require Texture-Modified Food

Rebecca Smith, Lucy Bryant, Courtney Reddacliff, Bronwyn Hemsley

https://intellectdiscover.com/content/journals/10.1386/ijfd_00034_1

The review aimed to determine what is known about the impact of food structure and visual appeal on the mealtime experiences of people with swallowing difficulties. The review included 35 studies that provide evidence concerning how modifying the physical characteristics of texture-modified foods for people with dysphagia has the potential to improve mealtime experiences. The literature review found visual appeal, texture, taste, aroma, temperature, mealtime environment, and mealtime assistance all impact the mealtime experience. When designing a person’s mealtime plan and food-related dysphagia interventions, the variables should be considered. The authors suggest that future research should include the views of people with swallowing difficulties who require texture modification for an extended period.

Dysphagia and Quality of Life, Participation, and Inclusion Experiences and Outcomes for Adults and Children with Dysphagia: A Scoping Review

Rebecca Smith, Lucy Bryant, and Bronwyn Hemsley

https://pubs.asha.org/doi/10.1044/2021_PERSP-21-00162

The article reviews 106 articles concerning the impact of swallowing disorders and intervention on mealtime-related quality of life, participation, and inclusion for people with dysphagia. The analysis revealed that dysphagia had several negative effects on quality of life. Some dysphagia interventions positively impacted quality of life, and modifying food texture had a negative impact. Limitations exist related to understanding how swallowing disorders and interventions impact the quality of life in people suffering from the condition.

As you may be aware, a growing number of markets are requiring Unique Device Identification (UDI)—the addition of barcodes to medical device labeling to improve traceability during distribution and use. UDI includes a device identifier (e.g., GS1 GTIN) and applicable production identifiers (e.g., date of manufacture or expiry date, lot number or serial number). IOPI is using GS1 2D DataMatrix barcodes to meet UDI requirements.
IOPI’s Pro and Trainer Kits (REF 1-3100-SD/DL and 1-3200) and standalone Report Generator product (REF 5-8101) will have this new UDI labeling. A sample kit label is shown below:

How does this affect IOPI’s customers?

Check your scanners - If you or your customers use barcodes to track inventory or enter patient treatment information into a medical records system, we recommend that you test these barcodes after receiving new product to confirm your scanner accurately processes the data encoded in the barcode. If you do not use barcodes, no action is needed, as the relevant information is included in plain-text format as well.

If you have any questions or concerns, please don’t hesitate to reach out. Our Regulatory team is ready to help you!