IOPI Medical Q4 2023 Newsletter - ASHA 2023

After a gorgeous, and thankfully mild summer, we are well into the darker and stormier days of autumn. While not everyone’s favorite, it does give us the opportunity for quiet, cozy evenings in, focusing on wrapping up another year and just enjoying whatever that may look like. For IOPI it looks like getting back to our people!

This quarter we are all about ASHA! Keep reading to find out what kinds of treats are in store for our IOPI fans this year.

Also don’t forget to visit our website. It gives you the opportunity to interact with our IOPI staff, and Patient Advocacy tools (have you seen the Dysphagia Cost tool?!). You can also use our Get a Quote page if you’re need of pricing information. It’s quick and easy! You can also follow us on Instagram (iopimedical), Twitter (@iopimedical) & Facebook (IOPI Medical LLC) for the latest news and information.

Please Note: IOPI Medical offices will be closed November 23rd & 24th in observance of the Thanksgiving holiday. We will also be closed December 23rd, 24th and January 1st for the Christmas and New Years holidays.

As we’re sure you are all aware, ASHA 2023 is taking place soon in Boston, November 16-18. What you may not know it that IOPI Medical will be back for the first time since COVID. We are incredibly excited to be back and to have the opportunity to engage with all of you. We’ve missed you!

Make sure to stop by booth #954 to say hello, but also to enter the Test Your Tongue Strength Challenge. Top strength of each full day of ASHA will win a “basket” full of amazing goodies. You can also secure multiple entries into our Grand Prize drawing of a Visa gift card. Keep an eye on our socials and stop by the booth to find out how!

However, you don’t have to wait for the show to start having fun. In the next couple of weeks, a trivia game will go up on our ASHA online exhibitor listing to get the fun started. Who knows? There could be a prize in it for you 😉

Many of you may already be familiar with our esteemed Clinical Consultant, Ed Bice, but did you know, you can learn from him from the comfort of your office or home? IOPI Medical offers ASHA Continuing Education Units with our two FREE courses.

The Role of Oral Musculature in Swallowing and the Therapeutic Benefits of the IOPI, will review the oral musculature and its essential functions, as well as explore exercise principles and how the IOPI can be integrated into a dysphagia treatment plan.

Our second course, Research Update, summarizes recent findings related to the IOPI.

Click the button below to register!

The study investigated the effects of the effortful swallow with a tongue emphasis and a pharyngeal squeeze emphasis using saliva swallows in forty healthy adults. The investigators examined the impact of the maneuver on hyoid displacement and hyoid–larynx approximation. They also examined the association between tongue pressure and hyolaryngeal movement during normal swallowing and the effortful swallow when produced with a tongue emphasis. The investigation also examined age-related differences in the movement of the hyolaryngeal complex. The study employed ultrasound to measure hyolaryngeal movement and the IOPI to measure tongue pressure. Surface electromyography tracked swallows. Both effortful swallow conditions resulted in greater hyolaryngeal movement than typical swallows. When the tongue emphasis was employed, greater hyolaryngeal movement occurred. Younger participants had greater hyoid to larynx approximation than older adults when producing effortful swallows with tongue emphasis. When using a tongue emphasis, the investigators found positive correlations between tongue pressure and hyolaryngeal movement during typical swallows and the effortful swallow with tongue emphasis. The correlation between tongue pressure and hyolaryngeal movement during typical swallows and the effortful swallow with tongue emphasis suggests that the tongue plays a critical role in swallowing, priming subsequent swallowing events.

Effects of Effortful Swallowing Exercise with Progressive Anterior Tongue Press Using Iowa Oral Performance Instrument (IOPI) on the Strength of Swallowing-Related Muscles in the Elderly: A Preliminary Study

Oh JC. Effects of Effortful Swallowing Exercise with Progressive Anterior Tongue Press Using Iowa Oral Performance Instrument (IOPI) on the Strength of Swallowing-Related Muscles in the Elderly: A Preliminary Study. Dysphagia. 2022 Feb;37(1):158-167. doi: 10.1007/s00455-021-10259-7. Epub 2021 Feb 10. PMID: 33566219.

https://pubmed.ncbi.nlm.nih.gov/33566219/

The study examined the ability of a 7-week effortful swallow intervention program to increase swallowing-related muscle strength. The experimental group performed effortful swallows using the IOPI for biofeedback. The control group performed effortful swallows without biofeedback. The participants performed effortful swallows 60 times in weeks 1 and 2, 80 times in weeks 3 and 4, and 120 times in weeks 5–7. The investigators measured tongue and swallow pressure at baseline and week 8. Isometric and swallowing tongue pressure in the experimental group was significantly improved compared to baseline. The control group did not exhibit significant changes. The authors conclude that effortful swallow exercise using IOPI as biofeedback improves isometric tongue and swallowing pressures.

A Systematic Review of the Physiological Effects of the Effortful Swallow Maneuver in Adults with Normal and Disordered Swallowing

Bahia MM, Lowell SY. A Systematic Review of the Physiological Effects of the Effortful Swallow Maneuver in Adults with Normal and Disordered Swallowing. Am J Speech Lang Pathol. 2020 Aug 4;29(3):1655-1673. doi: 10.1044/2020_AJSLP-19-00132. Epub 2020 May 28. PMID: 32463714.

https://pubmed.ncbi.nlm.nih.gov/32463714/

The systematic review included twenty-three studies and summarized the biomechanical and functional effects of the effortful swallow in adults with and without dysphagia. The investigators found the following concerning the effortful swallow:

• Tongue-to-palate maximum pressure generation increased.

• High-resolution manometry studies reported increased peak pressure in the upper pharynx, velopharynx, or hypopharynx.

• Studies consistently reported prolonged laryngeal vestibule closure.

• The duration of epiglottic inversion increased.

• Findings regarding UES opening duration were inconsistent.

• Conflicting results were reported for the effect on laryngeal elevation.

The authors suggest that future investigations address the effects of effortful swallowing in individuals with dysphagia. Additionally, standardization of the effortful swallow instructions is needed.

Exploring the Efficacy of the Effortful Swallow Maneuver for Improving Swallowing in People With Parkinson Disease—A Pilot Study

Pooja Gandhi, Melanie Peladeau-Pigeon, Michelle Simmons, Catriona M. Steele. Exploring the Efficacy of the Effortful Swallow Maneuver for Improving Swallowing in People with Parkinson Disease—A Pilot Study. Archives of Rehabilitation Research and Clinical Translation 5: 3, 2023

https://www.sciencedirect.com/science/article/pii/S2590109523000320

Eight older adults with Parkinson's disease (years post-onset 3-20) with a Hoehn and Yahr scale score between 2 and 4 performed the effortful swallowing with a tongue to palate emphasis using the IOPI for biofeedback. The participants received two thirty-minute sessions five days per week for four weeks. There were inconsistent responses on the Penetration-Aspiration Scale scores, time-to-laryngeal-vestibule-closure, total pharyngeal residue, and pharyngeal area at maximum constriction. Of note, positive changes when the effortful swallow was used as a compensatory probe predicted positive changes after rehabilitation.

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/