Swallowing and breathing: speech and language therapy
Reviewed by Anna Volkmer

Swallowing difficulties are a common comorbidity in just over a quarter of people living with chronic obstructive pulmonary disease (COPD). Given the associated risks of aspiration and exacerbation of COPD symptoms, speech and language therapists (SLTs) can offer valuable guidance in assessing and managing these issues. This is a developing area for SLTs and this study therefore aimed to determine referral patterns, identify practice patterns and explore SLTs perception of practice in this area. Answers from 48 US-based SLT respondents were included in the analysis of the 35 questions of an electronic survey which addressed referral statistics, COPD characteristics, evaluation methods, treatment methods and patient education. Data collected suggested growth in referrals for patients with COPD to SLT, particularly from GPs. SLTs report using clinical swallow exam, with a video fluoroscopy swallowing study in almost 80% of cases. Fiberoptic endoscopic evaluation of swallowing is used comparatively infrequently (23% of cases). Respiratory measures (such as respiratory rate and pulse oximetry) are routinely included in these assessments (between 60 and 80%). SLTs report using both compensatory treatments and restorative interventions (such as expiratory muscle strength training). This study highlighted this area as a developing area of practice and perhaps an area that may provide preliminary guidance for studies investigating respiratory compromised patients post COVID-19.

Clinical Practice Patterns of Speech-Language Pathologists Delivering Dysphagia Services to Persons with COPD: Analysis of Survey Outcomes.
Drulia T, Hodge A.
SEMIN SPEECH LANG
2021;42(5):363-83.