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BackgroundPurposeResultsConclusionsIt has been two decades since the World Health Organization’s endorsement of the International Classification of Functioning, Disability and Health (ICF). It is timely to undertake a rigorous search that analyzes the discourses around the ICF’s conceptual framework within physiotherapy, the kinds of enquiry to date and the professional areas where this is happening and how.The aim of this research is to synthesize the literature related to how the physiotherapy profession (practice, research and education) thinks about and puts to use the WHO ICF.A final sample of 37 papers was agreed. Five overarching third-order interpretations were derived: (i) A way of thinking and practicing, (ii) Endorsed but not embedded, (iii) Striking a balance, (iv) Power of participation and (v) Moving forward. Together, these themes illustrate the evolving role of the ICF in physiotherapy over the previous two decades. They highlight the ICF’s potential for shaping the future of physiotherapy practice, education and research.Work is needed to connect existing literature about the ICF and related models and embed the ICF, its language and philosophy across physiotherapy education and practice. Re-representation of the model might help address misinterpretation of the ICF, but fundamentally, embedding the ICF in entry-level curriculum is likely to be the most significant driver of change in practice. [ABSTRACT FROM AUTHOR]

The purpose of this study was to examine the application of anatomy and neuroanatomy knowledge to current practice of speech-language pathology (SLP), based on the perceptions of practicing SLPs, and to elicit information on participants' experiences of learning these subjects in their primary SLP degree with a view to inform potential curriculum development. A qualitative approach was taken to the collection of data. Eight practicing SLPs from four settings were interviewed. The critical incident technique, together with further probing, was used to elicit information. Interviews were transcribed and later thematically analyzed. This study found that knowledge of anatomy and neuroanatomy was perceived to be important by SLPs across all settings, to varying degrees, with a greater application in acute hospital settings. Negative experiences in studying this material were reported across all settings regardless of country of study. Participants discussed ways to increase students' motivation to learn this challenging material. Relevance of material demanded by students may be enhanced if active learning methods were used to teach anatomy/neuroanatomy, including case-based learning and with vertical and horizontal integration of material to provide a cohesive, spiral curriculum.

The World Health Organization International Classification of Functioning, Disability and Health has the power to shape professional behaviour and positively influence all aspects of health and social care practice. The visual depiction of the ICF framework belies the complexity of this multifaceted classification and coding system which students and practitioners can find challenging to grasp. This guide offers twelve integrated practical tips to help health and social care educators embed the ICF throughout the curriculum with a view to supporting student learning and ultimately interprofessional and inclusive practice. [ABSTRACT FROM AUTHOR]

The International Classification of Functioning, Disability and Health (ICF) is a compelling framework and classification system with the potential to enhance person-centred care. This mixed methods study investigates the degree to which the ICF is used by speech-language pathologists (SLPs) in Australia and ascertains their knowledge, endorsement, and perceptions of ICF implementation. Survey data were collected from 117 SLPs and analysed statistically and thematically. Respondents rated their knowledge as "good" and reported using the broader ICF framework more than the detailed classification system. Comparison revealed significantly lower ICF knowledge and use in practitioners working with children and in settings serving children, than those in adult based settings or working with adults. The ICF was discussed as being "a way of thinking" and respondents strongly indicated desire to use it further. Education and promotion strategies should aim to enhance ICF uptake and holistic, person-centred care, leading to improved client outcomes and realisation of the 2030 vision of Speech Pathology Australia. [ABSTRACT FROM AUTHOR]

Objectives/hypothesis: Characterization of the pharyngeal swallow response to volume challenges is important for swallowing function assessment. The diameter of the pressure-impedance recording catheter may influence these results. In this study, we captured key physiological swallow measures in response to bolus volume utilizing recordings acquired by two catheters of different diameter.Study Design: Ten healthy adults underwent repeat investigations with 8- and 10-Fr catheters. Liquid bolus swallows of volumes 2.5, 5, 10, 20, and 30 mL were recorded. Measures indicative of distension, contractility, and flow timing were assessed.Methods: Pressure-impedance recordings with pressure-flow analysis were used to capture key distension, contractility, and pressure-flow timing parameters.Results: Larger bolus volumes increased upper esophageal sphincter distension diameter (P < .001) and distension pressures within the hypopharynx and upper esophageal sphincter (P < .05). Bolus flow timing measures were longer, particularly latency of bolus propulsion ahead of the pharyngeal stripping wave (P < .001). Use of a larger-diameter catheter produced higher occlusive pressures, namely upper esophageal sphincter basal pressure (P < .005) and upper esophageal sphincter postdeglutitive pressure peak (P < .001).Conclusions: The bolus volume swallowed changed measurements indicative of distension pressure, luminal diameter, and pressure-flow timing; this is physiologically consistent with swallow modulation to accommodate larger, faster-flowing boluses. Additionally, catheter diameter predominantly affects lumen occlusive pressures. Appropriate physiological interpretation of the pressure-impedance recordings of pharyngeal swallowing requires consideration of the effects of volume and catheter diameter.Level Of Evidence: NA. Laryngoscope, 128:1328-1334, 2018. [ABSTRACT FROM AUTHOR]

There is widespread concern that individuals with dysphagia as a result of stroke do not drink enough fluids when they are prescribed thickened liquids. This paper details a retrospective audit of thickened liquid consumption of 69 individuals with dysphagia following stroke in acute and rehabilitation hospitals in Adelaide, South Australia. Hospitalized individuals with dysphagia following stroke drank a mean of 781 ml (SD = 507 ml) of prescribed thickened liquids per day, significantly less in the acute setting (M = 519 ml, SD = 305 ml) than in the rehabilitation setting (M= 1274 ml, SD = 442 ml) (t(67) = --8.34, p < .001). This daily intake of thickened liquids was lower than recommended standards of fluid intake for hospitalized adults. Fluid intake could be increased with definitive protocols for the provision and monitoring of consumption of thickened liquids, by offering more fluid via food or free water protocols or by routine use of non-oral supplementary routes. Future research into the effectiveness of such recommendations needs to evaluate not only the impact on fluid intake but also on health outcomes. [ABSTRACT FROM AUTHOR]

The purpose of this study was to examine the application of anatomy and neuroanatomy knowledge to current practice of speech-language pathology (SLP), based on the perceptions of practicing SLPs, and to elicit information on participants' experiences of learning these subjects in their primary SLP degree with a view to inform potential curriculum development. A qualitative approach was taken to the collection of data. Eight practicing SLPs from four settings were interviewed. The critical incident technique, together with further probing, was used to elicit information. Interviews were transcribed and later thematically analyzed. This study found that knowledge of anatomy and neuroanatomy was perceived to be important by SLPs across all settings, to varying degrees, with a greater application in acute hospital settings. Negative experiences in studying this material were reported across all settings regardless of country of study. Participants discussed ways to increase students' motivation to learn this challenging material. Relevance of material demanded by students may be enhanced if active learning methods were used to teach anatomy/neuroanatomy, including case-based learning and with vertical and horizontal integration of material to provide a cohesive, spiral curriculum. Anat Sci Educ. 7: 28-37. © 2013 American Association of Anatomists. [ABSTRACT FROM AUTHOR]

Irish speech-language pathology (SLP) graduates were recently required to have dysphagia competency. Five experienced dysphagia clinicians from a variety of settings were interviewed using semi-structured interviews regarding their expectations of new graduates and the best ways to prepare them for practice. Significant issues identified by the clinicians included the perceived fear associated with dysphagia management, new graduate competency, requisite personal qualities, taking a holistic client view, assessment of competence, and the need for support systems in the workplace. Continued collaboration between universities, professional bodies and working environments could facilitate successful fostering of professional confidence and optimum client care. [ABSTRACT FROM AUTHOR]

Background: Perceptual ratings provide a means of evaluating conversations involving individuals with aphasia. The influence of sampling segments of conversation and of segment length has not been established. Aims: To investigate the impact of the duration of the conversational segment on judges' perceptual ratings of elements of conversations between individuals with aphasia and their conversation partners. Methods & Procedures: A total of 64 speech pathology student judges rated two previously video-recorded conversations, elicited through a video-retelling task, between two individuals with severe aphasia and their respective partners via the Measure of Skill in Supported Conversation and the Measure of Participation in Supported Conversation (Kagan et al., 2004). Each judge was randomly assigned a segment from one or both conversations. The segment lengths were 3 minutes, 5 minutes, 10 minutes (for the longer conversation only), and the entire conversation (10:30 minutes and 19:17 minutes). The effect of segment duration and the interaction between conversation and segment duration were analysed for each rating scale using a 2 × 3 factorial analysis of variance. Outcomes & Results: There was no significant main effect for segment duration for any of the four rating scales of the Measure of Skill in Supported Conversation and the Measure of Participation in Supported Conversation. Conclusions: Aphasiologists who utilise these ratings of conversation as outcome measures can base the ratings on a segment of the conversation rather than the entire conversation. A 3- or 5-minute segment of a longer conversation on which no time limit has been placed is adequate to provide an accurate perceptual judgement. [ABSTRACT FROM AUTHOR]

Oropharyngeal swallowing involves complex neuromodulation to accommodate changing bolus characteristics. The pressure events during deglutitive pharyngeal reconfiguration and bolus flow can be assessed quantitatively using high-resolution pharyngeal manometry with impedance. An 8-French solid-state unidirectional catheter (32 pressure sensors, 16 impedance segments) was used to acquire triplicate swallows of 3 to 20 ml across three viscosity levels using a Standardized Bolus Medium (SBMkit) product (Trisco, Pty. Ltd., Australia). An online platform (https://swallowgateway.com/; Flinders University, South Australia) was used to semiautomate swallow analysis. Fifty healthy adults (29 females, 21 males; mean age 46 yr; age range 19-78 yr old) were studied. Hypopharyngeal intrabolus pressure, upper esophageal sphincter (UES) maximum admittance, UES relaxation pressure, and UES relaxation time revealed the most significant modulation effects to bolus volume and viscosity. Pharyngeal contractility and UES postswallow pressures elevated as bolus volumes increased. Bolus viscosity augmented UES preopening pressure only. We describe the swallow modulatory effects with quantitative methods in line with a core outcome set of metrics and a unified analysis system for broad reference that contributes to diagnostic frameworks for oropharyngeal dysphagia. NEW & NOTEWORTHY The neuromodulation of the healthy oropharyngeal swallow response was described in relation to bolus volume and viscosity challenges, using intraluminal pressure and impedance topography methods. Among a wide range of physiological measures, those indicative of distension pressure, luminal opening, and flow timing were most significantly altered by bolus condition, and therefore can be considered to be potential markers of swallow neuromodulation. The study methods and associated findings inform a diagnostic framework for swallow assessment in patients with oropharyngeal dysphagia.

Background: Comorbidities and complications of stroke have implications for level of care and hospital resources. It is critical, therefore, that hospital morbidity data accurately reflect the prevalence of these additional diagnoses., Objective: This study aimed to measure and describe the concordance between stroke clinicians/researchers and medical record coders when recording stroke and related diagnoses., Method: Diagnoses recorded prospectively, according to defined criteria by a clinical research team, were compared with the coding of stroke comorbidities and complications as per the Australian Coding Standards (ACS) from the separations of 100 inpatients from three rehabilitation facilities in South Australia. Percentage agreement, kappa coefficient, sensitivity and specificity values were calculated., Results: Kappa coefficients for agreement of prospective diagnoses with coding ranged from 0.08 to 0.819. The diagnoses with the highest agreement were stroke, aspiration pneumonia (nil cases), aphasia and dysphagia. The diagnoses with the lowest agreement were apraxia, cognitive impairment, constipation and dehydration., Conclusion: Not all stroke comorbidities are represented accurately in hospital morbidity datasets. Education of stroke clinicians about the current ACS may clarify expectations about medical record documentation for coding purposes which in turn may result in more accurate morbidity data and therefore costings for the rehabilitation sector.