What is MDTP?

September 27, 2021

.

What is MDTP?

.

Super excited to now be a certified MDTP provider! The McNeill Dysphagia Therapy Program (MDTP) by Dr. Michael Crary & Dr. Giselle Carnaby is a systematic swallowing rehabilitation program based on exercise physiology principles & proven in the research to improve (swallow) muscle performance & functional recovery of dysphagia (in adults). It “uses simple techniques focused on SWALLOWING as an EXERCISE, organizes these techniques into a hierarchy of events that progressively advance the patient toward a more “normal” eating behavior, begins with evaluation and ends with focus on eliminating maladaptive eating/swallowing behaviors, incorporates specific criteria for starting, advancing, or regressing a patient’s progress, and includes homework based on patient progress that facilitates return to a more normal eating routine”.

.

It focuses on progressive development & reorganization of muscle parameters, resistive loading (using different bolus types & volumes in a progressive hierarchy), reorganization of neuromuscular timing, sensory integration, development of endurance, control & extinguishment of abnormal movement patterns, multi-planar training, and functional practice & transference to functional performance. As stated in the manual, “as the MDTP program advances, it provides increased demands via progressive resistive forces, alterations in velocity of movement, timing, angle and functional specificity of the activity—with the main objective as rebuilding functional patterns of movement to approximate normal swallowing”. Yet again, all of the “worlds” I live in COME TOGETHER: fitness (physiology, strength, muscle growth, endurance, coordination, body transformation etc.) AND speech pathology (voice, swallowing, the musculature of the head/neck & respiration, motor learning, rehabilitation, etc.)!

.

Did you know that the swallowing musculature is comprised of at least 23 muscles? Did you also know that disuse atrophy of muscle begins within 4 hours of the start of disuse, resulting in decreases in muscle mass, muscle cell diameter, & the number of muscle fibers (with muscle fibers having been reported to decrease in size by 50% within 2-3 months)?! In the dysphagia-related speech pathology world, we see patients who have experienced a change in swallowing, often because of effects of radiation/chemotherapies (head/neck cancer), sudden trauma (stroke, brain injury), &/or generalized weakness (sarcopenia); these patients often present with muscular weakness and/or reduced neuromuscular coordination of swallowing. Principles underlying muscle physiology & retraining of skeletal muscle are applicable to the swallow musculature, & MDTP is a research-based swallowing therapy program that yields results proving exactly that!

.

One of the integral components of the program is to continually challenge the patient’s motor control capacity to stress, redirect & rebuild the motor program for swallowing. And just as it should be done in bodily EXERCISE, establishing the FORM (of the swallow technique) first before introducing multiple swallowing practice challenges is crucial to avoiding maladaptive movement patterns (& ensuring accurate motor learning and progress). Just like MOTOR LEARNING is (& should be) applied to VOICE therapy and bodily EXERCISE as well, it is applied to swallowing beautifully within the MDTP framework. WE LEARN BY DOING. “Motor learning relies upon EXPLORATION and ERROR to advance, learning by doing but refining our motor skill by trial to trial adjustment in response to errors. Learning is enhanced if motor adaptation occurs in the face of error; error allows us the OPPORTUNITY TO LEARN or change a movement plan to improve the performance of an action. If the system is not allowed to error, then no gain in performance will be experienced”. Now compare this to life—if we never fail, we never learn. “A smooth sea never made a skilled sailor” (Franklin D. Roosevelt). FAIL FORWARD.

.

Of course, to perform MDTP, you must be thoroughly trained on the program, patient criteria for candidacy, clinical assessment, instrumental assessment, establishment of clinical indicators, identification of a starting level, application of the food hierarchy, the appropriate times to progress or “regress” a patient during therapy, & you are required to pass a post-training assessment. I’m grateful to have been trained on this awesome program & enjoyed the comprehensive training course. I am really looking forward to utilizing MDTP right away in the clinic & truly appreciate the program’s direct application of exercise physiology principles to its methods. Movement is medicine (SWALLOW SWALLOW SWALLOW).

.

.

.

#voxfit #swallowfitness #swallow #swallowing #dysphagia #voice #speechpathology #mdtp #mcneilldysphagiatherapyprogram #motorlearning #exercisephysiology #failforward #dysphagiatherapy #repetition #rehabilitation #research #continuingeducation #qualityoflife #swallowswallowswallow #hardandfast #useitorloseit #welearnbydoing #swallowexercise