January 29, 2009

New Advances in Therapy Technology Bring Dramatic Results for Area Patients

Patients needing speech or occupational therapy have many new options thanks to technological breakthroughs in the field. In Outpatient Therapy at Rogue Valley Medical Center (RVMC), therapists are using three new, exciting technologies to help patients.

Cold Laser reduces inflammation, treats TMJ and other ailments.

Low Level Light Therapy (LLLT) or "cold laser" uses focused light energy on a small area to stimulate circulation and reduce inflammation. It is especially useful in hand therapy and some types of speech therapy.

Considered somewhat controversial at first, cold laser is quickly converting skeptics and is now viewed as a breakthrough in therapy. A 2006 study at Bergen University, Norway, 3 found cold laser to be as effective or better than non-steroidal anti-inflammatory drugs (such as Ibuprofen) and, "Results of nine trials were significantly in favor of photoradiation (cold laser)." The researchers concluded that cold laser does, "Significantly reduce acute inflammatory pain in clinical settings." Other studies have found cold laser to promote healing in tendons and muscle tissue as well.

How it works is relatively straightforward. Inside our cells, mitochondria convert molecules of sugar, fatty acids and amino acids to energy in the form of Adenosine triphosphate (ATP), considered the energy "coin" of the cell. When bathed in cold laser, mitochondria absorb the light and convert it to ATP. The resulting surplus of ATP can trigger a number of beneficial effects including reduced inflammation, improved blood flow, protein and enzyme synthesis, as well as cell replication and repair.

"We are using light energy to stimulate regeneration of mitochondria in nerves, lymph cells, muscles and ligaments," says Rich DeWitt, speech/language pathologist in Outpatient Therapy at RVMC.

Therapists use a pen-like wand to direct cold light laser directly to areas of inflammation to promote healing. Because the energy is low level, it only affects cells in a small path, making it possible to target specific areas. Cold laser has been especially useful in treating upper extremity and hand injuries, temporomandibular joint disorder, more commonly known as TMJ, and many other ailments. "And we are definitely having success," says DeWitt.

VitalStim helps patients to swallow again.

Bob Stearns is doing what many of us take for granted: eating. Stearns has dysphagia, a disorder that makes it difficult or impossible for him to swallow. It is often the byproduct of stroke or cancer and it affects over 15 million Americans. Until recently, there were few treatments for dysphagia. But a new therapy called VitalStim has helped him to greatly improve.

"His muscles are significantly stronger than they were after radiation treatments for throat cancer," says DeWitt. "His swallowing is safe and he is able to receive all his nutrition and hydration by mouth, rather than by a stomach feeding tube."

Called VitalStim, the therapy uses electric stimulation to cause muscles to flex. "We place the electrodes on the neck," DeWitt explains. "The electrodes make the swallow reflex faster and more efficient. They also help strengthen the muscles. " Stearns had cancer at the base of his tongue. After his chemo and radiation therapy the cancer was gone, but Stearns had, "A lot of swallowing issues," he says. The therapy was tingly, but not painful, and Stearns could immediately feel the muscles working. "That first night, when I went home, I could tell the difference with some of the stuff I was eating," he says. "Rich put it on my neck and throat and that reduced a tremendous amount of the swelling and improved my swallowing a great deal."

He continued the therapy for several weeks, and by the end his swallow was nearly back to normal.

FEES Helps with Vocal Chord Problems without Radiation

Fiber optic endoscopic evaluation of swallowing (FEES) is a new, safer, more effective method to assess swallowing without X-rays and to provide visual feedback to patients during therapy.

To use FEES, a speech therapist passes a small, flexible tube with a tiny camera attached to the end through the nose and into the middle of the throat. The therapist records pictures of the throat and voice box as the patient swallows liquid and foods. The therapist may ask the patient to try different postures, such as tucking in the chin, to determine if changes improve swallowing.

"We can see which muscles and structures are not working properly during swallowing and/or voicing," says DeWitt. The patient may also view his own vocal chords and throat, as the video image is displayed on a computer screen in real-time. "This allows not only for evaluation, but also fast biofeedback for therapy purposes," Dewitt says.

The test can be done in the speech therapy office in about 10 minutes. No preparation or visit to the hospital is necessary.