The Swallowing Neurorehabilitation Research Lab was established in 2013 by Associate Professor Sebastian Doeltgen in the Discipline of Speech Pathology at Flinders University in Adelaide, Australia. Sebastian has had a deep interest and passion for swallowing rehabilitation research and neuroscience ever since his speech pathology undergraduate degree. He is amazed at the body’s ability to coordinate 32 pairs of muscles in just the right time, sequence and intensity to move food and drink from the mouth into the stomach without us ever having to think about it – and all of this in less than one second!
As a seasoned globetrotter, Sebastian has spent the last decade studying and researching swallowing disorders, their neuro-pathological correlates and socio-economic impact in Germany, New Zealand and Australia. Following an NHMRC Postdoctoral Research Fellowship in the field of human neuro-motor control at the University of Adelaide’s Robinson Research Institute, he joined the Discipline of Speech Pathology at Flinders University. Sebastian’s research is driven by the detrimental impact of swallowing difficulties on a person’s health and quality of life. It aims to provide basic scientific data, as well as translational approaches toward novel and effective swallowing interventions.
Since its inception, the Swallowing Neurorehabilitation Research Lab has been a hive of activity with regular publications and presentations, and students graduating into various academic degrees.
Free full text copies of some of his research are available at Flinders Academic Commons.
The Swallowing Neurorehabilitation Research Lab is a proud member of the Centre for Neuroscience, Flinders University: CNS Swallowing Neurorehabilitation Lab
PhD Candidate Emily Lively
Children born with life threatening conditions often require artificial feeding from birth and therefore many miss the opportunity to develop ‘normal’ breast/bottle feeding. As the critical periods for feeding development are often missed in this first year of life due to required medical interventions and developmental challenges, these children often become dependent on tube feeding for their growth and nutrition. This has implications not only for the child but also the parent’s capacity to manage and enjoy mealtimes as a family. Emily’s doctoral research provides clinical direction to weaning feeding tube dependent children from enteral tube feeding to oral eating and drinking by evaluating the biopsychosocial aspects influencing successful weaning from enteral tube feeding.
PhD Candidate Rebecca Francis
Motor Neuron Disease (MND) is a rapidly progressive neurological disease, which currently has no known cause or cure. The nerve cells (neurons) controlling movement progressively die, which causes muscles to weaken and waste. This affects the person with MND’s ability to move and eventually leads to paralysis and death.
When the muscles involved in swallowing are impaired, it causes swallowing problems known as dysphagia. Almost everyone with MND will develop dysphagia, however, currently there is limited knowledge on the interaction between disease progression and swallowing decline. It is now also known that MND is a multi-system disease, with non-motor systems such as the sensory nervous system and frontal lobe experiencing change.
Rebecca’s PhD sits within a greater research project currently being conducted between SA Health and Flinders University. Rebecca will investigate how the non-motor changes of MND impact on swallowing function over the course of MND progression. She will employ high resolution impedance manometry to instrumentally assess swallowing function in MND, as well as qualitatively investigate how these non-motor changes impact on the quality of life for people with MND, their carers and families.
In December 2019, the Motor Neurone Disease Allied Professionals Forum and International Symposium are being held in Perth, Australia. Rebecca was awarded a 24th Nina Buscombe Travel Award to attend the event. Her abstract “Interaction between decline of swallowing and cognitive function in motor neurone disease” has also been accepted for poster presentation at the Symposium.
PhD Candidate Melanie McIntyre
Prolonged, or even short-term intubation can lead to swallowing impairment following extubation, a condition known as post-extubation dysphagia (PED). PED is common in the ICU setting and has detrimental impact on patient safety, recovery and quality of life. Melanie is an experienced senior speech pathologist at a leading regional health service in Victoria and will explore ways in which we can better diagnose and care for individuals with PED.
Since the beginning of the lab, several students have completed their research degrees under Sebastian’s mentorship. Student projects have contributed significantly to the lab’s success and have had a particular emphasis on integrated learning in a clinically relevant research environment.
Lakkari Rigney (2015-2016)
Brain stimulation in swallowing rehabilitation (1st class Honours)
For decades, swallowing rehabilitation research and clinical practice focused on the manipulation of swallowing biomechanics through rehabilitative exercises and manoeuvres. The advent of novel neurostimulation techniques expanded this focus and advanced the study of the neurophysiological underpinnings of swallowing neural plasticity and functional recovery. In this project, Lakkari evaluated whether a specific form of brain stimulation known as known as transcranial direct current stimulation, alters clinical swallowing function and biomechanics. You can find a copy of a conference poster of this project here.
Adam Caruana (2014-2015)
Biofeedback in swallowing rehabilitation (1st class Honours)
Adam’s research evaluated the effects of swallowing skill training on the excitability of cortical swallowing motor networks. Currently, he is working in two separate roles – one as a paediatric speech pathologist in the field of disability and the other as an adult speech pathologist in an outpatient rehabilitation setting. Dysphagia assessment and management plays a large role in his work with both populations. His interest in swallowing rehabilitation remains as strong as ever, and he is looking forward to participating in future clinical research in this area.
Ellisa Ong (2013-2014)
Pharyngeal pressure across swallowing manoeuvres (1st class Honours)
In clinical practice, approaches to dysphagia management often include the implementation of swallowing exercises designed to modify the biomechanics of swallowing, in particular as food and liquid passes through the throat. Subtle biomechanical changes can make a big difference to the safety and efficiency of a swallow. In this project, we employed state-of-the-art high resolution impedance manometry to assess changes in pharyngeal swallowing biomechanics in response to ingesting different volumes of food and drink, and implementing some of the commonly recommended swallowing manoeuvres. You can find a copy of this research paper here.
Ellisa currently works across aged care and adult rehabilitation, applying her clinical knowledge and skills in achieving patient-centered goals. Equipped with clinical research skills honed through her honours degree, she has successfully initiated quality improvement projects within her organisation.
The Swallowing Neurorehabilitation Research Lab hosts visitors from across Australia and overseas for short and longer periods, of which some are listed below. If you are interested in a research internship, please contact Sebastian for further details.
Kerstin Erfmann (2015-2016)
Visiting Speech Pathologist and PhD student Kerstin Erfmann from the Rose Centre for Stroke Recovery and Research at St George’s Medical Centre in Christchurch, New Zealand visited the lab in October 2015 and May 2016. During her month-long stays in Adelaide, Kerstin conducted experiments to evaluate the brain stimulation techniques to be employed in a larger clinical trial in New Zealand. Kerstin’s doctoral research explores the role of the cerebellum in swallowing rehabilitation, combining state-of-the-art non-invasive brain stimulation and motor skill training techniques that were developed by her doctoral supervisor, Professor Maggie-Lee Huckabee.
At Kerstin’s local project presentation, Sebastian said that
“being able to share ideas and research equipment on this project across Universities is an excellent opportunity to strengthen the collaborative links between our research groups and promises to provide important new insights into swallowing motor control that would otherwise be difficult to establish.”
Geraldine Kueck (2013)
Senior Speech Pathologist Ms Geraldine Kueck visited the lab in 2013. Geraldine works in an adult rehabilitation clinic in Germany and has a keen interest in swallowing neurorehabilitation. During her visit, Geraldine observed clinicians in the Speech Pathology Departments at Flinders Medical Centre and Repatriation General Hospital and worked on a joint project between the FMC, RGH and Flinders University Speech Pathology teams. This research has since attracted more than $25,000 in funding to evaluate the clinical reasoning and decision making processes employed by experienced Speech Pathologists when assessing swallowing at the bedside. A paper resulting from this research can be found here.
Associate Professor Taher Omari and Dr Sebastian Doeltgen are collaborating on studies investigating the effects of swallowing manoeuvres and non-invasive brain stimulation on swallowing biomechanics using high resolution impedance manometry. Dr Omari is pioneering the development of novel analysis methods for high resolution impedance manometry and leads an applied, translational research program into diagnostic tests and potential new therapies. Associate Professor Omari has extensive national and international collaborations and receives regular invitations to international meetings. He leads a strong, multidisciplinary team that includes gastroenterologists, nutritionists, speech pathologists, research staff and students/fellows.
Dr Charles Cock and Dr Sebastian Doeltgen are undertaking investigations into the biomechanics of pharyngeal swallowing across bolus volumes and interventions, over the lifespan, using high resolution impedance manometry. They also collaborate on a project investigating swallowing in Motor Neuron Disease. Dr Cock is the Director of Physician Training and Head of the Intraluminal Procedures Unit for the Southern Adelaide Local Health Network. His clinical career has spans 20 years and 3 continents, with experience in South Africa, the United Kingdom and Australia in internal medicine and gastroenterology.
Dr Jo Murray and Dr Sebastian Doeltgen collaborate on projects studying the implementation of Water Protocols into clinical practice. Jo has over 25 years of clinical experience as a speech pathologist in rehabilitation for stroke, spinal cord injury, burns, general medical conditions and dementia. She has extensive expertise in the area of fluid intake and hydration of stroke patients with and without dysphagia, and related health outcomes.